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APPLICATIQ-1 FOR CONSTRUCT'-1N PERMIT � <br />TO BE f�OMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM• ❑ GAS ❑ ELECTRIC <br />BUILDINC DEPARTMENT ' � <br />259-8810 <br />❑ DEMOLITION _❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />ONMER MAILA�ORESS I;ITY 21P _ PNONE <br />TENANT <br />MRIL <br />� <br />MAIL <br />CITY <br />ZIP <br />YMVNt <br />GENERFLCONTRqCIpR� � SI� �E55 I�L�� /1 Vf'V 1LAi� N S C'i/1T�1 �� N:�//(' ]�� SAT} ll'/CFLS� I�V J/ <br />i / <br />Si iI'I� �" /� <br />MECHNNI�RLCONT CTO�LaOD E� CITV 21P � p�� ' $7p7E���ErySEr <br />�� <br />PLUlABING CONTRACTOR IAAIL AODRE55 CITV ZIP PHONE STATE LICENSE 9 <br />`/ <br />�or <br />SOUARE FCOTAGE INVOI VCD <br />' PROPERTV (SHOWN BELOW Ofl ATTACH TWO LOPIES) <br />BLOCK OF <br />?A CELTAXI.D.NUMBER <br />�.�.� Ot3 ^ �- �-EMO <br />CONSTRUCTION LOAN LENDEfl, AUDRESS, TELEPHONE NUMBER <br />NO. <br />BATHTUB <br />LAVATORV(WASH BASIN) <br />SF+OWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK ISERVICE—BAR. ETC.1 <br />FEE <br />SUB TOTAL $ <br />PERMIT $ <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK pEARSETBACK <br />USEZONE ' LOTAREA <br />� — � � <br />iVPEOFCONS7 NO.OFSTOFIES <br />SIZEOFBLW. FIREa:RINKLER5RE0'D <br />OCCUPANCY LOAD FIRE ALAPM REO'D <br />INTANE BY PLANS APPRqVEO BV <br />onre �,7�1/4 <br />SIDE SETHACK <br />ANDPMONE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAAtINED 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 B�� COMPLETED WITH WHETHER SPECIFIED HEflEIN OR <br />NOT. THE GRANTING OF A PERt.!IT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFOqMANCE pF CONSTRUCTION. THAT I AM AUTHORIZED RY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICAT�ON IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />`��//�/i�.� . <br />MECHANICAL <br />A/C—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHUOD <br />WP,TER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNINf <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUS7 FAN <br />VACANT SITE FEES <br />❑ YES ❑ NO BUILDING <br />CC[OPAI:GY NO OfDWFILINGUNItS <br />�a�OF pLUM81NG <br />BnSEMErvr MECHANICAL <br />❑ YES ❑ NO <br />HEIGHT LIMIiATION ADDITIONAi PLAN CHECK <br />" a� OTHER <br />S7ATE BUILDI�iG SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3705 Tora� <br />PERMIT S <br />TOTAI FEE $ <br />S� SU <br />FEE <br />