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�� APPLICATIC~1 FOR CONSTRUCT-�1N PERMIT � <br />TQ BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING S'lSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259-8610 <br />❑ DEMOLITION 17 CdMBINATICN �BUILDING ❑ MECHANICAL `_i PLUMBING ❑ SIGN <br />OY:q'� MAILA �RE55 CiTY �IP PHONE <br />C rie'r��_ /�� � <br />TENANT MAILA��PE55 <br />i �e C�oS�� /y0� �E � <br />�RGHITECTOR�ESIGNER MFILFODRE55 <br />�rnFfiri� �- l�es,�ti (�r��{d i <br />GENER�LGONTF GTOR MA a�DPES$ —� � <br />�i�Anf Co,�i. �hc , �J• q)c <br />MECHANI'CA/LGONiRFCiOR MAILADDiiESS <br />N/� <br />PWMBINGCOIT ACTOF MAI�ADDRE55 <br />�7 <br />GONTRFCi PRIGE OF WOFN <br />o� S00 `� <br />DESLRIBE W06K AN� SOUAFE FOOTAGE INVO! VED /' /, <br />f,ITV <br />� <br />CITV <br />�� <br />� <br />cirv <br />CRY <br />r• - <br />PROP EOUSEOF9UILDIN � <br />� � )�O� _ <br />LEGAL DESCRIPTION OF PROPERN (SHOW�J 6ELOW OR ATTACH TWO COPIES� <br />LOT— dLOGN OF <br />PARCELTAXID.NUMBER <br />LONSTRUCTION LOAN LEI <br />TYPE OF FIXTI <br />WATER CLGSET(TOIL <br />BF,THTUB <br />LAViSORY�WASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER _ <br />LAUNDRYTRAY <br />CLOTHES WASHER_ <br />URIIJAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT <br />ROOF DRAINS—RAINI <br />TELEPHONENUMBER <br />SUB TOTAL $ <br />PERMIT $ <br />FOR GFFICE USE ONL.Y: <br />FRONTSETBACY, REARSEIBRCN <br />USEZONE LOTAREA <br />iYPEOfC�NST NO.OFSTORIE° <br />SIZEOFBLDG. FIRESPRINKLEFSREO'D <br />OCCUPANCV LOAD FIRE AIARId REO'D <br />REASON <br />INTAKE 0V <br />pATE <br />ev <br />FEE <br />0 <br />ZIP PNONE <br />�� � <br />ZIP PNONE <br />'�u�P--r—�vr � �.1 u f-� <br />' I ZIP PNOIJE <br />� �- �r ��� <br />ZIP PHONE <br />21P PYONE <br />CONTACT PERSON �ND PHONE NQ .� <br />S7ATE UCENSE a <br />� c -�ti <br />STATE LICENSE a <br />STATE LICENSE p <br />� <br />�(/h /�\� 1,-J /h <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 uRDINANCES GnVERN�^:G THIS TYPE OF <br />WOAK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTINC OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL iHE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TI1E <br />PERFORMANCE 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 LQV� 7827 RCW PND 296200 WAC. <br />" .c�. �/'� ' / _ �; t� <br />• oAie <br />L YpU5:NE55LiCEN5EN0 <br />MECHANICAL <br />NO. TYPE OF E�UIPMENT FEE <br />A/C—NHNDLG UNITS—H.P. <br />FQRCED AIR SYSTEMS—B.T.U. M E.A. � <br />UNIT HEATERS—B.T.U. M � <br />CLOTHES,^.RYERS <br />JENTiLATION FAN ; <br />T <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BUHNING) ' <br />FIREPLACE �NSERT I <br />HEAT PUMP � <br />GAS PIPING <br />EXHAUSTFAN � <br />SIDESETBACK PLI.NGH GKNUM1�tltN <br />� .�5 /% <br />VAC4NTSRE FEES <br />G VES G NO BUILDING <br />a�uvnucr r�oo�owEw�;sw.us <br />cAo��a pLUMBING <br />BASEMENT MECHANIG�L <br />❑ YES �-i NO <br />HEIGHT LIMITATION ADDITIONAL PIAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCaL SALES <br />TAX CODE IS 3105 �OTAL <br />S <br />PERMIT <br />TOTALF <br />FEE � NELEIPTNO. <br />i <br />� <br />i <br />