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APPLICATIC � FOR CONSTRUCT. N PERIIAIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: 29 GAS J ELECTRIC J —� <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION X BUILDING �j�MECHANICAL XPLUMBING SIGN <br />OIYNEF Id41LAD�PE55 CITV ZIP PHONE <br />i�1�2�wo..� , Z�oz-7i0'�r1vE�y r"�•c.� aeo3_c� 354�435" <br />TENANi ^ fAILAODq[55 CILY 21P PHONE <br />�auc.�-, Ti��..�•.�+e 2�5ot-3G�' �4✓P.u.,. �a.�, 40o'9c �55c.-2435 <br />MCHrt[CTORDES�GNER� h�IIApDRE55 CItV ZiP PMONE <br />D�si� t-��s� �'�r 353-a53� _ <br />GENEFALCCNTPALiOR MAILF�DRESS CITY 21P FM04[ STATEIICLNSE• <br />�tuawt�w3t�0i+ S�NN.-219D2-3a� �JE.w..i��c� 40oiv 35�-�4jS" FA�xwtFi.T^��T� <br />MECHANIC�LCONiRFCTOR MAILADORESS QTY P PHONE SIATEULENSE• <br />�A�SL'N-4" -1N6- SNp �j�S4-'�4111 <br />PWM�INGCONTRACTOR MMLApDRESS CITY ZIP PHONE STATELICENSE� <br />� . w . � . �" __ ._ �f��i—O�ILb <br />CONTPdGT PRILE OF VlOW( <br />� � <br />OESCf.IBE N'ORN ANO SOUAI <br />PROPOS[� U5G OF <br />INVOLVED <br />l[G�1L DESLRIPTIQN OF PROPEPTV I�NOWN BEIUW OR ATTACH TWO COPIES� <br />LOT�� 'c ����� <br />— BLOCH —1�— OF 1�+=N Q� <br />L.� W�ya_ _ <br />P4RLELT�%IO.NUTA6F.R <br />5oo3-�c��5- <br />CONSiRUGT10N LOAN IENDER., <br />PROJECTADDRESS <br />J�/�c�- <br />PLUMBING <br />1- Ooo"S <br />iS.TEIEPHONENUMB[R <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATpRY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDFYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FIOOR DRAIN <br />�ACKFLOW PREVENTERS <br />ROOF ORAINS—RAINIEAC <br />SINK (SERVICE—BAR. ETC <br />FOR OFFICE USE ONLY: <br />FPONTSEiOACN F[FRS[TB/CK <br />28 � 2-� � <br />USE ZO LOT AfiEA <br />�"z- �yo <br />fYP[OFCC4Li. NOAFSTORIES <br />� � <br />SRE OF BtDG FlRE SPRIYNLEPS fiC�D <br />�� h�� <br />OLCUPANCVLOAD FlREALAFA!RE00 <br />5z Y�� <br />PE4504 <br />INTAHE BY I PLANS APPROV[� BY <br />OnT[ <br />)TAL 5 <br />f 5 � <br />FEE 5 <br />sioe serencrc <br />S� <br />VACANi SItE <br />YES NO <br />OSb'rnsCr .)J��6tu+.;u:6 <br />,api y/_ � <br />!Jf_�_ <br />BAS[MENT <br />,- �, VES �NO <br />HEiGNT LIMITATION <br />Z9� <br />I]�Y/ OVC�1`� �� <br />CITY pF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />C0�1TlCT PERSON AND PMONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORflECT. ALL <br />PROVISIONS OF LAWS AND OFiDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WlThl WHETHER SPECIrIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM[ TO GIVE <br />AIITYORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHEFi STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PER�ORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />ON'NER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />�� �'LICATION IS MADE AND I COMPLY WITH THE STATE <br />�. .TRACTORS LAW 1827 RCW AND 296.200 WAC. <br />FOFCED AIR SY: <br />UNIT HEATERS— <br />CLOTHES DRYEI <br />VENTILATION FA <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPIA� <br />FIREPLACE INSE <br />HEAT PI1MP <br />GAS PIPING <br />EXHAUSTFAN <br />r��x-y <br />BUILDING 'J:j�L{/,fJ <br />_—�_��1Lv <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />Pl1�LIC WORKS <br />TO7AL <br />M <br />_c��� 14�__ -_ <br />T.U. M E.A. <br />PERMIT <br />TOTALFEE <br />'— 7 <br />� <br />