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APPLICAT101 FOR CONSTRUCT! �N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM GAS J ELECTRIC J <br />BUILDING DEPARTMENT ' '� <br />259-8810 <br />DEMOLITION COMBINATION BUILDING �ECHANICAL �UMBiNG ! SIGN <br />I�AL L�1 �' 2./-1 �� :�(nl � j-(�r_c Si1��. (i� �I�C/',77 9,��� .?,�s-�o�� <br />iEti�NT I.IAILADORESS CITV IIP PHONE <br />�Arn � <br />ARCHrtECTORDESIGNER h1AtLA�DRE55 CITY ZIP PNONE <br />GENER CITV IIP PM NE STATELICENSEa <br />�'�ECH4I i AC D�RESS CITV � Zp� �('� pH� /��,�S�E��Etsf• � <br />� � OStii%� <br />PLU6' ,:NG CONTaAGtOR <br />CONTRAGT PRICE OF \Y� <br />OESCFIPE \YORK AND SOUA <br />//1 sTl,l(� � <br />D, �� � a,,;,l <br />� <br />INVOLVED <br />s <br />LEGAL DESCRIPTION Of PROPEFTV ISHOWN BELOW OR ATiACH TWO COPIES� <br />LOT BLOCN OF <br />7 �-C'(—VU �—l.. <br />PARCELTAXID.NUAIBER <br />GONSTRUCTIONLOANIEN�ER.ADDRE55. <br />PLUMBING <br />NO. TYPE OF FIXT URE Oq ITEM <br />BATHTU3 <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLJTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVICE—BAR, ETC <br />FC5 OFFICE USE ONI.Y: <br />FRONT SEIDaCH R, AR SETB�CK <br />iVPE OF CONSi. <br />512E O° OIOG. <br />OCCUPANCVLORO <br />FEASON <br />INiAKE�Y <br />PERMIT S <br />TOTAL FEE 5 <br />NO. OP STORIES <br />FlRE SPRINKLERS REOt� <br />FIRE ALARM REO�O <br />PLANS APPPOVED UY <br />onre <br />CITV <br />21P <br />CONTFCTPERSON <br />PNONE STATE LICENSE e <br />`-'+--."`i'--'�-- <br />E�' `{/� <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 ORJINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GfiANTING 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 />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROP �Y.TO PERFORM THE WORK FOR WHICH <br />APPLICATION I ADE NO COMPLY WITH THE STATE <br />CONTRACTOR AW 18. A 296.200 WAC. <br />-- . // / '7 /U i // Lf �� <br />MECHANICAL <br />FEE NO. TVPE OF EOUIPMENT <br />AiC—AMNDLG UNITS—H.P. <br />; FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />' CLOTHE3 DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />; WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />� HEAT PUMP <br />� � GAS PIPING <br />SIDE SETOACN I PLAN <br />V�CANT SITE FEES <br />� � YES � NO gUiLUING <br />OLCcnANCY 40 OfDWIIINGWIrtS <br />aeour ALUMBING <br />9ASEMENT MECHANICAL <br />�-! YES C NO <br />HEIGNT LRAl14TION ADDITIONAL PLAN CHECN <br />_ OTHER <br />STATE BUILDINO SURCHARGE <br />CITY OF EVERETT NUOLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE 5 <br />FEE I RECEIPTNO. <br />I <br />�— — <br />i <br />