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APPLICATIC ] FOR CONSTRUCT" 1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT <br />259-8810 <br />i.l DEMG'..ITION ��i fjp(g' <br />OWNEq R1qiLApDPE55 <br />1 <br />� r� �h r�> rhr�- . r� <br />i[N�NT MAILAppR[55 <br />���n n- — <br />�� <br />GENI[RALCONTNAC1OR MAILADDPESS <br />4el�,Mc+ CCY�S�IY I I c <br />IdFC��NICALCONTRqCiJR I,Iqi�ADOPESS <br />_l�; �n �I-cc� I ll� � l_9� <br />CONTRACT 'RICE O��OR� <br />DLSCRIBE WORK AND SOURRE FOOTAGE INVOLVED <br />HEATING SYSTEM: �/;� <br />)N BUILDING <br />CIiY <br />n `J4C�� mc�n--,u� <br />GiV � <br />arv <br />.�R/� <br />CITY <br />�-O�('U-e �-►'1 <br />CITY <br />. f ITV <br />�, � <br />�cL) i"c! <br />raoeoseouseoFeuamNe' � � <br />��� <br />t[GAL GESCRIPTION OF PROPERtt �SH014N BE�OW OR ATTACH TYO COPIE51 <br />lOi BLOCK OF <br />FAR�ELTA%ID NOMOER <br />NO. TYPE OF FIX' <br />�'Y WATEF CLOSET(TOI <br />'�.� BATHTUB <br />_ ? LAVATOFY(WASH BF <br />i SHOWER <br />� KITCHEN SINK 8 DI�I <br />�_ DISfiWASHER <br />LAUNDRYTRAY <br />I CLOTHES WASHER <br />URINAL <br />_ – DRINKWG FOUNTAIN <br />–� FLOOR DRAIN <br />– BACKFLOW PPEVEN" <br />_ ROOF DRAINS—RAIN <br />— SINK fSERVICE—RAR <br />NUMBER <br />_ , ,-. -, <br />SU8 TOTAL 5 <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FRONi�T�AGJ PEARSETBt�N _ � <br />�� �s <br />c C/ �jvJ <br />I1;Ei.ONE� ` LULAREa <br />i�PEOFCONSi NOAFSiORiES <br />�—� <br />SIZEOFpLOf FlRESFRitlKlEASF[0'D <br />?� Jf� eou <br />i�' s. `Z.un.:c O <br />OCCUPANCV LOAD FiRE 4LARA1 REOD <br />L9FYQ.�1 <br />iNiAVFf1v PLANSAPPqLLOVEDOV <br />�i� <br />onre S�/K/� <br />0 <br />Ll ELECTRIC!) �;;J <br />I MECHANICAL <br />ZIP FNONE <br />�ft �_. A.,��t <br />Z�P PNONE <br />I�P PNONE <br />❑ PLUMBING i � SIGN <br />ZIP PHONE ciqtE LICENS� R ZGy <br />1 �� SM'� � �C +�i -�l�'17 I `�`a'-� <br />�11P PHONE SiniE LICENSE n ����� <br />2��' PMONE STATELI�E`N� P <br />� �"e ) �.Ll �,�.�.�Q�.�'-7C� <br />GONiAGT PERSOY AND PHON[ NO. <br />n! �\ .� 11 <br />i HERFBV CERTIFY THAT I HAVE HFAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF LAWS AND OP,DINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITFI WHETHER SPECIFIED HEREIN OR <br />NOT. TF!E 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 PROPC(iTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />COIJTRACTORS LAW 18.27 RCIN AND 296.200 WAC. <br />x 1 '.�1/� ln �2�i�( ) � �' <br />s�a..,,r�-=---- o„E <br />crtvoasrvtssucv�str� <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />A%C—A/HNDLG UNITS—H.P. <br />FORCE� AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS �— <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER � <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACEINSERT <br />HFAT PUMP �— <br />GAS PIPING <br />/- EXHAUSlPAN <br />���•L'� � — <br />SID[SEiC�CN pLANCMEC NUM�ER <br />� , '�' c} � �. <br />vncnNr sire FEES <br />�� YES ❑ NO BUILDINc <br />occ�r.vcv i.00rmnwacu•,:s <br />ncaaco PLUMBING <br />J�-" � <br />CASEh1EN1 � <br />� � YES [/Np MECHANICAL <br />��EIGHT uMiil.TlpN A�DITIONAL PLAN CHECK <br />✓'� � <br />OTHER <br />STATE BWLDING SURf!I.^.:i3E <br />CITY OF EVERETT PUBLIC WORK3 <br />LOCAL SALES — <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAI S i /S' — <br />PERMIT $ <br />�. <br />