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APPLICATI�1 FOR CONSTRUGT"�"DN PERMIT ��� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEP4RTMEN"f �— <br />259-8810 <br />' DEMOLITION COMBINATION <br />01YNEF 1dAILA0pRE55 <br />ii/Z� ���cJ&L 1l/a7 <br />TE11ANi MAILADORE55 <br />ARCHITECTOROESIGNER /AAILPDDRESS <br />GENEFALCONTRACTOR MAILAD�FE55 <br />IAEGHANICFLGON�RFGTOR IAAIL/AD�DRESS <br />�� W OC�iJ �j}7/.✓C C C-QJ l� �!. � <br />PLUId61NG CONTRACTOR IdPlt ADORE55 <br />f R��E o_��K <br />., <br />WOPN AI:D SOOAPE <br />HEATING SYSTEM: <br />BUILDING <br />CITY <br />'Y ��,� <br />f.ITY <br />CITV <br />PqOPOSED l�E OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTV �SHOWN BELO140R ATTFCM TWO WPIE51 <br />LOT BLOCN OF — <br />PARCEL TA%ID� M1'�tADER <br />CONSTRUCTION L04N LEI <br />NO. TYI'E OF FI%TI <br />WATER CLOSET (TOIL <br />BATHTUB <br />LAVATORY(WASH BA� <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNORY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING fOUNTAIN <br />FLOOR DRAIN <br />BACKFIOW PREVEN7 <br />ROOF DRAINS—RAIN <br />NUMBER <br />CITY <br />SUB TOTAL S <br />PERMIT $ <br />TOTAL FEE- S � <br />FOR OFFICE USE ONLY: <br />PIIDNTSETBACK REFRSETBhGK <br />USL ZOt1E LOT AREA <br />irF(OfGONSi. NOO`STORIES <br />SiZf OF BLDG FIFE SPFINKLERS REO'0 <br />OCCUPAIICV LOAD FlRE ALARI,1 REOD <br />R[�SON <br />VlIAHE�Y PLANSNPPROVE�B'/ <br />DFTE <br />SIpE SETBRCN <br />J ELECTRIC J _ <br />ECHANICAL <br />ZIP ❑HONE <br />� ei� G✓A <br />ZiP �'HONE <br />ZIP PNCNE <br />ZiP PMONE <br />jIP PNONE <br />�ln.rp uH • <br />ZIP PHONE <br />CONTAGT PERSON AND?NONE N0. <br />_. PLUMBING <br />SThTE LICENSE a <br />STATE LICENSE a <br />�%(�IJ//� <br />SiRTE LICENSE N <br />SIGN <br />I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PRO'JISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETfiEfl SPECIFIED FIEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOE;i NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL TViE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WOFK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />.. ���'�/_ �l�iti.__,c� 70�� 9� <br />CIl V OJJiNLSy l ICF M1SL 1.0 <br />MECHANICAI <br />NO. TYPE OF EOUIPMENT <br />A/C—AiHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DAYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNING) _ <br />FIREPLA�.E INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PLpNCHEGKNUMBER FEE <br />I % .�/�� � <br />❑ YES I . NO BUILD!NG <br />oeeuvauc� eo o�oweurveunas <br />cnou� PLUMBING <br />BASEMENT MECHANICAL <br />G YES '�'- NO <br />HEIGNT LIUITATION ADDITIGNAL PLAN CHECK <br />OTHER <br />S7ATE BUILDING SURCHARGE <br />CITY OF EVERETT rueucwoaKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />FEE <br />� <br />�p <br />tl <br />