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APPLICATIO�. FOR CONSTRUCTI N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDWG DEPARTMENT hEATING SYSTEM: J GAS J ElEC7RIC J 1 <br />259-8810 <br />;�EMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />ARGMIiECi OP <br />IdAIL �DDRESS <br />MAII AODPESS <br />mLCnumcniWrv�HnGiON MAI�ADDRE55 <br />GIUMBINGCONTR�CTOR MAILq�DFE55 <br />COuiPAGT PRICE OF WORN <br />DESCRIBE WOBK FND SOUARE FOOTpGE iNVOLVEO <br />QTY <br />�� <br />CIiV <br />an <br />QiV <br />PNOPOSEO USE OF BUROING <br />I[G4L D[SCRIPTION OF Pq01'ERTY �SHOWN BEIOW OR ATiACH T WO COPIE9 <br />L01 — BLOGK OF — <br />rnqrf�rnrlDr� BFa <br />/�o_;�� a/� o00 � <br />COh5ifi11CiiON LO�N LEND[4 ApORE55, T[l[PHONE NUMBEF <br />PROJECTADDRESS �L <br />99r�i� �! %P u� <br />NO. TVPE OF <br />WATER CLOSET <br />BATHTUB <br />LAVATORY�WASI <br />SHOWER <br />KI?CHEN SINK 8 <br />UISHWASHER <br />LAUNDRV TfiAY <br />Cl0'HES WASHI <br />URINAL <br />D(iINKING FOUY� <br />FLOOR DRAIN <br />BACKFLOW PRE� <br />ROO� DRAINS—I <br />SINK (SERVICE- <br />6Y�I:1N]F_11 <br />FOR OFFICE USE ONIY: <br />F�ONTS[iBACN qEARSETHACN <br />US[20NE LOtAREA <br />iYPE OF GONSI NOAF STOPIES <br />SiZE OF 9LOG. FlRE SPFINKLEflS REOD <br />OCCUPANCV�OAD FlREALARMREOD <br />R[ASpN <br />WTANE9Y PLANSAPPROVEDBV <br />Df.TE <br />GTY <br />CITY <br />ZIP <br />IIP <br />21P <br />jIP <br />GONTACT PERSON nN� PMON[ NO <br />STAtE �ICENSE e <br />STAi[ I�CENSE � <br />SiATE L�C[NS[ � <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINE� THIS <br />APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORflECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WIIL BE COMPLETED WITN WHE?HEF SPEqFIED HEREIN OR <br />NOT. THE GRANTING OF A P[RMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLAiE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW P.EGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH TNE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Y/ l L �.a-./�'/�t-�: � i�_ . l v�A/ Li Z <br />cin nus�v[ ss � �cr rv�v.o <br />MECHANICAL <br />NO. TYPE OF E�UIPMEN� <br />AiC AMRDLG UNITS—H.P. <br />FORCED AIR SVSTFMS—B T.U. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />FANGENOOD <br />WATEN HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BUF <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />� EXHAUSTFAN <br />SIDES[T9ACK PL�NGHEGM/��U�ABE� FEE <br />r b <br />vncar�r sirE FEES <br />� YES NO BUILDING <br />a[cwwa �.on�w.��..��.�e•�.is <br />scaim <br />PLUAIBING <br />BnSE�dEr�i MECNANICAL <br />YES NO <br />HEIGNi �nartanON ADDITIONAL PLAN CHECK <br />O7HER <br />STATE BUILDING SURCHAHGE <br />CITY OF EVERETT Pl1BLIC WOFNS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOiAL S <br />PERMIT $ <br />TOTALFEE 5 <br />FECEiPi ND <br />