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APPLICATIQ"1 FOR CONSTRUCT'lN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT r <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259-8810 <br />DEMOLITION I! COMBINATlON � BUILDING I� MECHANICAL ❑ PLUMBING f_i SIGN <br />OWHER MAILAO�RESS // LITY ZIP Q.� PHONE <br />��f�l(:I��EI. NC�� J�3 /�CL/y1K'M"�/ r�✓' I���C�� /�$.�! ����—�� <br />TENANi MAILAODflESS "�— CITV 21P PMONE <br />ARCHIIECTORDESIGNER ldAl�qO�RE$5 <br />CONTqACiOR <br />RIML ADDRESS <br />IAECMANICAL WNiRaCTOR MAIL <br />PLUMBIYGCONTFACTOR MFILACDRESS <br />CONTPACT PPICE OF WORN <br />� ��� � <br />OESCR13E WORN AUD �tOUARE FOOTAGE INVOLVED <br />23��"x 13' <br />V.N IAiAI 41 ' n <br />PROPOSED USE OF OUIL NG <br />LEGAL OESGRIPTION OF PROPEFTV (SHOWN BELOW OF ATTACH TWO COPIES� <br />LOT BLOGN OF <br />PARCEI.TAXID <br />Y� ' .��_y "LI(/G -CC, <br />LENDER.ADDRESS.TELEPMO"4 NUMBER <br />PLUNBING <br />N0. i <br />WATER "LOSET <br />BATHTUB <br />LAVATORYIWAS <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />bACKFIOW PREVENTERS <br />ROOF DRAINS—RAINLEADEqS <br />SINK (SERVICE—BAF. ETC.1 <br />FOR OFFICE USE ONLY: <br />FRONTSE7��GN REARSETBAGK <br />�� l � � <br />❑SE 20N[ LOT �REA <br />D .— 7 <br />INTANE 0Y <br />SUB TOTAL $ <br />PERMIT S <br />TOTAL FEE S <br />FIRE SPRINNLERS REOD <br />FIFE AI.ARl.1 REOD <br />�-"-- <br />PLAN$ APPRpVEO BY <br />J�1 <br />�ti � <br />nnTe �i�5•�a <br />CITY T�p <br />CIiY 21P <br />CITY ZIP <br />CITY IiP <br />FEE <br />SI�E SETBAGK � <br />r <br />V�CANi SIiE <br />��:: YES ,_, NO <br />occ �u+cv xo a� oxtwxe uens <br />;_ 1 YES i i NO <br />NEIGHT LIMI iATIpN a <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />CONT�LT PERSON AND PHONE NO. <br />PNJNE STATE LICENSE R <br />PHONE $TATE LICENSE � <br />PNONE Si�iE LtGENSE t <br />i HEREBY CERTIFY THAT 1 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 COMPLETEU 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 IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PER ORM THE WORK FOR WHICH <br />APFLICATION IS MADE AND MPLY WITH THE STATE <br />CONTRACT RS LAyY18.2J W 6200 WAC. <br />� tiu� ��/,P/� g -l� - �Y <br />MECHANICAL <br />N0. TYPE OF <br />FORCED AIR SVSTEMS—B.T.U. M E.A. <br />UNITfIEATERS—B.T.U. M <br />CL(�THES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />!^!nOD STOVE <br />ME'AL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />HEAT PUMP <br />G�S PIPING <br />EXHAUST FAN <br />PLA4 C1�ECK NUAIBER <br />BUILUMt; <br />PLUMBING <br />MECHANICAL _ <br />ADDITIONAL PLAN CHECK <br />OTHEFi <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />FEE <br />SUB TOTAL S <br />PERMIT $ <br />TOTAI FEE $ <br />i <br />