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APPLICATIC-1 FAR CONSTRUCT' lN PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��T <br />HEATING SYSTEM: ❑ GAS :J ELECTRIC i�_ __[�'%+� I <br />BUILD�NG DEPARTMENT <br />259-8810 <br />DEMOLITION � COMBINATION I BUILDING MECHANICAL i PLUMBING �SIGN <br />OVJNEF 1dAILADDRE55 CITV 2i'r AMONE <br />Iit 2/� ,7/ s /S�oa F�+..,..�'r7 l�+u.�lv�.., ,�'i.ezue.zT� i�aoE- 3 s"3'-7�° o <br />TENANT IA41lA�ORE55 CiTY ZIP �'HUiIF <br />ARCHITECTOR�ESIGNEfl MAILMO�RESS CITY ZIP PHONE <br />GENERALWNTRACTOR lAA�LADDRE55 GTV 21P PHONE STAiELICENSEk <br />Tifna S;�r is'��i wr-,r • a- xh �»-OD. ��/,33 0?5'0 ��� �'r�siG�o��LF1 <br />I.�ECHANICALLONTFA TOR IA�ILPDDRESS <br />PLUMBIN3GONTPACTOR 61AIL�ODPE55 <br />CONTRACT PRICE OF WOHN b <br />.�Ooo � <br />INVOLVED <br />/�b <br />CRY <br />CITY <br />LEGFL DLSCRIPTIUN OF PROPERTV �SHOWN BELOVJ Ofl ATTACH TWO COPIE51 <br />�pT— BLOCK OF <br />PFRCELTFXID.NUMBER <br />CONSTRULTION L04N LEI <br />PLIIMBING <br />p, TYPE OF <br />WATER CLOSET <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDAYTRAY <br />TELEPHONE NUldBER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINKSSERVICE—BAR, ET( <br />FOR OFFICE USE ONLY: <br />FRONTSETBFCK n REFRSETBACK <br />R <br />USEZO � J�AREA Q_ <br />l / <br />iVPE0FL0115i NOAFSTORIE: <br />ITEM <br />/t �A� L <br />SUB TOTAL 5 <br />PERMIT 3 <br />TOTAL FEE S <br />.�. <br />SIZEOFBL�G. FlRESPPINKLERSREO'0 <br />OCCUPANCVLOFD FIREALARMPEOD <br />INTAK[6Y PLANSAPPROVEDBV <br />�'Mn <br />OATE �/�%iLi <br />SIDE SEiDACN <br />zIP PNorlE <br />ZIP PNONE <br />LSrM q <br />ST�TE LICENSE a <br />a Fo -- 8- E�o 3 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OFi LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 29G300 WAC. <br />NO- <br />A/C- <br />FOR� <br />UNIT <br />CLO <br />VEN' <br />FAN� <br />WAT <br />WOC <br />MET, <br />FIR[ <br />HEA <br />GAS <br />EXH� <br />� <br />: YES �� N� BLIILDING <br />ow�o>�.a r:oarm4[u�acu•.ns <br />cao�..�P PLUMBING <br />BnSEMENT AIECHANICAL <br />YES NO <br />HEIGMJ7u1AITATiON AD�ITIONAL PLAN CHECK <br />��-�� �-��" OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WOFKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />�,,, �a-`�, <br />�� /� <br />VALUATION FEE � <br />� --. G,-� 'r��i <br />i <br />8 <br />i%' i ��'1 <br />� <br />