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A,pPLICATI�)� FOR CONSYRUCT�W pERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />ihe Ever9rnen <br />CITY OF <br />everett � <br />BUILDING DEPARTMENT <br />259-8870 -- --• <br />i�ARCMITE OtiOESIGNER <br />GEHERALCONiRACTOR <br />MELHANICALCONTRAriOF <br />.I NEW f �I ADDITION <br />MAIL AODRESS <br />sc, �.-7 e <br />MpIL ADDriE55 <br />MAIL <br />AODPESS <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />i_i BUILDING !�MECHANICAL i:'.PLUMBING <br />CITY 71P o(p ,�� PHONE �f��0 � <br />CITV <br />an <br />CITY <br />ALTERATION .�. REPAIFi I. I DEMOLITION <br />� CONTA 1 <br />���_ l ��� � �1 <br />L�� � � � v��r � <br />LEGAL UESGRIPT� N OF PROPERTY ($HJWN 9ELOW OR <br />LOT ��OCK OF _ <br />;raooaE � <br />/ � % ' r . .E �v' <br />UMBING <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN _ <br />FLOOR DRAIPI <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—fiAINLEADF <br />SINK (SERVICE—BAR. ET0.) <br />ar <br />21P <br />21P <br />PMONE LICENSEp <br />PHOYE LIGENSE � <br />! SIGN <br />�U��� Hp�/ f?� 3 LICENSE a <br />/ tJ �r��sra �issar <br />.��, WOODSTOVEIFRPL INSERT �_I BUILDING RELOCATION <br />)N / / �N rN..._ .' .1`i /` L� A � 1 l__ <br />/�-i". i7 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />Foua coPtes� PROVISIONS OF LAWS AND ORDINANCE� GOVERN�NG THIS TYPF OF <br />WORK WILL BE COMPLETED WITH WHE"IiiFR SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PR�SUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW FlEGULATING GONSTHUCTION OR THE <br />PERFORMAIJCE Of CONSTRUCTION. THAT I AM AUTHORRED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH <br />APPLICATION IS RiADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 29G.200 WAC. <br />SIGNATUREOPCONTRACTORORA THOFIZEDAGENT DATE <br />X l� .i �/ � <br />% �u� " , <br />// / —.— <br />s,� APPLICANTSC 9USINESSLICENSENO.ANDBUSIu[SSNn6�[ <br />SUBTOTAL 5 <br />PERMIT 5 <br />TOTALFEE 5 <br />FOR OFf=10E USE ONI_Y: <br />FRqry75ET��CK AEARSETBACH <br />USE ZCNF LOT AREA <br />iVPkOFCOtR5.ALL0YJABlE 7YPEOFCONSi.ALIDAL <br />SIZE OF BLOG NO.Of STOPIEfi <br />OCCUPANCY LOAD FIRE SPRNNLEFS FEO'0 <br />REASON FOR SPR'VNLERS <br />INTAKE�Y PLANSAPPROVEUBV <br />NO. TYPE OF EQUIPMENT <br />AI�FVHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />� CLOTHES DRYERS <br />' VENTILATION FAN <br />�— RANGEHOOD <br />� WATER HEATER <br />� WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />. FIREPLACE INSERT <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL S O � <br />PERMIT 5 .f� � <br />TOTAL FEE 5 yf ;_ <br />CNECKNUMBER � FEE I RECEiPTNC. <br />VACANT SI*E �CCa <br />OUILDING <br />OCGt1FA4LY HO OfpWELLi�,G11NiI5 <br />cAouo PLUMBING <br />BASErAENi NECHANICAL <br />HEIGHTLIfA1TATION ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING Sl1RCHARGE <br />CITY Of EVERETT PUBL.IC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />