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APPLICATI�*�1 F'OR COI�STRUCT`-71f� PERMIT �v�" <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING GYSTEM: J vAS /fELECTRIC J I <br />� <br />BUILDING DEPARTMENT --- <br />259-8810 <br />DEMOLITION COMBINAiION Y' BUILDING I � MECHANICAL <br />01YNER RIAILAD�FE55 UTY ZIP ?HONE <br />%i`{�hlc �SSo�i�'ir5 f�c �ic Eve✓r{i Ma(� V✓a� EJcvt(i� lA%A 98a. <br />/TE�NANT/ �dAILAD�RE�S <br />( 4v��[�UUN �1�4%O�L <br />AflCMIiECiORDESIdNEP hb�il ADORE55 <br />,�ary��oN A��Gt�g-�c4� <br />G[NERALCONTRACTOfi 1dAILA�ORE55 <br />8�� �d��� Na►-fa,��s-F, �, <br />IAFfNGNIf.PI C.ON(RACTOR MFILADDRESS <br />N�A <br />COKTRFCT PRICE OF W^I <br />..� �\ <br />OESCFIBE WORK AND SOl <br />_�c�iG{C � G <br />cvcr l/ /Ul` <br />ldAIL AOORE55 <br />��� <br />FOOTAGEIt <br />ZI° <br />f`MONE <br />PLUMBING ! i SIGN <br />cz�> 3s�=s��5� — <br />CITY ZIP PMON'e STATELICENSEn <br />�.. oZ�l3^ IZ�"�c%�E: �4{:r5%✓�.,S�,JA-4a9s8 33'f-'S�.S Bou-DNT�L3129 <br />CITY ZIP PNONE STATLIICENSEu <br />7PROP�O�S/ED USE OF BUIL/OING /J <br />�f �T4 � $�4(F7 OT� (��'Id/� ____ <br />LEGAL DGSCRIPTION OF PROPERTY �SNOYlN 6El OW OF ATTACM TlYO COPiE'a; <br />LOT BLOCK OF <br />�DKtr #� 8� ��__�✓_c✓c <br />PARCEL TF% ID. 11UM1I�ER <br />CGIlSTR�UACTION LOAN IENDER. ADCBESS. fELF.PHONE NUMBER <br />P O� CTADDRESS <br />PLUMBING — W o N (� <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LP.UNDRYTRAY <br />CLOTHES WASHER <br />UNINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS-RAINLEADERS <br />R�":�� (SERVICC-RAR, ETC.) <br />SUB TOTAI 3 <br />PEFt.AIT $ <br />TOTAL FC-E 5 <br />FOR OFFICE USE ONLY: <br />fRONTSEiBACK REARSETBACK � SI�E <br />USE ZONE <br />iYPE OF GOIiSi. <br />� <br />SIZE OF BL�G. <br />10 3'L <br />OCCUPANCYLOAD <br />3� <br />PUSON <br />�NT�KE OV <br />LOT AREA <br />NOAF STORIES <br />% <br />FIRE SPRINKLERS (iE0'D <br />�S <br />FIRE ALARIA REO'D <br />Y�= s <br />PLANSAPP q/V'�E�DBY <br />on.�q _,S. 9 j <br />CIIT <br />21P PMONE SiA�tLICtNJta <br />PND <br />I HERGBV CERTIFY TfiAT I HAVE READ AND EXAMINED THIS <br />APPLICAI'AN AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GO\'ERNING THIS TYPE OF <br />W09K WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE G9ANTING OF A PERMIT DOES NOT PRESUME TO GIJE <br />AUTHORITI' TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LO(;AL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPFRTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADe AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X�� w�.� 5�9 f a�, ,�ss <br />SiG�:aioHE �A�� <br />MECHANICAL ^ ���jJ?NC� "� <br />10. TYPE OF EOUIPMENT FEE <br />A/C-AiHNDLG UNITS-H.P. � <br />FORCED AIR SYSTEMS-B.T.U. M E.A. ; <br />UNIT HEATERS-B.T.U. M � <br />CLOTHES DRYCRS <br />VENTILATION FAN ' <br />RANGEHOO� <br />WATER HEAT'eR <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNING) ' <br />FIREPLACEINSERT � <br />GAS PIPING <br />EXHAUSTFAN <br />S <br />5 <br />0 <br />PLANCHf KNtJlABER FEE RECEINiNO. <br />�c,c�� //3,�G <br />VACANT SITE FEES <br />.- YES � NO BWIDWG <br />occu�escv r.00�caaucrii,s <br />�j°0� PLUh101NG <br />ia <br />Ba5E1dENT �,�ECHANICAL <br />:� YES �. �. NO <br />NEiGMT uMlinTiON ADGITIONPL PLAN CHECK <br />OTY,ER <br />STATE AUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOt;AL SALES <br />TAX CODE IS 31(IS TOTAL <br />poo <br />FEE <br />V� <br />,7i� � 5, <br />