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APPLICATIC3;1 FOR CONSTRUCT-1N PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ � <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION �BUIL.DING ❑ MECHANICAL C; PLUMBING L.] SIGN <br />OW'1ER MRILAD�RESS CITV ZIP P40NE / <br />I,,, a C �/ j Z �`.1(` �I- C A1 �l Y: 4l 1- ,':r= k� �\ T`� c� ,� i:� :� 3'-�-� -1 `-/ �- (,. <br />NAIL <br />21P <br />ARCHITECTORDESIGNEF MAILAODRESS dTV ZIP FHONE <br />GENERAICONTRACTOR MAILAODRE55 CIiV ZIP PMONE STATELICENSEa <br />MEGHRNICAICONTRAC70R MAILA�09E55 <br />PLUMBINGCONTRACTOR MAILADDFESS <br />CITY ZIP PHONE <br />CITV ZIP P•HON3 <br />CONTRACT PRICE OF WORK <br />>�C�O � <br />DESCHIBE WORK AND SOUARE fOOTAGE INVOWED <br />3�c��_ -�+ o(e �.k�s <br />PROPOSED USE OF Bl11LDING <br />LEGAL DESCRIPTION OF PROPE RTV �SHOWN BELON OR ARACH N/O COPIES� <br />LOT � \ BLOCN (�I OF 1��� � I� �4-1F <br />(�c'� 3/ �\v�S i Ov� 2. <br />PaRCELTA�%ID� N�UMBER C 1 <br />� V t"i 1r l,, l P$� J C� U�c� Q,`—�_ <br />CONSTiUCTION LOAN LENDER. �1DDRE55, TELE� <br />PROdECT ADDHE S <br />1 t��3 ��,c � ��l-'�c ��J �. t� <br />^ PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (?OILET) <br />BATHTUB _ <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />� OR OFFICE USE ONLY: <br />FRONTSETBACK REARt <br />USE ZONE <br />ttPE OF GON51. <br />SIZE O� <br />S�, <br />OCCUPANCVLi <br />� <br />REASON <br />INTAKE BY <br />SUB TOTAL 5 <br />PERMIT $ <br />TOTAL FEE S <br />LOTAREA <br />NO OF STORIES <br />FIFE SPRINKLERS REO'D <br />� <br />FIPE ALARM REOD <br />�O <br />PLANS APPROV� BV <br />OATE ^7 �� �j�K <br />STATE LICENSE e <br />STATE LICENSE • <br />CONTACi PERSON AND PHONE NO <br />�v Grl C_c' S L�✓ <br />`�`J i -� �-I- �-! � <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAM�NED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEFNING THIS NPE OF <br />WORK WILL BE COMPLETED WITH WHET.-iER SPECIFIED HEREIN OR <br />NOT. TH[ GRANTING OF A PERMIT DOES NOT PRFSUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER ST�TE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296,200 WAC. <br />�( �i <br />� l /� .� �-I � � �- �i �� � <br />MECHANICAL <br />10. TVPE OF EOUIPMENT <br />FORCED AIR SYSTEMS-8 <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS _ <br />VENTILATION FAN <br />RANGEHOOD <br />� WOODSTOVE <br />METAL FIREPLACE i <br />; FIREPLACE INSERT <br />� HEAT PUMP <br />' GAS PIPING <br />� EXHAUSTFAN <br />SIDE SETBACK � PLAN CHECN NUMBER <br />\'ACANTSITE � 1'CC, <br />� vEs � No gUILDING <br />a:ar�ncr xa ovovrtuix;�ans <br />Jf�a'n° 1 PWMBING <br />��� <br />BnSEMEr+T �� M[CHANICAL <br />_] YES L�S NO <br />HEIGHTLIMITATION ADDITIONALPLANCHECK <br />�' <br />OTHER <br />STA7E DUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WOfiKS <br />LOCALSALES <br />TAX CODE IS 3105 rorn� <br />E.A. <br />SUBI�OTAL S <br />PERMIT S <br />TOTALFEC $ <br />� <br />n <br />� <br />