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tTf th � <br />A�x <br />C N <br />9HfA <br />�x9 <br />HxH <br />�H� <br />0r`�� <br />'i1 H h] <br />VJ H <br />Hx <br />[�1 O <br />OHd <br />H�g <br />�r n <br />t"y5 <br />t-� y <br />g �' <br />n d � <br />� � [?' <br />zym <br />HOm <br />APPLICATiOh FOi� CONSTRUCT!(o.� PERIVIIT ��`°'�°« <br />�,,, E,,n�,,,� TO BE COMPLETED IN INK—PLEASE PRlNT � <br />a rv cr <br />eve rett HEATING SYSTEM G� GAS CI ELECTRIC J <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING DRMECHANICAL PLUMBING SIGN <br />OWNER 1.'AiLAD�a[55 CiIY ZiP PHOtIE <br />(-'hl-,c�F'sL2c��r 3�zz �or-ra.r�2� rUr�zt,1- g8zai Zs�o��� <br />i[NANT MAILRDORE55 GITY ZIP PHONE <br />Sff�'�•?� <br />nRCHIiECTORDESiGNEB IAAILADORE55 CITY ZiP PMONE <br />GENERALGONTRACTOF MARpDDRE55 CIN ZIP PNONE LICfTSEs <br />6i[GHRNICRLGONTRACTOR MAIIADOPESS � GIiV ZIP PHONE LICENSE/ <br />Q C� N E �-- <br />PLUTABWGLCNTR4CtOR M�ILADDHESS CItY ZIP PNONE LICENSEn <br />CLA55 OF\VORH <br />NEW �JC ADDITION � AL7ERATION � REPAIR <br />CONTRACT?RIGEOFWORN � O�DTJ <br />�OESCRI�B[ WOR•K AND SOUARE FOOtAGE INVOLVEO <br />M✓�fl l.. f.6.�. �LI�sG�-c-fr V IL,�W � <br />G A <br />PRO�'OSED USE OF pUiLDING � <br /><51 N 61 f_ F j—/i-1�^ I L y /L E 5/OIC.^.'71p-L <br />�EGAL DESCRIPiiON OF PBOPENTV I+HOWN BELOW OR ATV GN FOUR COPIES� <br />LOi2�-2Z BLOCN ✓C)I OF �N�L� I�l� <br />PROJfCTADDRE55 <br />3� 2 2 �or� <br />PLUMBING <br />NO. TYPE OF FIXTUHI <br />WATER CLOSET ITOILETI <br />SHOWER <br />KITCHEN SINK 8 L�I'� <br />DISHWASHEfl <br />LAUNORYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAI <br />FLOOR DRAIN <br />ROOF DRAINS—fiAINLEADEFS <br />SINK (SERVICE—BAF. ETC.) <br />FOR OFFICE USE ONLY: <br />1'BOYTSETEACK PEARSETBACK <br />❑SEZON[ LOt�RE! <br />1VPEOfCON15.ALlOWABIE iVPE�iC2V5i.AC1Ue: <br />SIZE OF 9LDG NO.OF 5'(`^IES <br />LORO <br />R[A501! FOR SPRINHI[RS <br />II:1I�K[ Ov <br />0 <br />DEMOLITION WOODSTOVE/FRPL INSERT <br />I CONtACTPER50NANOPHONENO <br />IT�FEE $ <br />SIDE SETBACN <br />VACANT SITE <br />OCCJP4NCY NO Oiq1fLLIHLOHi15 <br />G90UP <br />FIREiPRNNLERSPEO'0 I HEIGHTLIIAITATION <br />{'l ANS APPROVGD BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COOE IS 3105 <br />BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SA6'E TO BE TRUE AND CORRECi 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 P'cFi.!IT fiOES NOT PRESUME TO GIVE <br />AU?HORITY TO VIOLATE JR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL :AW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF I'HIS PROPERTY TO PERFORM THE WORK FOR WFIICH <br />APPLIC4TION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACT.ORS LAV/ 1827 RCW AND 296200 WAC. <br />SIGNATUREOFCONiRPCTOPORAUtMORIZEDAGENT DATE <br />i <br />X ��---'�� � i�/ ��f p <br />APPLIC�ANiS CiiY�9U51NE55 UCENSE NO. AND BUSINE55 N�Id[ <br />MECHANICAL <br />JO. TYPE OF EQUIPMENT FEE <br />NC—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />� METAL PIREPLACE 8 CHIMNEY <br />FIREPUICE INSERT _ <br />HEAT PUMP <br />,2 GAS PIPING <br />ExHAUSiFAN <br />SUB TOTAL S .S <br />PERMIT S / <br />TOTALFEE 5 C <br />PLANCHECKNIJM�ER FEE �EC[IPil10 <br />BUILDING <br />—�_ <br />PLUMBING <br />MECHANICAL /o S� � — <br />ADDITIONAL PLAN CHECK <br />OTHER <br />�— <br />STATE BWLDING SURCNARGE <br />PUBLIC WORKS <br />TOTAL C � � <br />