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APPLICATIC"-1 FOR CONSTRUCT'�lN PERMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />BUILDING DEPARTMENT � <br />2�9-8810 <br />� DEMOLITION 1 COMBINATION <br />aa�%� C / %�aooaes�s <br />. <br />OR DESiGNER <br />O <br />MAIL RDDFE55 <br />I�IAiL �DDI,'_SS <br />i'WdpINGCONiRACTOR IAAILADDRESS <br />CONTqqpT PRICE OF WOPH N <br />-� .� 3�?:S _ d <br />DESCFIBE 1 ORK AND SOUARE FOOTAGE INVOLVED <br />HEATING SYSTEM: J GAS J ELECTRIC J <br />PROBOS[D 115[ OP BUIL�ING <br />i CGAL OESCRIo7�ON OF PROPERTV �SHOW N BEL01Y OR ATTACH TWO COPIES� <br />LO1 �LOCK OF <br />r�•n/�� ,t qx i D. HUn+oEn <br />Y C C7 Zi� I L�C'J 3 �C� C7 <br />CONSTqUCT10N LO�N LENDf R. ADORESS. TEIEPMONE NUMOER <br />�r+vn whiY ( WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISH WASHER <br />LAUNDRYTRAY <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK ISERVICF—Rna Frr <br />SUB TOTAL S <br />PEHMIT 5 <br />_ TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONI�ETBACN <br />BUILDING MECHANICAL PLUMBING <br />Crtv ZiP_ PHONE <br />����u��� ����-��/ �sl s3s�5' <br />CIiY ZIP PHONE <br />CITV ZIP PHONE <br />7QTV LP PMONE�J���15TAtELILENSEi <br />�.3�/ �lb,�,s�, l,�-� .T1's;",Dr��c/I/ <br />Q Y Z�P PNONE STATE LICENSE v <br />��t� ZiP PHONE $TfTE LIC[NSE � <br />R <br />8 <br />tl <br />CONiACTPEF50NANOPHONENO. <br />SIGN <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WiLL BE COMPLETED WI7H WHETHER SPECIFIEU HEREIN OR <br />NOT. THE GRANTING OF A pERM1T 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 />PERFORA7qNCE OF CONSTRUCTION. THAT I AM AUTNORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMP�Y WITH THE STATE <br />CONTRACTORS LAW ;8.27 RCW AND 296200 WAC. <br />X ���i <br />.��-� 3 � � - 9�/ <br />sicrumm�i - nerz <br />CIiY0U5:N[SSUC1'S( 4p <br />TYPE OF EOUIPMENT FEE <br />A�C—A�HND�G UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOJE <br />METAL FIREPLACE (WOOD BURNING) � <br />71REPLACE INSERT � <br />HEA7PUMP <br />GAS PIPING , <br />EXHAUST FAN � <br />FEE <br />:S <br />S <br />• � FEARSETBACN EiDE5R9ACK PLANCME NlJnipER F[E qECEIPiNO <br />� ��/J//' <br />usezone LOTAREA vncnNrSiTe FEES VALUATION FEE <br />�. YES ,-; NO �� <br />i1P[OFCONS7 NO.OFSiORIES BUILUING �,`�1J �p� <br />ottw+ca neoroxtu�xcuuas — �� (_ <br />cac.;v <br />PLUMBING <br />SR[OFBLDG. FIFESPRINKlER5RE0'0 BASEM1IENT ---�-- <br />. YES . i NO MECHANICAL � <br />� <br />OCCUPANCVLOAD FlREALARMRE00 HEIGNiLI�1lTqilON A�DITIONALPLANCHECK <br />flEA50N - OTHER <br />STATE BUILDING SURCHAqGE i <br />IMnK[ BY C.J <br />PL�N.iAPPROVE00V CITY OF EVERETT pU�LIC WJflNS <br />LOCAL SALES <br />onv TAX CODE IS 3705 TOTAL 3� ; v� <br />