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APPLICATI :� FOR CONSTRUCT:y�IN PEI�MIT � <br />TO BE COMPLETED IN SLACK INK—PLEASE PRINT <br />HEATING SYSTEM: +j��GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />.. 259-8810 <br />I I DEMOLITION I 1 COMBINATION ' BUILDING ' MECHANICAL PLUMBING i! SIGN <br />OWNER MAILADDRESS CITY ZIP1,� � �pp PHONE <br />t�.a� �s_N�z.� �'7d..r�s 2ZIi���v.�u�'p�.���°2� 1l`lt��Z1CaJ�`�i.3��). <br />TENRNT MAILA�DflESS CITY ZIP PHONE <br />qqGHITECT08DE51GNER MALLADDFE55 CITY IIP PHONE <br />5 bt,AG <br />GENERALCONTflRCTOR M/ILAOORESS GITV ZIP PHONE STATELICENSEI <br />�i Od1JG <br />MECHFNICALCONTRACTOfi MFILAOORE55 CITY ZIP PHONE SiATELiGENSEa <br />PWMBINGCONTHr1CTOR MAILAOORE55 CITV ZIP PMONE STATELICENS[! <br />cuss oF woe�: <br />! I NEW $-ADDITION I I ALTERATION <br />n� d1"� �0 � � .� _ <br />SOUAflE <br />l <br />�or d-L' 1 I Z e�ocK <br />8 <br />FOUNTAIN <br />��. FEPAIR '. � DEMOLITION '�. WOODSTOVEiFRPL INSERT I�� BUILDING RELOCATION <br />� CONTACT PEflSGN FND RMONE NO. <br />I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLIChTION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />BELOW ORATTACH FOURCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />oF Lo�LL. Ji,J �1'1A� WORK WILL BE COMPLETED WITH WHETHER SPECIfIED HEREIN OR <br />— NOT. THE GRANTING OF A PERMIT DOES NOT PRES�IME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVIS'JNS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTFU';TION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />7( ��Ldr� � �� cJC 71�14 � L <br />SiGN41U�E OAiE <br />FOR OFFICE USE ONLY: <br />FRONTSETBACN REARSETBACK <br />Zo ' o' <br />USEZO LOTAREA <br />-1 1 00 <br />tVPEOFWNIS.ALlOWABIE iYPEOFCONSLA( <br />- -� <br />I1�7ABSF AOOU f NO.OFS^ORIE; <br />INTAKE BV <br />LOAD <br />NO. <br />TOTAL $ <br />NIT $ <br />\L FEE S <br />SIOE SET9ACN PLAN <br />—' . <br />FIRE SPflNNLERS REO D <br />N� <br />PLANSAPPROVEDBY <br />TYPE OF <br />NC—A/HNDLG UNI� <br />FORCED Alfl SYSTI <br />UNIT HEATERS—B. <br />CLOTHES ORYERS <br />VENTILATION FAN <br />METAL FIREPLACE 8 <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />� � eui�owc <br />OCLOPAILY NO OipWfILINGOq115 ' <br />� uP PLUMBING <br />43 <br />6nSEMEt+T MECHANICAL <br />0 <br />HEtGHruMITnTION ADDITIONALPLANCHECK <br />SPRINKLER <br />STATE BUILOING SUflCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX COUE IS 3105 TOTAL <br />IAI����l#_l <br />SUB TOTAL $ <br />PERMIT S <br />TOTAL FEE B <br />RECEIPi N0. <br />'�= 76 <br />VALUATION FEE <br />T <br />-n .. ni iM..� <br />