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r_ <br />I <br />,w <br />i <br />APPLICATIC-7 FOR CONSTRUO%T_ )N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE ?RINT j <br />HEATING SYSTEM: AGAS ❑ ELECTRIC ❑ I <br />BUILDING DEPARTMENT <br />259-8810 <br />I DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />it <br />CITY ZIP PLKINE <br />OVMER MAIL ADDRESS �y <br />y�aa W c"� -� = ,,, \��, <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />dRCNITECT OR DESIGNER MAIL ADDRESS CRY ZIP PHONE <br />.. __..-.......... .uu enrwccS Citt 21P PHONE STATE LK:EN6EE <br />NOP:KI:TCHEN <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NV. <br />• • �•- �• �•-�•• <br />OSET (TOILET)AT�AMNDLG <br />UNITS—H,P. <br />FORCED AIR SYSTEMS—B.TU <br />UNIT HEATERS—B.T.U. M <br />(WASH BASIN) <br />CLOTHES DRYERS <br />VENTILATION FANHERRANGE <br />INK 8 DISP <br />HOOD <br />WATER HEATER <br />TRAY <br />i <br />WOOD STOVE <br />CLOTHES WASHER <br />CHIMNEY <br />G FOUNTAIN <br />RAIN <br />MCE <br />!FLOOR <br />OW PREVENTERS <br />RAINS-RAINLEADERS <br />RVICE-BAR. ETC.) <br />I <br />-- <br />SUBTOTAL $ <br />SUBTOTAL $ <br />PERMIT $ <br />PERMIT $ <br />- <br />— TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />FOR OFFICE USE <br />UNLY: <br />RECEIPT No, <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER FEE <br />37 9(v3 <br />VACANT SITE <br />FEES VALUATION <br />FEE <br />USE ZONE <br />LOI AREA <br />BUILDING <br />TYPE Of CONTS ALOWABLE <br />TYPE OF CONST. ACTUAL <br />ocaWocv <br />No-IPWRuxs I-- <br />-- <br />PLUMBING <br />MECHANICAL <br />i vv <br />OF STORIES BASEMENT <br />SIZE OF BLOf.. ND. <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FlRc SPRNKLERS REDO HEIGHT LIMITATION <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />REASON FOR SPRINKLERS <br />PUBLIC WORKS <br />INTAKE BY <br />SANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />; <br />TAX CODE IS 3105 <br />TOTAL <br />