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APPLICATII.N FOR CONSTRUCI.�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PR�NT <br />HEAT�NG SYSTEM: U GAS ❑ ELECTRIC U <br />,• BUILDING DEPARTMENT <br />• 259-6810 <br />� DEMOLITION COMBINATION x BUILDING MECHANICA k PLUMBING SIGN <br />ONTIER MAiLqpDRE55 GITV 21P NE <br />�-.� ,y,= r,�� zwu �st� �� �-�F.�-,— � zsZ—s3Z� <br />T 1! NT MAILADORE55 CITV ZIP PHpNE <br />FRCHIiELT OR DESIGNER M1IAIL AD�PESS QTV ZIP PMONE <br />,-- � . � <br />;1 E RNLGONiHaCTOq MAILAD�RESS CITV ZiP PIIONE STATELICENSE� <br />D6Si�,vT=�Js �_,,r7� .,.r. �ay S�tc���� x�LOI IM.,,,s..'��iiL7. 7�sicTr _/ZL• /�7 _ <br />MECH�NICAL CONTfl�CTOR 1AAIL qDDRESS CITV ZiP PHON[ STATE LICENSE � ��� <br />I <br />PL11M61NG GONTRACTOR MAIL pD�RE55 CIiV 2iP PHONE SiATE UCENS[ • I <br />CLASS OF WORK <br />�. ' NEW . ' ADDITION �. �. ALTERATION <br />CONTRACTPRiCEOFWORN � <br />DESCRIBE WORN AND SIXIARE FOOiAGE INVOIVED <br />LE.iAI OESCF�PTiON OF PROPERTV ISHOWN BELOW OF <br />l0T BLOCN OF _ <br />TYPE OF FlXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 Y �F <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEFS <br />ROOF DRAIN�RAINLEADERS <br />SINK (SEfiVICE—BAR, ETC.) <br />% <br />SUB TOTAL $ <br />PERMIT 5 <br />TOTAL FEE 5 <br />FOR OFFICE USE ONLY: <br />FflONTSEiBACK PERRSETBACK <br />❑SEZONE IOTRREA <br />ttPEOiCON15.�llOWABtE iYPEOi[Of151�L1UAL <br />SREOFBLDG. NOAFSi0P1E5 <br />OCCl1PANLYLOAD FIRESPqNNLEfl5PE0'D <br />RE�SON FOR SPRINNIERS <br />u��x.r�aa:r� <br />REPAIR <br />DEMOLITION � WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />CONtACTPER50NANDPHONENO <br />)�1 Ci�.ln /n�i �.1/ � � <br />i HEREBV CEflTIFY 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 TVPE OF � <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � <br />NOT. THE GRANTING OF A PERMIT DOES N0T PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEFFORMANCE OF CONSTRUCTION. THAT I AM AUTHOFIZED BV THE <br />OWNER OF THIS PROPERTI' TO PERFORM THE WORK FOR WHICH I <br />APP TION IS MAD[ ND I COMPLY WITH THE STATE � <br />NTRAC 0 AW 18.27 D D 296.�90 WAC. <br />X /`�� <br />5�' .. ` D�l[ ' <br />/ <br />AIR SYSTEMS—B.T.U. M E.A. <br />UNIT FIEATERS—B.T. <br />C�OTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />FIREPLACE INSERT <br />HEAT PUMP <br />SIDESETBRCK PLAF)CJ�ES,!(�{{I�IBfeil <br />JiyS S � <br />vac�wt sirE FEES <br />BU�LDING <br />accuwxr xoawrt�uxcu�uns <br />saouv � PLUMBING <br />BASEMEr+t MECHANICAL <br />HEIGHTLIMIiATION ADDITIONALPLANCHECK <br />SPRINHLER <br />S7ATE Bl11LDING SURCHARGE <br />CITY OF EVEflETT PUBLIC WORNS <br />LOCALSALES <br />TAJ( COOE IS 3105 Tor�i <br />PERMIT 5 <br />fiECEIPT ry0 <br />0 <br />