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APPLICATIC�] FOR CONSTRUCTiN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />FiEATING SYSTEM: U GAS 0 ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259•8810 <br />C DEMOLITION ❑ COMBINATION �UILDING [-7 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILADDRESS GTY 21P PHONE <br />Aw;a s�v�+.so�✓ ��is �MK�:�� ��•�r s�x�3 3stir-nss9 <br />TENANT MAILAD�RESS CITV 21P PNONE <br />ARCHITECTURCESIGNER MRILPDDtiE55 CRY '_I^ PNONE <br />GENERALCONTRACTOR MAILAD�RESS CITY ZIP PMONE STATELICENSEt <br />�;: � �,�w.ir,ss .T.rC b�b l.�«�,tL�•r �i/raEO` g8�o/ �s��.i// ��'i'FGZaBd� <br />MECHANICAI,CONTRACTOH MAILAODRESS CITV ZIP PHONE S�ATEUCENSE• <br />PIUMBING CONTRACTOR M�I� ADDRE55 GITV ZIP PHONE STFTE UGENSE � <br />CONTRACT PRICE OF WORN <br />/ 11�- Z - <br />OESCHIBE WOPK AND S�UARE FOOTAGE I VOLVED CONT PEF� N AND PHONE NO� ��—, ,/ <br />OifY �O_ f� /►G�t% �TQ�i � <br />� PflOPO5E0 USE OF BUIL�ING <br />' LEGRLDESCRIPTIONOFPFOPERTY�SMOWNBELOWOflATTACMTWOCOPIES) <br />� LOT 37 BLOCK OF �/� �I� <br />� PARGELTA%ID.NOMBER <br />� 1�/7�/�000 — <br />CONSTRUCTION LOAN LENOER. A <br />' PROJECTADDR'c33 <br />N0. TYPE OF FlxTi <br />WATER CLOSET (TOIL <br />BATHTUB <br />LAVATORY (WASH BA: <br />a'HOWER <br />KITCHEN S�NK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />UfiINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENI <br />ROOF DRAINS–RAIN <br />SINK (SERVICE-8AR <br />TELEPNONENUMBEF <br />FOR OFFICE USE ONLY: <br />FRONTSETB�CK REARSETI <br />� y � <br />USEZONE LOTAREA <br />-S �L 3S <br />TYPE OF CONST NO OF SP <br />� <br />� <br />PERMIT $ <br />TOTAL FEE $ <br />SIZE OF BLDC. FIPE SPRINKLERS REO'0 <br />sf <br />nCCtIPANCv LOAO FlFE ALAFM PEO'� <br />� IIEREBY 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 TNIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETH'cR SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO G�VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW flEGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TIiE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I� �MPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />FEE NO. TYPE OF E�UIPMENT <br />� fv�/VHNDLU UNITS–H.P. <br />� FORCEDAIRSYSTEMF,—B.T.II. M E.A. <br />—r UNIT HEATEPS–B.T.U. M <br />� CLOTHES DRYEflS <br />' VENTILATION FAN <br />� RANGEHOOD <br />WOOD STOVE <br />METAL FIREPLACE � <br />�IREPLACE INSERT <br />HEAT PUMP <br />GAS P�PING <br />EXHAUSTFAN <br />S�DE SETBACK PLAN CME�I NUMB , FEE <br />7.5'd-/5 M 6,� j <br />vncnNr sire FEES <br />�1 YES �, NO BUILDING <br />acuoevcv xaarnv[wxcurv�rs <br />�^�1P PLUMBING <br />BnSEMENI' �� MECHANICAL <br />❑ YES f'.'NO <br />NEIGHT LIMITATION ADDITIONAL PLAN CHECK <br />� , <br />OTHER <br />STATE BUILDING SURCHARGE <br />PERMIT <br />TOTAL! <br />$ <br />$ <br />� <br />� <br />� <br />H <br />INIAKE BY PLANS APPRQV�Y CITY OF EVERETT PUBUC WORK$ `�f <br />V � LOCAL SALES � <br />onre TAX COOE IS 3105 TOTAL ,�% �� <br />3�ig <br />�=� <br />:1. <br />