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APPLICATIQ'"1 FOR CONSTRUCT' 1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: ❑ GAS U ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION L}(BUILDING f�ECHANICAL D�LUMBING f� SIGN <br />PMONE <br />OWNEP � MAILADORF55 CITY 21P e�ap�(� ��_`^2��� <br />-�'-v4t�cun„�f-� ,,,g.i_'"�N� Z14o7�-1��'�A,.F 1r,�`f3w.e+-tis�-'� <br />TE pNT MAILADORE55 <br />CITV ZIP PHONE <br />��ni �_ <br />pRGNRECTORDE5IGNER MAILAODRESS CITY 21P PHONE <br />��s�� � �-c� � 3`�3-6531 _ <br />GEN�ERRL •CONiRAQOR J M/RIL AODRESSy CiTY�Lt 2�Fn � 8 03 � PMONE� �s �SiATE LICENSE <br />�F-�f41K1A1.Y�T'�� '�'�`� y�CLUi �a1•21�}1��fr�Y'jIL-C�U-� J�� `��LICENSE~I�(�'��l�, <br />:TOR - M1�IL q00RE55 <br />� rf�t nT ___ N+ REsS <br />N�l.�c�Gi-1pc*� I � <br />WOPK <br />�\ <br />SOUARE FOOTr1GE INVOLVED, <br />_.- sz��.��._v <br />PROPOSE lISEOiBUIL�ING <br />Ce,.r�,, k� -+r4�...� �� <br />LEGALDESCRIPTIONOFPROPERttISHOWN _ 01 <br />LOT--K- BLOGK OF <br />PARGELTAXI.D.NUMBER <br />GONSTRUCTIONLORNLENDEF.AD�' � <br />s,"hhN �.v Wl � <br />PROJECT ADDNESS �... <br />SINK 8 <br />TRAY <br />p�- <br />ATTACN <br />FOR OFFICE USE ONLY: <br />FRONTSETBALK REARSETBALK SIDE <br />USE <br />TVPE Of CONST. <br />�Z]U <br />SIZE OF BLDG <br />CITY <br />-S N <br />cirv <br />v� <br />Lu0 <br />Q <br />CONTACT PERSON AN� PHONE NO. <br />a <br />i HEREBY CERTIFY THAT I 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 COMPLETED WITH WHEtHER SPECIFIED HEREIN OR <br />�IOT. THE 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 PROPERTY TO PERFOHM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />rnN7a/iCTORS LAW 78.27 FiCW AND 296.200 WAC. <br />l ��� <br />sc o��c <br />UiYBUS�� SU SCNO <br />MECHAN CAL <br />�p, TYPE OF EUUIPMENT <br />NC—A/HNDLG UNITS—H.P. <br />FORCED AIR SVSTEMS—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 />METAI FIREPLACE (WOOD BURNING) <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />i E%HAUSTFAN <br />LOT AREA VACANT SIIE <br />;-� YES -: NO BUILDING <br />NO.OFSTOtilES tttun>�,[r �o0�m51w'.uuvil5 <br />2 c�av / PLUMBING <br />� <br />FIRESPRINKLERSPGO'0 BRSEMENT MECHANICAI. <br />��i� �- YES k� NO <br />FIFE ALAR�d FEOD MEIGHTLIM�TATION <br />ADDITIONAL PLAN CHECK <br />y�iL� OTHER <br />�� C��j [r'�//.� IO STATE BUILOING SUflCHARGE <br />PLANS APP�10VE0 BY CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />o�te �i�%�I94' TAX CODE IS 3105 TOTAL <br />SUB <br />1=%i � � U� "> <br />