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APPL�CATIC"'1 �OR CONSTRUCT"'1N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDING DEPARTMENT HGATING SYSTEM: GAS LI FLECTRIC ❑ <br /> 259-8810 <br /> i I DEMOLITION k�COMBINATION I i BUILDING I 1 MECHANICAL ❑PLUMBING ❑ SIGN <br /> OWNER MAILA(O�GP^E5l5 [� ^,� \. <br /> �U��� I 6 0� 1 1 1�L\ ��\ 1' l�^\ I�+/ 7 1��� PH� I� ^` 1✓ `C_1 <br /> TENFN? h1AR AUDRESS CITv ZIP — <br /> PHONE <br /> ARCHITECTORLOESIG��N/E�R� M/A,�ILAD�RE55 y� CIiY Z�p <br /> _ 7J�I'U'J v\S '/ I+��D'1�� PNONE <br /> GENERALCONTFACTOR MAILAOORE55 GTY Z�p <br /> PNONE STATE IICENSE n <br /> MECHANICALCONiRACTOR b!AIiI.DDREiS CIT1' <br /> Z�P PFONE STATE LICENSE� <br /> PLUMBING WNTRACTOR MAIL ADORESS CIT1' Z�p <br /> CiiONE STqTE UCENSE r <br /> CONTRALT PRICE OF WOBK <br /> OESCR10E WOHN ANO SOUARE FOOTAGE INVOIVED CONTACT PERSON AND PHONE N0. -- <br /> ' �et� LD/IS�', I�� � �re-�' Su�i� <br /> -�-� ��- �-,�ir� -I�, <br /> PROPOSEDUSEOFBUILUiryc � ^ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> 5 Q� APPUCATION AND F;NOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG4LDESCR/IPT101lOPPRJPERTy�SHOWNBELOWORATT,qrC�HTWOCOPIESI WORK WILL OE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR <br /> ior--/� BLOCK pF SI`" '��Z�-�',� NOT. THE GR�NTING OF A PERMIT DOES NOT PRESUME 1'O GNE <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF qNV <br /> OTHER STATE OR LUCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOR�7ANC=OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPEfiTY TO PERFORM THE WORK FOR WHICH <br /> PARCELTA%ID.NUMBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTGRS LAW 18.27 RCW AND 296200 WAC. <br /> CONSTRUCTiON�OANLENDER.pDDRESS.TELEPHONENUIdBER �� /� . <br /> // _.' �_��_%� <br /> .� r ��i: <br /> PROJECTADDRESS s�crvn nc <br /> D�IE �— <br /> LIIYBUSIYf55lICEN5EN0 ' ' <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> WATER CLOSET(TOILET) FEE <br /> A'l'—A/HNDLG UNITS—H.P. <br /> BATHTUB ; FOF��EO AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVqTORY(WqSH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS � — <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISH WASHER RANGE HOOD � <br /> LAUNDF� T!iqY ' WqTER HEATER <br /> CLOTHES 1VASHER � WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FIOOR DRAIN , � � <br /> i_ HcATPUMP , <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAIN!EADL-RS EXHAUST FAN � � <br /> SINK(SERVICE—BAR,ETC.) � , ' <br /> — �,. , <br /> � ; <br /> SUB TOTAL S ' ! <br /> � SUB TOTAL $ <br /> PERMIT 5 PERMIT $ <br /> TOTAL FEE S ' TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: )�t� � a�� <br /> FRONTSETBACK REARSETDACK SI�ESETBACN PLANCHECKNUMBEP FEE RECEIPLNO. <br /> Zv ' z0 � �..-� � /��� 31� /5� IO�3 <br /> usezone �ornaen VACFNTSIfE FEES VALUATION FEE <br /> �- I S��J l"YES :7 NO BUILDING �870 � � <br /> ivPE�Of-C/O^NSi NO.QFSTORIES Occu•<r;tv e0orm5Ew!;r.��r,�t5 � — <br /> _�]L—N' ( �-J3 � PLUMBING ' <br /> SIZE OF BSpG FIRE SPflINNLERS flE0'0 B�SEAIENT � <br /> IL93 Sf T RIECHANICAL � <br /> �z sf Gaa �/� � ves :�o <br /> OCCUPANCV LOA� FIRE��ARhI REO'D HEIGMT LIIdITAT10N ADDITIONAL PLAN CHECK i <br /> ' 28 ADoN T . <br /> REASON � OTHER i <br /> i <br /> STAfE BUILDING SURCHARGE � � <br /> INIAKE�V PLANSAPPROVEDBY CITY OF EVERETT PUBLIC WORKS i � <br /> J�" LOCAL SALES ZO I — <br /> ome 6��ty � TAX CODE IS 3105 TOiAL _ i <br /> :J:J �;? L•' <br />