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A�PLICA�l�1 FOR CONSTRUCT�ON PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT �^�'�`TING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ N. A. <br />259-8810 <br />O DEMOLITION ❑ COMBINATION � BUILDING � MECHANICAL ❑ PLUMBiNG ❑ SIGN <br />OMMER WIIADDRE55 LRV 21P PNONE <br />Housing Authority of the City of Everett, 1q01 Poplar, �:verett, WA 98201 256-9222 <br />TE�WIT MA0.ADOIIESS CITV Z�F VMONE <br />Same <br />AqCHITECTORDE5I�NER MAILADONE55 CIiV ZIP PNONE <br />CNJJ Architects, 2722 Colby, Suite #607, Everett, WA 98201 259-1560 601-291-582 0 <br />GENEMLCONTMCTOfl MA4.ADDflE55 CIfY ZIP PHONE STAIELICENSEI <br />MEGMANIC�L CONTNACTOR MAIL ADDRESS GITY 21P PHONE ST�7E LILENSE / <br />PLUMBMIGCONTRACTOq AWLADDfiESS CITV LP PHONE ST�TELICENSE� <br />CONTRACT GRILE OF NORK <br />.�. <br />PROPOSEO USE OF BU0.DRK3 <br />DESLflIPT10N OF PN�PEflTV <br />�or e�ocic <br />(See Attached) <br />PMGEL TAX I.D. NUMBEP <br />or minus 2000 <br />� <br />.1 259-1560 <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 />LOWORATTACHTWOCilPIES� 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 OH CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br />OWNEq OF THIS PROPERTY TO PERFORM THE WORK FOR WHICN <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />TYPE OF FlIfTURE ON ITEM <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 6 DISP � <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTERS <br />ROOFDRAINS--RAINLEADERS <br />FOR OFFICE USE ONLY: <br />USE ZONE <br />rn[ a ca+s� <br />� <br />s� a a�oo. <br />N%N"� �� <br />PERMIT <br />TOTAL FEE <br />LOT MFA <br />NO.OF STORIES <br />� <br />FIRE SPRqlKlERS NEOD <br />Fr ^J u <br />x fi-t�-es <br />s�urune022521 wrE <br />tmeusressuc[raera. <br />MECHANICAL <br />H0. TYPE OF EOUIPMENT FEE <br />NC—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNR HEATERS—B.T.U. M � <br />CLOTHES DHYERS ' <br />VENTILATION FAN � <br />RANGEHOOD ' <br />WATER HEATER ' <br />WOODSTOVE � <br />METAL FIREPLACE (WOOD BURNING) ' <br />FIREPLACE INSERT � <br />HEAT PUMP ' <br />GAu PIPINQ � <br />EXHAUSTFAN ' <br />� <br />SUBTOTAL S <br />� <br />PERMIT S � <br />TOTALFEE S ' <br />PIAN LHECK NUMBER . FEE PELEIPT NO. <br />❑ YES ❑ NO BUILDING <br />anwc+ w.ao�rtwxcuxin <br />�Jp1j°7 P�UMBINO <br />15EMtNl <br />❑ VES NO <br />V�7-lS-f? � TAXCODEIS3105 <br />OATE <br />MECHANICAL <br />ADDITIONAL PUN CHECK <br />OTHER <br />STATE BUIL�ING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />i <br />�— <br />