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APPLICATIOi. FOR CONSTRUCTI� N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: 'ZkGAS ❑ ELECTRIC ❑ <br />259-8810 <br />1 1 DEMOLITION I I COMBINATION j/I BUILDING L I MECHANICAL I PLUMBING Li SIGN <br />OWNER <br />MAM1 AGGRESS <br />CITY <br />PP <br />PHCIIE <br />;V 7T /-%yy:✓.✓G <br />AUTiJGCsre /40/ <br />"n 49 411 osrr <br />WA S'YY1J/ <br />aAa' o4�a'LS3/ru <br />nNANT <br />MARL ADDRESS <br />CON <br />ZIP <br />PHONE <br />AT.NII ECT OR DESMNEA <br />WIL AI)WESS <br />CRY <br />lP <br />PIgNE <br />PLUMBHOCCNT TCX MAIADCHESS CT' ZIP PIONE STATE LICENSEE <br />I I uEw n enmmnN Vf ALTERATION LI'REPAIR I DEMOLITION n WOODSTOVEIFRPL INSERT LI BUILDING RELOCATION <br />CCNTRACT PRICE OF WORK W <br />CONTACT PEPSONAH ENO <br />�� SS� <br />DESCRIBE WORK ANDSWAHE FOOTA EWYOLVE" <br />3lee � <br />PROPOSED USE OF BUILDING <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 BF C)MPLETED 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 CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF S P PEflTY TO PERFORM THE WORK FOR WHICH <br />APPLICA ON IS ACEAND I COMPLY WITH THE STATE <br />CONTR T/OR'SLA 1S.27 WAND296.200WAC. <br />X �✓ <br />LEGAL DESCRIPTKIN OF P{ EWY ISIIOYM BELCH OR ATTACH FWR COPIE51 <br />LOT BLOCK of <br />PRWEL/T �A/DDRESS / <br />('TI L--Aj ee / C/� C// <br />SwNnE w1 <br />CR�pu5mf 54CfMFW <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OF ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSLT (TOILET) <br />NC—AIHNOLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />_ <br />FLOOR DRAIN <br />HEAT PUMP <br />SACKFLOW PREVENTERS <br />GAS PIPING <br />' <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK fSERVICE--BAR. ETC.) <br />SUBTOTAL $ <br />SUBTOTAL $ <br />_ <br />PERMIT $1 <br />i <br />I <br />PERMIT E <br />_ <br />TOTALFEE $1 <br />1 <br />1 <br />TOTAL FEE E <br />FOR OFFICE USE ONLY: <br />USEZCNE <br />LOTAREA <br />iEiw* <br />FEES <br />VALUATION <br />FEE <br />61 �D�ANi <br />PLUMBING <br />nOl U�M�MSS��A//IL�LDMIll <br />No VA9VLUTi <br />TYRIXCDNSZACTWL <br />OTN[I.." <br />MECHANICAL <br />SIZEOFBLBC <br />STORIES <br />BASEMEN <br />ADDRIONALPLANCHECK <br />j <br />OCCUPANCY LOAD <br />FIRE SPRNKLERS REM <br />HEIOHTLUITATON <br />SPRINKLER <br />REASONFORSPRWKLERS <br />STATE BUILDING SURCHARGE <br />i,S7I <br />INAKE BY <br />P SAPPROVED BY <br />7Lf/jjj_ 1/M <br />CITY OF EVERETT <br />LOCAL SALES <br />I TAX CODE IS 3105 <br />FUBLICWORKS <br />TOTAL <br />