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APPLICATIC l FOR CONSTRUC4 )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM� ' GAS ;J ELECTRIC ❑ I <br /> BUILDING DEPARTMENT '— <br /> 259-8810 <br /> DEMOLITION I COMBINATION BUILDING h1ECHANICAL PLUMBING u SIGN <br /> /MAIL A?DDRE55 / �,/ PHONE ��'� �� <br /> o�/ a /1 �t�( ��'/v� ?�),e� !J`-�/1��� f74 Z��/LC�G� PM�.�'�� c��?_�r> >� <br /> T NANT(^^ IAAIL ADORE55 QTY Z P <br /> !� /�" ,� PNONE <br /> nPCH11ECTORDE5IGNER MPILADDRESS GITY ZIP <br /> GENCRAL � WN�Y����1 � LITY ZIPn I , PMOM1E / STA/TELICENSE� � � <br /> �� AIL CITY ZIOC.J�' / ��UF �A(J��///i�ENSE . <br /> I,!ECHnNIC F � L 5 <br /> s�rnF, w� �i99 <br /> �iTy ZIP PNONE STATE LICENSE r <br /> PWMBINGCONTRAf.TOq MAILADDRES$ <br /> f 4iRAGTPRIGEOFWORK �� � � <br /> DESC IBE W RK AND SOl1ARE FOOTAGE NVOLVED CONTACT PERSON AND PHONE NOGEU� � � I <br /> L <br /> � �f � �r <br /> �G� I HEREBV CERTIFY THAT I HAVE READ AND EXAIdINEO THIS <br /> PROPOSEDUSEOF BUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCRIPTIONOFPROPERTYISHONT18ElOW�RATTACHTNOCOPIES� NOR THELGP�V�NG OF A PERMITyDOES NOT PRIESUME TO GOE <br /> LOT — BIOCN o� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHEFi STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> _ �\ PERFOR�7ANCE OF CONSTRUCTION.THAT I AL�AUTHORIZED BY THE <br /> � v OWNER OF THIS PROPERTY i0 PERFOR THE WORK FOR WHICH <br /> '-' APPLICATION IS MA AND I Y WITH THE STATE <br /> nnace�rna i o.r+uraaea CONTRACTORS LAW .27 RCW 96. 0 WAC. <br /> � <br /> CONSTRlICT10N LOAN LENDER.AD�fiESS.TELEPMONE NUMDER <br /> s�cr+>run[ oeit <br /> PROJECTADDRESS - —�- <br /> env eusiuess ucr ase r+o <br /> PLUMBING MECFiANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. A'C—aH DLG OF g UH P ENT <br /> FEE <br /> WATER CLOSET(t01LET) , FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> BATHTUB ' <br /> LAVATORY(WASH 9ASIN� � UNIT HEATEFS—B.T.U. M <br /> — � CLOTHESDRYERS <br /> SHOW ER � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRYTRAY <br /> WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> METAL FIFEPLACE(WOOD BURNING) <br /> URINAL <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,FTC.) <br /> �i�/ � <br /> � <br /> � <br /> � <br /> SUB TOTAL S SUB TOTAL S � <br /> PERMIT 5 PERMIT 5 � <br /> TOTAL FEE � <br /> TOTAL FEE S <br /> FOR OFFICE USE ONLY: aeceirr No <br /> P�ANGHE��UM�i� FEE <br /> FRONTSETBACK REAP$ETBACN $IDESET�4GN / <br /> i� <br /> — vncnr+t srce FEES VALUATION FEE <br /> CSG20NE IOTARE� <br /> �,-' YES N� BUILDIrvG <br /> iYPE OF C0115i NO.OF STORIES OGcunp�t� x0 or rnvnwaun'�5 i <br /> �°JpP PLUMBING <br /> i <br /> SIZEOFBLDG. FIRESPRINNLERSFEO'D 9ASEMFNT MECHANICAL <br /> : VES NO <br /> OCWPANCVLOAD FIREALARMREOD MEIGHTLIMITAiION <br /> ADDITIONAL PLAN CHECK _ <br /> OTHER __T_ <br /> aEnSON S7AiE BUILDING�URCHAf7GE <br /> INTANE BV PLPNS APPROVED BV CiTY OF EVERETT PUBI.IC WORKS I <br /> LOCAL SALES <br /> DATE <br /> TAX CODE IS 3105 TOTAL <br />