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APPLICA7IQ�' FOR CONSTRUCT'�N PERMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />BUILDING DEPARTMENT � <br />259•8810 <br />❑ DEMOLITION ❑ COMBINATION <br />OWNEq MqILAD�RESS <br />�FLt�E[,CIE '�iC,S �'In �s.v,vRc <br />OR <br />IAAIL ADDHE55 <br />N.AIL� RESS <br />CONTRACT RI�EOFWOqK <br />���.SOp- <br />UESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />BUILDING ❑ MECIIANICAL <br />GTY <br /><1T I /�L Gcf <br />CIiY <br />ST 5b� �-1 <br />CITY <br />7N /YLE /vE- <br />G1Y <br />t�Tq : Tn.AaT SPstcE � '�6 �yPp�c <br />' <br />/6 n� SF, <br />PROPOSED IISE OF Bl11LDING <br />OFF� c. E <br />LEGAL DESCRIPTION OF PROPEPTV (SHOWN BELOW OR ATiACH TWO COPIES� <br />LOT--_ BLOCK OF <br />S� ArrncR�n <br />PARCELTA%I.D.NUMBER <br />i82$ -OS - <br />CONSTflUCTION LOAN LENDER, AO <br />PLUMBING <br />NO. TYPE OF <br />WATER CLOSET <br />BATHTUB <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />SINK <br />TELEPHONENUMBER <br />PREVENTERS <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FflONTSETBACK )� REARSET <br />��C.] �� <br />USEZONE LOTAREA <br />i�'PEOFCONSi NO.OFSP <br />1�Fi� 4 <br />SIZE OF BL�G. FIRt SPRINKLERS REO'D <br />� 3g� �iF T 1� A.'G <br />OCCUPANGY LOAD FIRE ALARM REO'D <br />�0 i4� I .1. N� <br />INTAKEBY I PLANSAPPROVEDBV <br />ontE GM��CI.z <br />SIDE <br />, �r <br />� <br />ZIP <br />PHONE <br />GC- /iY7Uf <br />❑ PLUMBING ❑ SIGN <br />��i 'l�� �i2n� <br />Z�P PHONE <br />�' ,: � , va9 . ('3 6`f 3 � ro -lo%!o <br />Z� PHONE STATE LICENSE # �!�X���yJ <br />1'W� i.tet. iPdSZ �Z-,43� '� �•-� <br />Z��� PHONE STATE LICENSE A <br />CIT`' ZIP <br />LILENSE p <br />I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORflECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN GR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTFIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONS7RUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACT9RS LAW 18,27 RCW qND 296200 WAC. <br />MECHANICAL � <br />N0. TYPE OF EOUIPMEN' <br />FvC—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B,T.U. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES URYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATFR <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BUF <br />FIfiEPLACE INSERT <br />HEAT PUMP <br />GAS PIPIPJG <br />EXHAUST FAN <br />VACANT SITE FEES <br />❑ YES ❑ NO <br />BUILDI�IG <br />OCCOPANCY Ii0 OiOWELLMGUNIiS - <br />GFOUP <br />�Z �� PLUI�IBING <br />BnSEkENT MECHANICAL <br />CI YES �G' NO <br />MEIGHI'LIMITATIGN ADDITIONALPLANCHECK <br />— OTHEFl <br />STATE BUILDING SURCHARGE <br />CITY Of EVERETf PUBLIC WORKS <br />LOCAL SALES <br />TAX COOE IS 3105 rorn� <br />SUB TOTAL $ � <br />PERMIT $ ; <br />TOTAL FEE $ � <br />FEE RcCEIPTNO. <br />8/.90 OsS�< <br />VALUATION FEE <br />h __;_ <br />Z�� i� — <br />1 <br />i <br />i <br />� <br />i <br />� <br />. �T— <br />i <br />� <br />� <br />