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OLIN, <br />amu <br />APPLICATION FOR CONSTRUCT ON PERMIT <br />TO BE COMPLETED IN BLACK INK --PLEASE PRINT <br />HEATING SYSTEM U GAS U ELECTRIC <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />(1syMp T MAIL ADDRESS CITY 21P PHONE <br />.-... YIP 1I1 GSS CITY ZIP PHONE <br />LASS OF WORK J ni mnM WnnnSTnVFIFRPL INSERT <br />BUILDING RELOCATION <br />NEW I AUUIIIVn . <br />�7� <br />3 <br />COt CT PERSO! AN HONE NO <br />CONTRACT PRICE OF WORK O `� <br />DESCRIBE WORK AND SOVARE FOOTAGE INVOLVED <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED USE OF BUILDING <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACHFWN COPIES( <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />MADE AND I COMPLY WITH THE STATE <br />W 18.27 RCW AND 296.200 WAC. <br />MACT <br />OAII <br />CSS / <br />PLUMBING <br />MEANICAL <br />MECHANICAL <br />FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />WATER CLOSET (TOILET) <br />AIC—AMNDLG UNITS—H. P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />; <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />' <br />CLOTHES DRYERS <br />SHOWER <br />VENI ILATION FAN <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />' <br />METAL FIREPLACE & CHIMNEY <br />URINAL <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />— <br />i <br />SUB TOTAL $ <br />SUB TOTAL $ <br />' <br />SS <br />PERMIT $ <br />PERMIT $ <br />TOTALFEE $ <br />TOTAL FEE $ <br />' <br />rum urrwc uac <br />VVILG <br />FEE <br />RECEIPT NO. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CIICLK NUMBER <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />MEDF LDNiS.ALLOWABIE <br />TYPE OF CONST A6TUAL <br />pG(yPANLY <br />NB UINttwxc UNlrs <br />GAWP <br />PLUMBING <br />1 <br />MECHANICAL <br />' <br />SIZE OF BLDG. <br />NO OF STORIES <br />BASEMENT <br />ADDITIONAL PLAN CHECK <br />i <br />I <br />OCCUPANCY LOAD FIRE SPRNKLERS RED HEIGHT LIMITATION <br />I <br />SPRINKLER <br />i <br />STATE BUILDING SURCHARGE <br />I <br />REASON FOR SPRINKLERS <br />PUBLICWORKS <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EEVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />1 <br />