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l�Y t�1 � <br />H <br />�H[~i� <br />y�H <br />�H� <br />'� H '�J <br />V1 H <br />Cj] O � <br />HC <br />H�1�g <br />y�Y � <br />!-i <br />2; H <br />��yHH <br />p� <br />H <br />c�CyyM <br />�� L•J <br />zy�n <br />HOf/� <br />AIPPL�C/�T'!C ! FOFi CONsTF�IJCT''JN PEI�MIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS �J ELECTRIC ❑ <br />BUILDING L�EPARTMENT - <br />259-8810 <br />DEMOLITION '' COMBINATION 'k' BUILDING ! i MECHANICAL `J PLUMBING SIGN <br />OWNEF �'4iLAC�9ESS G�tY ZIP PHONE <br />i <br />.ruY>'� � f� "tj'it. %2C"j L P-� �. c iZ (' �' � - �� �I GZci Z61 - l '75 � <br />TENANT h1AILFDOPE55 Cltt 21P PItONE <br />ARLMITECTORDESIGNER MARAD�qE55 Gnr <ir rnv�.c <br />GENERALCONTRACTOR MAILAO�RE55 CITY ZIP PHONE STATELIGENSEk <br />�'_'J> � n c- 13 ��cl'i� �3Zc �- �{ �-s: N.F �1.�_,�.�.� b�.� °jY,2d3 43SfT71 .�E�.��i�b-lcd'ar� <br />IAECHANICAL CONTFACTOR IAAIL ADDRE55 CITY ZIP PHONE STAiE LICENSE � <br />/ <br />PLUMBINGCONTRACTOR MAILADDRESS CITY ZIP PHONE STATELICENSEv <br />'. I NEW \� ADDITION I� ALTERATIOti i�l REPAIR I.�I DEMOLITION '�. I WOODSTOVE/FRPL INSERT �� 1 BUILGING FELOCATION <br />,��p / CONTAC/TP�ERSON/NDPHONENQ_/' ( `' , (/( <br />GONTRACTPRICEOFYlORK .3ZuL'•U<' U�2`� ��J 1 G1•�II � <br />DESGRIOE WOFK AND S�UARE FOOTAGE INVOLVED <br />L' </ _.. .� J 3�� L, r.�.. �.(� <br />use oc omiowc <br />LEGAL OESCRIPTION OF PROPERTY �SNOWN 6EL01 <br />LOT •� % BLOCH OF <br />r�s=�-� ���<� Ci.P 2.CG�'.0 . <br />( <br />i / �.,�/ <br />.SOz.,�L /i0 / <br />l C i /D /�,i�_ 'i <br />PROJEGTAOOF[55 <br />7Zc � LLI._� <br />NO. <br />KITCHEN SINK 8 <br />DISHWASHER <br />IAUNORVTFAY <br />CLOTHES WASH <br />URINAL <br />DRINKIMG FOUN <br />FLOOR DRAIN <br />BACKFLOW PRE <br />ROOF DRAINS— <br />SINK (SERVICE- <br />FOR OFFICE USE ONLY: <br />FRONTSETONCH REABSEt2ACK/ <br />Z- ' <br />� <br />uSE20NE LOI'AREA <br />ivPE�OtliS.AIIOWF&E lYPEOFLOpSt.AGN� <br />SiZE OF �LDG. <br />SPRINKLERS <br />NO.OF STOFIES <br />FIRE SPRNKLERS PE <br />�� <br />PLANS APPROVEO OV <br />�1 r� `��Q <br />nnncH <br />Su <br />TOTAL 5 ; <br />NIT S —�— <br />\L FEE 5 <br />SIOE�5i8�CN <br />: <br />VACFNT SITE <br />�ccuraxcr uaurmv�wis��.irs <br />cFo3 /� A <br />�RSEMENT <br />A <br />O'D NEIGNTIIAIITATI(pJ <br />� <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COOE IS 3105 <br />I HEREBY ^.ERTIFY THAT I HAVE READ AND EXAMINE� THiS <br />APPLICATION AND KNOW THE SAME TO BE TR JE AND CORRECL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HIS NPE OF <br />WORK WILL BE GOMPLETED WITH WHETHER SPECIfIE� HEFEIN OR <br />NOT. THF GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE FROVISIONS OF ANY <br />Ol"HER STATE OR LOCAL LAW REGULATING CONSTFiUCTION OR THE <br />PERFURMANCE OF CONSTRUCTION. THA1 I AM AUTHORIZED BY THE <br />OWNER OF THIS PFOPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />x � /,��-�,,� i-.w �- - � L <br />S�cunrunc (� � o"TE <br />TYPE OF EQUIPMENT <br />NC—NHNDLG UNITS—FI.P. <br />FORCED AIR S�STEMS—B.T.U. 1A E.4. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATIO� FAN _ <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIIANEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAl1ST FAN <br />PIAN CHELK NUMBER <br />39s�co <br />Bl11LDING � <br />a�uMemc <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />STATE BUILDING SURCHPRGE <br />PUBLIC WORKS <br />TOTAL <br />TOTAL FEE 5 I <br />FEE REGEIPTNO. <br />/l�. �S `% S3 <br />VALUATION FEE <br />A�o .�s : �, <br />