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. . �.,..�u:�,��}s,.,.::? ., _ . <br />APPLICATIOii�l FOR CONSTRUCT�N PERMIT <br />TO BE COMPLETED IN BLACK INK-PIEASE PRINT �T <br />BUILDING DEPARTMENT HEATING SYSTEM: U� D ELECTAIC p <br />2sa-se�o <br />❑ DEMOLITION C 1 COMBINATIOk Ll BUILDING Ll MECHANICAL C I PLUMBING U SIGN <br />OVRIER / MARMORE65n � CRY 21P PHONE <br />CITY ZIP <br />ARCHITECTORDESIGNER W����ESS CITY 21P PHONE <br />pENEq/LL�pH7qAC7pp MAILAODRESS CITY ZIP PHONE STATELICENSEI <br />MECIUNICALCdAMCTOR MALAU�RE55 CITY 21P PMONE STATEUCENSEI � <br />Q/1680F WORK <br />❑ NEW ❑ ADDITION <br />CONTRACT PRICE OF YqRK <br />OESCRIBE WOfIK AND SOU�NE Fl <br />PROPOSED USE OF BUNING <br />IOT BLOCK <br />KITCHEN <br />DRINKING <br />AUIL ADDNE55 <br />or rn�rvc aum�n:enx• <br />CI ALTERATION LI REPAIR !. I DEMOLITION I! WOODSTOVE/FfiPL INSERT CI BUILDING RELOCATION <br />CONTqCT PERSON AND PHONE N0. <br />r-� <br />FOR OFFICE USE ONLY: <br />FRONT�ETBACK REAHSETI <br />USEZONE LOTAflEA <br />7YPEOFCONiS.AIIOWABLE TYPEOFWI <br />OCCUPRNCYLORD <br />REASON FOR SPFINKLEHS <br />� � <br />OF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL <br />FWRCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER 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 REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICAT�ON IS MADE AND I COMPLY WITH THE STATE <br />CONTRA W 18.27 RCW A 200 WAC. <br />� � �7 i � � A Y / <�¢r�4 (/ �0'�9 'L <br />PERMIT $ <br />VACANT SITE <br />OCCUPANcr xa orMIFIUYcuxiK <br />4flOIlP <br />BASEMENT <br />FIPESPRNKLEPSREO'D I HEIGHTLIMITqTION <br />PLANSIPPROVE�BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COOE IS 3105 <br />TYPE OF EQUIPMENT <br />Al�lVHNDLG UNITS—H.P. <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIFEPLACE 8 CHIMNEY <br />PLANCHECKNIIMBER i <br />� �%" <br />BUILDING <br />PLUMBING <br />MECHFNICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />PERMIT <br />$ <br />FEE <br />a <br />+zy� : : <br />. . , �sF;:'. <br />,xi'i <br />. <br />. ' � . ;�'�y.. <br />