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APPLICATIO_. FOR CONSTRUCT: jN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />HEATING SYSTEM: A GAS ❑ ELECTRIC U . --� <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION 1. COMBINATION ❑ BUILDING Ll MECHANICAL Li PLUMBING SIGN <br />' It o A /J tcc+FF ia1FT r-7Yc) zgXv rt A4). z19- As';c <br />TENANT MAE A�DOaRE35 CITY LP PNONE <br />ARCNITECTORDESIGNER MAEADDRESS CITY ZIP PHONE <br />OENEPALLpITMCTOR LIALADMiE55 CITY ZIP PNONE STATELICENSE• — <br />IA[CNANCAL CONTRACTOR MAEADORESS CITY ZIP PIgNE STAIELCENSEF <br />!GE r T s� /+�eitn.\lz i � /'Aesovdr �8 F'T 98z�/ Liyonoo� <br />PIUMBINDCONIRKTOP 1MBADOF1E55 CRY PP FIgNC S1ATC LICENSE <br />CWTMCTPRICEOFYlUR" <br />DESCRBE NCRF AND S ARE FOOIAGEPo VED <br />CONTACT PERSON AND PRONE NO <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 ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING 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 />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW I8.27 RCW AND 296.200 WAC. <br />PPorosEOISE OF euaoaljy <br />5 /L <br />LEGAL DESLPIPTXN1a PI RTY15NO IEELMORATTACH iN'O CCPIESI <br />LOr BLOCK OF <br />PARCEL TAX I D NUMBER <br />'r <br />CDNSTRUCTgIILOAN LENDER. ADDRESS. TELEPI 'NUMBEN <br />PROJECT ADDRESS <br />i -7,4 Y -x fid <br />mTo <br />KI NSFM <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC—A'HNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-8.111. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />' <br />Y <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 OISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEAOERS <br />--T <br />EXHAUST FAN <br />SINK (SERVICE -BAR. ETC.) <br />SUBTOTAL 5 <br />SUBTOTAL S <br />D ' <br />PERMITS <br />PERMIT 5 <br />�S <br />TOTAL FEE 4 <br />TOTAL FEE S <br />S ' <br />FOF nFF1(:F NSF ONLY! <br />FRONT SEIBACA <br />IIEAPSETBACX <br />BOE SETBACX <br />RRICNEC ^^NUMCMBER <br />�W <br />FEE <br />RILIIWNO <br />USEANE <br />LOI AREA <br />VACANT SEE <br />❑ YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />amtDwG <br />PLUMBING <br />Fm A CCN51 <br />NJ Of STOPES <br />0.0MY. AO V PADlA4 W M1 <br />FAO) <br />52S OF BOO <br />FIRE 6MITYllEPS REQp <br />BASEMEM <br />❑ YES ❑ NO <br />MECHANICAL <br />/-'+-'—• <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE ALARMREO➢ <br />HEIGHT UMEIATIGN <br />OTHER <br />REASCN <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PL ANS AI'euCP[O By <br />oAn. <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLICWORKS <br />TOTAL <br />