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APPLICATI�Q�"! �(�R CON:STf�i1C'T`"lN PERM1� �✓� <br />TO BE COMPLETED IN BLACK INK—F:.EASE PRINT <br />HEATING SYSTEM: U GAS J ELECTRIC U— <br />BU!LDI�JG DEPARTMENT '— <br />259-8810 <br />f i DEMOLITION I COMBINA710N <br />OWNER �A�ILAD�RESS CITV ZiP FHONE <br />iT�N/�' /yIGMT- <br />i4NANTA hlpllAD�RESS CITV ZIP PMONE <br />G/J/� �iG.EK_/.�.JJ^� _ <br />ABCHIiECTO DESIGNER MARpDORE55 Cliv ZIP PHONE �Go�( <br />^�•,t�,n S-�rv�.S S�'��wR /a.,6�GB2-��R wcs-��v �r��v�o <br />LNL � / RN /�.��.7N /^J� . �•T � � - P;10NE S7ATE LI�ENSE u <br />GENEILILCO. RACTOR MAILAD�RESS ��iY i �P ` <br />NECHANIC�LWNTRACiOR MAILPDDRE55 <br />CITV ZIP PMONE STnTELICENSEe <br />IJ BUILDING ! MECHANICAL l � PLUMBING <br />� W 61fIING <br />MRIL <br />RICE OF WOFK <br />/� cx�c"�. OU <br />)AN anl0 SOUARE FOOTAGE <br />GI1V 21P PHOtlE STFTELICENSEa <br />��r/ �i/.1P2.nviG'T. � <br />�' i(/�'� Cv��,S'. . , <br />PROPOSED USE OF BURCllt1G � <br />� �37A��P,.t_� <br />LEGAL �ESCRIPTION OF PROPERTV (SNOWN BELOW OP ATTAGH RNO COPIE51 <br />LOT- BLOCN OF <br />PARCI:LTAXI.O.NUMdER <br />CONS"�UCTIONLOI�N�END[R.ADOFE55. <br />N0. TYPE OF FIXTI <br />WATER C.OSET (TOIL <br />BATHTUB <br />LAVATORY (WASH BA� <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOiHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DAAIN <br />BACKPLOW PREVENI <br />ROOF DRAINS—RAIN <br />SINK ISERVICE—BAP <br />OR <br />FOR OFFICE USE ONLY: <br />FRONiSETB�CK REARSETB4CK <br />USEZONE /j LOTAREA <br />iYPEOFCONSi. <br />S¢E OF BLO <br />9EASON <br />INTANE B\' <br />NUME:FR <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />�_ F'RESPRINNLERSREO'0 <br />LOAp FIREAL4RMRE0'D <br />P�ANSFPPROVEDOY <br />onre M�Z/�%� <br />S <br />$ <br />CONTACi PERS:)N AN� VHJNE NO <br />�a _ �> <br />i HEREEY CEFTIFV THAT I HAVE READ AND EXAMWED THIS <br />APPLICP.iION AIJD KNOW T4E SAME TO BE TRUE AND C09F�ECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TFIIS TYPE OF <br />VJORK `NILL B[ COMPLETEf� WITH WHETHER SPECIFIED HE-REIN OR <br />NOT. TNE GRANTING CF A FEAMIT DO[S �IOT ?RESUM[ TO GIVE <br />AUTHORITY TO VIOLATE GR CANCE� THE PROVISIONS OF ANY <br />OTHER STATE OFl LGCAL I.AW FEGULATWG CONS�RUGTION OR THE <br />PERFORMANCE CF CO�STRUCTION. THAT I AM AU?HORIZE� BY THE <br />OWMER OF THIS nF±OPERTY TO FEFFORM THE VlORK FOR WHICH <br />APF'LICATION IS MADE AND I COMPLY WITH THE S'iATE <br />CONTRACTORS L4W 1827 RCW AND 296.200 WAC. <br />�/ ^ 1 23 �9� <br />�5 _-.nrun��. •�g ouf / <br />cnv ouSt�eSs �¢b:se titr <br />AlC—Alf iiJ �LG UNITS—H.P. ' <br />FORCED P'�R SYSTEMS—B.T.U. M E.A. ' <br />_-1 <br />UNIT HEATERS—B.T.U. M __T <br />CI.OTHES DRYERS _ ' <br />VEN1lLAT,ON FAN _� <br />H.aNGEF00D ' <br />� WATER FIEATER <br />WOOD STOVE <br />METAL f�IREPLACE (WOOD BUR�!ING) � <br />FIREPL4CE INSEFT � <br />HEATFUMP <br />GAS PiPING � <br />EXHAJSTFAN —. <br />SI�ESET84CK P�ANCHE�KN/U�M✓-O�ER FEE <br />�'✓ . � <br />VFCANT SITE FEES ! <br />❑ YES � N� BWLDING _ <br />acuvasc xo.ovow[u�xeuxns <br />enour PLUMBING _ <br />BFSEMENT MECHAIJIGP.L <br />❑ YES '-'. NU '—" <br />HEICHiLVAITPTION — ADDiTION�LPLANCY._JK _ <br />OTHER <br />STATE BJII.DIYG SUFGHARGE <br />CITY OF EVEqETT Pueuc wo�Ks <br />LOCAL SALES '—"— <br />TAX COOE IS 3105 T�TAL <br />TOTAL <br />v1IT <br />1L FEE <br />3G� I Rt���U% � d <br />�, <br />