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APPLICATIC"��1 FOR CONSTRUCT� )N PERMIT �✓� <br />TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br />BUILDWG DEPARTMENT L- <br />259-8810 <br />OEMOUTION ' COMBINATION <br />ov+NEa _ _Mnannontss <br />iLNANT I,IAILAD�PE55 <br />SA/vl� <br />AHCHITECTORDf51GNER 61NLq00R[55 <br />I�/ C �T <br />GEN[RALCONTR�CTOR MAILADDFE55 <br />`.IECN�NICALCONTqACiJR 61NLAOORESS <br />PINABINGCCNiRqC10R ldA1LA0�RE55 <br />H[ATING SYSTEM: J GAS J ELECTRIC , <br />BUILDING MECHANICAL 1/i�LUMBING <br />cnv ir r��uN[ <br />��.�d, i�� ��3 z-s"�- io7o <br />GTV <br />��T� <br />CIiV <br />� CIIY <br />���• � <br />DCSCRIBE 1YOPK AND SOU�RE FOOiAGE INVOLVED <br />/,i/.sT/i�� /�i � or� �hZs �/�2 <br />� Z Oi�OT �5 <br />PRUPOSED US[ Of Bl11LDING <br />LEGAL DESCR�PTION OF PROPERTY �SHOWN BEIOW OR A1iACM TWO COPIES� <br />LOT OIOGK — OF <br />rnnce� Tnz i o r+un�oer+ <br />,sas� o�e-� <br />CONSiRUG1lON IOFN lENOER. �D�RE55. � <br />PROJECTADDRESS • <br />��i�� ��%ii�i��./L./YL <br />PIUMBING <br />NO. TYPE OF FI%TUF <br />s <br />LAV�TORV�WASH BASIN) <br />SHON'ER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY�iRAY <br />CLOTliES WASHER <br />URINAL <br />DRINKING FOUNTAIY <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FOR OFFICE USE ONLY: <br />FRONTSETdFLN REARSET9ACK <br />USE20NE LOT�REA <br />1VPE Of CON51 NOAP STORIE: <br />SIZE OF BLC`G <br />OCCUPANCVLOA� <br />REFSON <br />INTAA� pY <br />SUB <br />PIPE SPRINKLERS REOD <br />FlliE ALARM REO � <br />onre <br />LVL:P1/b�1W1 <br />�� <br />FEE <br />S <br />5 <br />SIDE SETOACK <br />0 <br />vnurve <br />Z�P PHONE <br />Z�P PHONE STATELICENSEv <br />ZIP PHON[ STFiELICENSE/ <br />Z�P PHONE STATE L�CENSE � <br />CONTACT PERSON AND PMONE NO <br />SIGN <br />i HEREBV 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 P[RMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OH CANCEL THE PROVISIONS OF ANY <br />OTHER ST�TE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFOR�IANCE OF CUNSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICN <br />APPLICATION IS MADE AND I COMPI.Y WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />����'�,���� �-�� 9� <br />s�ar:arun,_ n,�[ <br />CIiY 1iV51NC5511� l Y'.: IiJ <br />MECHANICAL <br />N0. TVPE OF EOUIPMENT FEE <br />AiC—A�HNDLG UNITS—HP. i <br />FORCED AIR SVSTEMS-6.T.U. M E.A. <br />UNIT HEATEFS—B.T.U. M <br />GLOTHES DRYERS ,j/,Z� <br />_ VENTILATION FAN <br />RANGE HOOD ---�— <br />/ WATER HEA?ER <br />WOODSTOVE <br />M1IETAL FIREPLACE IWOOD BURNINGI � <br />�GAS PIPING <br />EXHAUSTFAN <br />SUDTOTAL 5 <br />PERMIT S <br />TOTAL FEE 5 <br />NUI.:O[R � ICE � RECEIPiNO <br />vacnrur sirE FEES <br />� YES .., NO BUILDING <br />MNn;,:ry �AN�N6Li•F,uV95 <br />' "- PLUMBING <br />�ASEldENi MELHANICAL <br />�- YES �.-'� NO <br />HEiGHT UMiTnTION A�DITIONAL PLAN CHECK <br />OTHER <br />STATE �UILOING SUHCHARGF <br />CITY OF EVERETT PUBLIC WOflKS <br />LOCALSALES <br />TAX CODE IS 3105 TO7AL <br />�X <br />np <br />Nn <br />Yu <br />n <br />�y <br />9 <br />