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APPLICATiC l FOR C�NSTRUCT )N PERMIT ���V�,�rr� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT C�ErEJrErr <br />BUILDING DEPARTMENT i HEA7wG SYSTEM: J GAS :_I ELECTRIC � OZ� � X/ST I r'��� <br />259-8810 <br />DEMOLITIOi� COMBINATION BUILDING xMEChiANICAL PLUMBING SIGN <br />O'.:':EF MAiLADDiiE55 Cliv ZiP PHONE <br />.Su� ��eis�cu ��� �{O�rf" �✓ �" y5'2�3 2S?-zZyS- <br />TE4�'!T � IAA�L/1�DFE5� CRV ZiP PHONE <br />A5C':rtECiOR0E51G1iER 1.141LADDRE55 QTY ZIP PnONE <br />Oa5 <br />GEt1EriAlCONiR� MAIIADDRESS . �LiTY „ ➢P PNOtJE STFTELiCENSE <br />1.'ECHANICALLONTRAGiOR LIARA�DRE55 <br />.�.�+ � �., . ,� <br />PLUiA9�NGCONTPACTOF IdAILAODPESS <br />CLASS OF WOPK <br />NEW ADDITION �CALTER� <br />COf�iHFCT PRiCE OF WORK <br />DFSCFi9E WORK AND SOUARE FOOTAGE INVOLVE[ <br />� i. i � a. v� i — <br />LEGAL�ESC IPTICNOFPPOfERTVISH /NBEL01'!OF <br />LOi�_ BLOCK �90 OF � <br />E�,. „/, ✓. ..4, i/� l. 3 <br />PHGJEGTAODRE55 <br />� �Z/ <br />TYPE OF FI%T <br />WATER CLOSET (TOII <br />BATHTUB <br />LAVATORY�WASH BA <br />SHOWER <br />KITCNEN SINK 8 DISF <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKWG FOUNTAIN <br />Fi00R DRAIN <br />BACKFLOW PREVEN- <br />ROOF DRAINS—RAIN <br />SINK (SEFVICE—BAF <br />Ul:l <br />REPAIR <br />DEMOLITION <br />� <br />ZIP <br />�� <br />LP <br />WOODSTOVEFRPLINSERT <br />AND PHANE NO. <br />' l-CO <br />STATE LIGENSE A <br />4 <br />BUILDWG RELOCATION <br />- �/Z�2 <br />� I HEREBV CFR71F'/ THAT I HAVE READ AND EXAMINED THIS <br />� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />:51 PROVISIONS OF LAWS AND ORDINANCES GOVEflNING THIS TVPE OF <br />t! WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />� D NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF AM1Y <br />� OTHER STATE OR LOCAL LAW flEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY 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 />FEE <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />FRO'JTSEIDACN REARSETBACK <br />USE ZONE LOT AREA <br />ivt{ OfCONiS.A�LOWABLE iY°EOFCONST ACiUR;. <br />SiZEOF�LDG. NOOFSTORIES <br />OCCl1PANLV LOR� FIRE SPRNNLERS REO'0 <br />R[ASON FOR SPRiNNlERS <br />In;nKenr v�nr+snrraoveno�, <br />SIDE SETBACIf <br />onr[ <br />si 55 uc[us v0 <br />ANICAL <br />TYPE OF EQUIPMENT <br />lvC—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UIJIT HEATEFS—B.T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD _ <br />WATER HEATER <br />WOODSTOVE _ <br />METAL FIREPLACE & CHIMNEY <br />FIREPL�CE I�SERT <br />HEAT PUIdP <br />GAS PIPMG <br />EXHAUSTFAN <br />9UILDING <br />tt0.'�'ANLY M1OOiDWRIiNGOldiS — <br />"'� PWM1181NG <br />BnSEMENi MECHANICAL <br />HEiGHT IIMtTAiION �DDIPONAL PLAN CHECK <br />SPFINNLEP <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC NJOF7K5 <br />LOCA! SALES <br />TAX CODE IS 3105 TOTAL <br />-2 `-9,� <br />SUB TOTAL 3 � L{C/; <br />PERIJ,j7 a I <br />TOTAL F[E 5 ,.� <br />FEE RECEIPTNO <br />VALUATIOid FEE <br />—� <br />