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AflCMITECTORDE5IGNER IdFiLFpDRE55 <br />GENERALWNTRACTOR MAILA�DPESS <br />ldECHANICAIGONTRqQOq IAAILApORESS <br />��,�����.ti D�s�: � �se9 <br />PWMBINGCONTRACiOR IdAILFODRESS <br />CLASS OF IVOFK � <br />NEW � ADDITION s�ALTERAT10N <br />CONTRFCTPflICEOf WORK �� O � <br />DESCRIBE WORN AN� SOUAPE FOOTAGE INVOLVEO <br />PROPOSED USE OF BUILDING <br />REPAIR <br />LEP1L vCo�A1PTION OF PROPERTV (SHOV/N BELOW OR ATTACH FOUR COPIES) <br />LOT BLOCN OF <br />PflOJECT ADDRESS `� � / /� , <br />E� �.�,C <br />// <br />PLUMBING <br />NO. TYPE OF FlXTURE OR IiEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY�WASH BASW) <br />SHOW[R <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />9RINKING FOUNTAIN <br />FLOOR DRAIN <br />BAI;KFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK �SERVICE—BAR, ETC.) <br />� TOTAL <br />FOR OFFICE USE ONLY: <br />FFONTSETBFCK RE�R SETBACK <br />USE20NE LOTAREA <br />NPEOfCONiS.ALLOWABLE lYPEOFCaNSi.AGTUAL <br />SREOFBL�G. NO.OFSTORIES <br />OCCUPANCY LOAO FIPE SPFNKLERS REO'D <br />flEA50N FOR SPRINNLERS <br />INTANE BY <br />PLANS APPPOVED BY <br />5 <br />S <br />QTV 21P <br />QTV Z!P <br />LITY ZIP <br />�J�4JJ y �UPl�1� <br />CIIV 21P <br />PHONE <br />i � s'.c:3 <br />PHONE <br />STATE LiCe�lSE n <br />STATE LICEt�SE a <br />/,2/�fE72 r. <br />SiATE uGEt15E a <br />s'5:�� � <br />DEMOLITION WOODSTOVE/fflPL INSERT .. BUILDING RELOCATION <br />I CONTACi PERSON AN� PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. 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 PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRU�TION. THAT I AAA AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTO W 1827 RCW AND 29&200 WAC. <br />/ <br />�J / <br />X �'< <S � // %c <br />S��G' . nE On�L <br />cirv eusirvess ucv;sc r.o <br />MECHANICAL <br />NO. TVPEOFEOUIPMENT FEE <br />A�C—A�HNDLG UNITS-4.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRYERS � <br />VENTILATION FAN ' <br />RANGE HOOD �— <br />WATER HEATER ' <br />WOOD STOVE i <br />METAL FIRE?LACE & CFIIMNEY <br />FIREPLACEINSERT ; <br />�T <br />HEAT PUPAP � <br />GAS PIPING <br />ExHAUST FAN � <br />SI�ESETBACK PIANCHECNNUTABER / FEE <br />�i�l��n <br />VFCFNT SITE FEES <br />BUILDING <br />OCCO�AMCv NO OiOWFILiNG11Nit5 <br />caaw � pLUMBING <br />DASEMENT MECHAI�ICAL <br />NEIGNTUMITATION ADDITIONALPLANCHECK <br />SPRINKLER <br />STATE 6UILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEE 5 <br />fiECEiPT ND. <br />r <br />