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APPLICATIC � 1 FOR CONSTRt�CT'"lP0 PERMIT �✓� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />�HEATING SYSTEM J GAS J ELECTRIC J <br />BUILDING DEPARTMENT — <br />259-8810 <br />DEMOLITION I� COMBINATION „� BUILDING MECHANICAL i'': PLUMBING SIGN <br />pi;1r+eq ,� ,unanoqaEs /J cirv , _ zic PHONE _ <br />MCHITECT OR �ESIGNER <br />� <br />MAIL <br />PHONE <br />IApI.ADDFE55 CITV ZIP PHONE <br />IANL �ppPE55 CITV ZIP PMONE STATE LICENSF s <br />///�"_7�yAvGSI�`. �/�r�/f �,f�a5 ?3Y-Gias Le/,sAyr,�y�L� <br />MAILADORE55 CITV� 21P PHONE STATELiCF.NSE�- <br />PLUMBINGCONTRACTOR MAIL�DORE55 <br />GONTRACT PRILE OF <br />�ESCFIBE WORK AtJD SOUARE FOOTAGE INVOLVED <br />/V,MO�L 1"�,n�G�,-G Y170T _ <br />PROPOSED USE F BO/�ILOItlG /' <br />iS J ?�G % _ <br />LEGAL OESCFIPTION OF PFOPER�TV q�SH�(OWN F,ElO'N OF <br />LOT� BLOCK ��� OF � <br />PARCELTAXID.Nt1MBEH <br />i �//��/ ^%�i��,L, <br />IOANIENDER.A0DRE55. <br />NO. TYPE OF FU <br />WATEfl CLOSET (TC <br />BATHTUB <br />LAVA'iORY (WASH B <br />SHOWER <br />KITCHEN SINK 8 DI: <br />�ISHWASHER <br />LAUNDRI'�(RAY <br />CLOTHES WASHEP. <br />URINAL <br />DRINKING FOUNT,\IN <br />FLOOR DRAIN <br />BACK; LOW PP.EV'_NTERS <br />ROOF DRAINS— rIAINLCADERS <br />FOR pFFICE USE ONLY: <br />FRONT SET3ACK REAR SETBAGK <br />US[ ZONE <br />rvae oF cor�sr <br />SIZE OF BLD4. <br />OCCUPFYC LDAD <br />RE�504 <br />II.ITAKE f1Y <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE S <br />LOT ABEA <br />NO. OF STORIES <br />FIRE SPRINKLF.FS REO'D <br />FIRE nLARM REO'0 <br />PLANS AF'FOVED 0Y <br />on1E <br />CITV ZIP <br />CONT�CT PERSON FND PMONE NO. <br />PHONE StATLtICENSEn <br />— I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APFLICATION AND KNOW THE SAME TO BE TRUE AND CORRECi. ALL <br />PROVISIONS OF LAWS AND ORDINANI;ES GOVERNING THIS TYPE OF <br />cowesi WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CAN','EL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIO-�- OR THE <br />PERFORAIANCE OF CONSTRUCTIO�:. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFO^.S ?Nc WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH �, ��: S?ATE <br />CONTRACTORS LAW 18.27 RGW ANI�i96.200 WAC. <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT <br />A/C—AMNDLG UNITS—H.P. <br />FORCED AIR SY:ITEMS—B.T.U. M E.A. <br />UNIT HEATERS—I.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDE SETBACK � PLAN <br />vncnNr sire rtt� <br />❑ YES i1 NO BUILDING <br />acuvcvc u�o�aw¢un�cwurs <br />r.aeu� p�UM81NG <br />BASEMENi MECHANICAL <br />� i YES f�! NO <br />HEIGHT ulAiinTION ADDITIONAL PLAN CHECK <br />OTHER <br />S7ATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WOflKS <br />LOCAL SALES <br />;AX CO�E IS 3105 TOTAL <br />FEE <br />SUB TOTAL 5 ; <br />PERMIT S <br />TOTAL FEE S <br />RELEIPi NO. <br />VALUATION FEE <br />�� <br />�1 � � _ <br />i <br />� <br />0 <br />♦ <br />