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APPLICATIC�h FOR CONSTRUC7'�N PERMIT � <br />TO BE COMPLETED IN SLACK INK—PLEASE PRINT <br />( HFATING SYSTEM: � GAS _] ELEGTRIC ❑ <br />BUILDING DEPi+RTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING xM�CHANICAL `.1�PLUMBING SIGN <br />Q�yryEq MAR AUJRE55 GTV ZiP PHONE <br />S�tC�\\ �\\C`C �U V ��"C����1. i�\�t� � V r�' ' � � �� �� � �7 -.�� - � �3 7 <br />TENI.NT MAiL FODR[55 —Z� CITV IIP PHONE <br />�_�� � <br />qRGNREGT OR DESIGNER MAIL ADORE55 CITY ZIP PHONE <br />MPIL <br />V'� � l'. A'i��CG <br />LGNTRAGTOR MAIL <br />� <br />CIiY "' <br />� �. T <br />21P <br />Y <br />PLUMBING CONTPALiOR MnIL ADDRESS CIT' 2iP PNONE SiRTE LICENSE • <br />LLA55OF WORK <br />'� NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE;FRPLINSERT <br />I CONTACT PERSON FNO PMONE N0. <br />CONiRAGT PPICE Oi WORN \'` `n \'t ��1 V t�T U <br />DESCRIBE WORK AND SOUI.RE FOOTAGE INVOLVED <br />��.ox ILGc� `'ae4��. <br />PHOPOSED USE OF BU�l01NG ; <br />LEGAL DESCRIPT161tl bF PROPERTY <br />LOi BLOCH _ <br />RDDRE55 <br />t.��h �l \' <br />WATER CL03ET <br />BATHTUB <br />LAVATORV(WAS <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRY TRAY <br />DRAIN <br />uF <br />FOR OFFICE USE ONLY: <br />FRONTSETBALK PEARSETBAGK <br />USEIONE LOTAREA <br />iVPEOFCONiSALIOWPBIE 1YPEOiCON5i.A1 <br />FOUR COPIES� <br />SUBTOTAL S I <br />PERMIT $ f � <br />TOTAL FEE $ L <br />� SIOE SETBACN <br />SIZE OF BLDG. FO.Of STJRIES <br />OCCUPANCVLORO FlRE::PPNKLEP <br />REASON FOR SPPINKLERS <br />INTAKE 9Y PUNS APPRO`/I <br />BUILDING RELOCATION <br />i HEREBY CE(iTIFY THAT I HAVE READ AND EXANIINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CGFiRECT. ALL <br />PROVISIONS OF LAWS 4ND ORDINANCES GOVERNING TNIS TYPE OF <br />WORK WILL BE COMPLETED WITH'n,IETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMII DOES NOT PRESUME TO GIVE <br />AUTHORITY TO �'IOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMA�CE OF CONSTRUCTION. THAT I AM AUTHORIZED 6f TNE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS L�W 18.2' RCW AND 296200 WAC. <br />X �._�a.�S_. , ���\Vl� d � ti��l � `.i_ <br />s�cunruaE o�•E <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HF.ATERS—B.T.U. M _ <br />CLOTHESDRYERS <br />RANGE <br />WATER <br />PUMP <br />PIPING <br />lUST FAN <br />8 CHIMNEV <br />v■�i�a� <br />��IIJr� <br />FEE I RECEIPTNO <br />BUILDING <br />OLGUP�NGY NOOipW[IIIHGUMIt: � <br />tanue pWM81NG <br />BASEMENT � .% f / � <br />MECHANICAL <br />ADDITANAL PLAN CHECK ' <br />HEIGMT UMITATION i <br />SPRINKLER �,�.� <br />STP.TE BUILDMG SURCHARGE ' <br />CITY Gf EVERETf PUBLIC WORKG � <br />LOCAL SALES � � ' <br />TAX CODF IS 3105 TOiAL <br />