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APPLICATIC''1 FOR CONSTRUCT"1N PERMIT � <br /> �� I" TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS �ELECTRIC ❑__ <br /> 259-8810 <br /> ❑ D OLITIO ❑ COMBINATION � BUILDING LI MECHANICAL ❑PLUMBING U SIGN <br /> OVJN MAILAp E55 CITV ZIP PHONE <br /> / <br /> TENA T MAI�ADDRESS � CI7Y 21P PHONE <br /> � �55 e�e 3 3 — /�' <br /> AFCHITECT SIGNEP 61RIL ADORE55 CI ZIP PNONE <br /> � ,S G�� c �P>� — <br /> GEN AL CONTR R MAI�pODRES V ZIP pHIN�E STATE IICENSE� <br /> ,_ �c�e��� �� i ,�.� P�cs Ll�!-r 53� 66 SS�'c��,CSY ,�4 <br /> MECHAN� IC/AL CONTflACTCR MAII ADDRESS CITY ZIP PHONE STATE LICENSE� <br /> V <br /> PLUMBING CONTRqLTOP MAIL ADDRESS CITV 21P PMONE STATE LICENSE� <br /> CONTRACT PRICE OF WORN <br /> f V <br /> i <br /> DESCRIBE WORK AND SOUA(7E FOOTAGE INVOLVED CONiACT PERSON ANO PHONE NO. <br /> i / <br /> � � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> S. PROVISIONS OF LAWS hND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCRIPTIONOFPROPEFTY�SMOWNBELOWOflA7TACHTWOCOPIES) WOFK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioi BLOCK pF NOT. THE (iRANTING 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 CONSTFUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER TH�S PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APP ATIO MAD AND 1 COMPLY WITH THE STATE <br /> PARCEL TA%I.O.NUMBEF CO TRACTOR L 18. 7 CW AND 296200 WAC. <br /> � CONSTRUCTIONLOqNLENDER.A�DRESS.TELEPMONENU-BEq — � — <br /> PROJECT ADDRESS /� scN,mae o <br /> �P..'.��� ILSdL,P=. — ertvauswessuceHse�vo <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FU(TURE OR REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � AiC—FVHNDLG UNITS—H.P. , <br /> BATHTUB � ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> � LAVATORY(WASH BASIN) 7 � UNIT HEATERS--B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP � ; VENTILATION FAN ' <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRYTFAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAI ' METAI FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP ' � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS--RAINLEADERS � EXHAUST FAN - <br /> SINK(SERVICE—BAR,ETC.) ; <br /> � ; <br /> � , <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMIT $ PERMIT $ � <br /> TOTAL FEE r ; TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK PEARSETBqCN SIDESETB�CK PLANCHECKNUMBER F / AECEIPTNO. <br /> 'j}� 2�^ S �l(a��o �0 • 3•`-� 2�� <br /> USE ZONE LOT AREA VACANT SITE � FEES VALUATION FEE <br /> fL- � � IJYES NO BUILDING j Q i� <br /> ttCEOFCONSi. NO.OFSTORiES acur,wcv xoaow[uixeuNirs � <br /> �I� ' °� PLUMBING ' <br /> i <br /> SIZE OF BLOQ FIflE SPRINNLERS REO'0 BASEMENT � <br /> MECHANICAL � <br /> 65 Ap V G YES � : NO , <br /> OCCUPANCV LOAD FIRE ALARM PEO'D HEIGHT LI�MJITAiION ADOITIONAL PLAN CHECK i <br /> A �O `S / OTHER � <br /> PEASON <br /> STATE BUILDING SURCHARGE � <br /> 1'�fANE BY PLANS APPROV�D BY CITY OF EVERETT PUBLIC WORKS � <br /> JN LOCALSALES � <br /> onre S S TAX CODE IS 3105 TOTA� ��' �J� <br />