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APPLICATIC 1 FOR CONSTRUCT" 1N PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />C'� � �' <br />BUILDING DEPARTMENT HEATING SYSTEM: J GAS J ELECTRIC J <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />��• [j' I.IMLADDFESS <br />1%A1F.� � �/ S��-.�r Da • <br />'L0.A4i 6LLAL_qF.55 <br />MC�iRECTORDESiGN[R 1dACADDiiE55 <br />r�fJER4LCON7PACTOR t.:AI�A0DRE55 <br />:�ll,��s�/ll.�c �a.� �/.✓.i-✓ <br />VCCMnN�CnLCONiRACT09 6�nILAD�RE55 <br />�LUt.!�INGCONTRPCTON l.INLADDRESS <br />��� • � �57� <br />G iRACTPFIC OFWOFK <br />! ZSLY� % S �%! <br />G@SCfiIPE WPRK �ND SOUARE Fppi�GE INVOLVED <br />PROPOSED USE OF BUILDING <br />l CGAL DESCRIPTION OF PROPERTY �SHOWN BELOW OR ATTACH TWO COPIES� <br />l.Ui BLOGK OF — <br />r•nH:ri..naio Nur.+[�en <br />���:5���i'�_�„G <br />PROJECT <br />R, nD0liE55. TELEPlIONE NUAI�GR <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET(TOILET) <br />BATHTUB <br />LAVATOFY�WASH BASIN) <br />SHOWER <br />ICITCNEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SRJK ISERVICE—BAR. ETC.1 <br />SUB TOTAL S <br />PERMIT 3 <br />TOTALFEE S <br />F�JR OFFICE USE ONLY: <br />,�HpNiS@TBALN �EARSEipACH <br />IP.�E ZONE LOT ARE� <br />1��i0iCON5i. NOAFSTORIES <br />S,'"e OF BLDG. FIRE SPRINNlERS REO'D <br />uzCUPANCVLOAD FIREAL�RMqEO'0 <br />r,t_nsON <br />c�inefi'.- - �� '.lnNSAPPROVE00V <br />r,an <br />SIDE SETB�CK <br />CI:Y <br />L�f� <br />�„v <br />CIiV <br />�ITY <br />�ds��Q: <br />GIiV <br />CITV <br />FEE <br />0 <br />LP PNONE <br />-�� 3�3 -z��s <br />ZIP Pl�DVE <br />;u- PHONE <br />ZiP i'MOhE STATE UCENSE e <br />9Pisa 3�-.��/r' —it 1 <br />ZIP FHONE 57ATELIGENSE� <br />ZIP P40NE ST�TELICENSE� <br />CONTAGi P[RSOIJ At:p PMONE NO <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED iHIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TriIS TYPE OP <br />WORK INILL �E COM1IPLETED V�9TH WHETHER SPECIFIE-D HEREIN OR <br />NOT. THG GRANTING OF A PERMIT DOES NOT PRESUME TO GIV[ <br />AUTHORITY TO VIOLATE OR C�NCEL T4E PROVISIONS OF ANY <br />OTHER STATF OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORA1ANCE 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 COM1IPLY WITH THE STATE <br />CONTRACTORS LAIN 18.Zi RCW AN^ �96200 WAC. <br />�/1� �� -�--�/� � 93 ---- <br />_i.,:nR q�. oAiE <br />cnvn�.�se��.snr�,, — . <br />MECHANICAL <br />NO. TVPE OF EOUIPMENT FEE <br />A�C—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEI�AS—B.T.U. M E.A. �__ <br />UNIT HEATERS—B.T.U. M I <br />CLOTHES DRYEHS <br />--�'— <br />VENTILATION FAN ' <br />—� <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE � <br />METAL FIREPLACE �WOOD BURNING) � <br />FIREPLACE INSERT <br />�-- <br />HEAT PUMP � <br />GAS PIPING ; <br />EXHAUSTFAN � <br />PLANCHELKNUMEiLR � fEE <br />�:': ves �' No euaoiNc <br />OCcur�ncv Aa o�CWFulneiVels <br />°°pp° PLUMBING <br />DASEMENT M[CHANICAL <br />f -�. YES � � NO <br />HEiG�+i uMirnnoN �DDITIONAL PLAN CHECH <br />OTHER <br />STATE �UILDING SURCHARGE <br />CITY OF EVERETT r�uouc woaKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL 5 <br />PERMIT S I <br />TOTALFEE 5 ! <br />C'� <br />