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APP�_�ICATIO.,i FOFt CONSTRUCT'b.�N PERIRIIIT eV1P't <br />TO 3E COMPL'cTED IN INK—PLEASE PRINT � <br />fhe Evorgreon <br />CIiY OF <br />everett HEATING SYSTEM: ❑ GAS Q1 ELECTRIC ❑ —� I <br />BUILDING DEPARTMENT <br />259•8810 <br />❑ DEMOLITION I I COMBINATION I� BUILDING I I MECHANICAL f I PLUMBING f-1 SIGN <br />owNEn n�na3lc�`� 1�3�Z�'�st �. c�rUUF �IS�OD�+—I3Z3 rHnne�n`,"3 '�fi3L�v <br />.A-��a�1��iCrta � <br />TENr1NT MAII �OOfiE55 CITV ZIP �'MONE , <br />I <br />FRCIIITECT OR O[SIGNEq MML AOORE55 CITV ZIP PHONE <br />V�TT Uc �' Zr��1 "'3I �o I <br />���ilw\I�'ZCN Il�n7 �Ir�--- - i1 {'Y��f�`�-'�- I �ciU I <br />__.._ ...................� .�.i� nnnncee GTY 21P �NONE UCENSEt <br />MECHANIC�I GONiRACiOfl 1AnR n�ORESS <br />CItY <br />PHONE <br />PLUM�INOCON7RACTOR lAAILAD�RESS GITY ZIP P110NE LICENSEr <br />cv.ssoFwonK '1"ENANT INI1='Me���f-1Er1T <br />yG NEW I J ADDITION I I ALTEFATION I � REPAIR <br />CONTlIACT PflICE OF WOfiN �, �� i b�V <br />OESCRIBE WORK AND SOWRE FOOTAGF INVOLVED <br />�RSIG T. S � �'Sr� `a.F. <br />PROPOSE� USE OF BUILDING <br />LEGAL DESERIP�IOH OF PfiOPEfITV �SNOWN BELOW OIi �TTACII FOUq COPIES� <br />LOT BLP:H OF <br />, PIIOJECTA0�0E55 <br />'770`� EVEI�L.C�'I�'E��'v �.)k`� � — <br />PLUMBING <br />N0. TYPE OF FIXTURE OR ITEM FEI <br />� WATERCLOSET(TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHO W Eii <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />; LAUNDRYTAAY <br />� CLOTHES WASHER <br />� URINt�L <br />, DRINKING FOUNTAIN <br />FLOOR DRAIN <br />� BACKFLOW PREVENTERS <br />' ROOF ORAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FOR OFFICE USE ONLY: <br />FRONTSETOACN REARS[10ACR <br />USE ZONE <br />TYPEOFCON75J <br />SRE OF BLDG. <br />0���--��N�� <br />REASOH i0� <br />INT�KE BY <br />LOT <br />SUB TOTAL 5 <br />PERMIT $ <br />TOTALFEE S <br />sioe sernncK <br />VACANTSITE <br />IYPE OF CON5T ACIUAL <br />�, N <br />NO.OF STORIES <br />i <br />FIRE SPRNNLEFS f1E0'D <br />y� s <br />PLANS �PPROVED �Y <br />!' DEMOLITION I I WOODSTOVE/FRPL INSERT I l BUILDING FELOCATIUN <br />CONT�CT PEfI50N ANO PHONE NO. ' <br />M dl {el E � . �1.-_Ki�F'c�.N�'C— <br />VYz�s C'-� � �-3-43ac <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COflRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL 8E COMPLETED WITH WHETHEii SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULAT'!JG CONSTRUCTION OR THE <br />PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AN� I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATUREOFC01lTRACtOqOf1�U7HORREUAGEN7 DATE <br />� "� ./ � �/��/'�✓L� �/' 7 <br />7 APPLI A TSCRYBl151NESSLICENSENO.AND0U5WE55Nt,ME <br />x� o�mvrtun,uxns <br />H— <br />� a <br />CITY OF EVEflETT <br />�ncn� sn�es <br />TA:< COUE IS 3105 <br />N0. <br />NC—AlHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL 5 <br />PERMIT 3 <br />TOTAL FEE $ <br />OUIL�ING ���(,C '�' � <br />� <br />PLUMOING � <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OiHER <br />STATE BUILDING SURCHARGF <br />PUBLIC WOF7KS <br />TOTAL <br />i <br />T <br />1 <br />� <br />i <br />i <br />, <br />i <br />� .�v <br />' <br />i <br />T <br />�JD ' 92 <br />