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APPLICATIC"'f FOR CANSTRUCT''�N PEirtMIT � <br />TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br />� ��� <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ,�_ <br />BUIL�ING DEPARTMENT <br />259 861� <br />❑ OEMULITION [ 1 COM@INATION xBUILDING I I MECHANICAL <br />ONNER MFILAODRESS CTy'�YC� z��� /���ONE <br />K��s S�L.�(�.�sdrz w.v;u,.� p���E , ZP � P ONE <br />TLNANT <br />MAIL ADORESE GITV <br />GENERAlCO iRACTOF MAILADORE55 <br />731_f - <br />MECHANIf,qLGONTRACTOR MFILpDDRE55 <br />pa _ sF_ . `.�ti,�C, . l.,yhP5P�24o <br />QiY . IP <br />�,. IVE . �'laySv�l�e 932% <br />r ZIP <br />zm <br />� —7360 <br />S1AiE LiCENSE Y <br />��-�g36 <br />ETRTE UGENSE � <br />C] SIGN <br />7RICE GF WORK / / � � — <br />00o r3� <br />CONT CT P[PSON AND PNONE NO !/Ia� S � I�, � <br />IO K ANO SOUAPE FOOTAGE INVOLVED [�( w <br />33� r-� cL�Qd.:-�-�oc..� or Lo� ��•-,as� sbd-i36c� <br />„ . � ! ,� re.vt-� d� 1 <br />i HEREBY CERTIFY THAT I HAVE READ AND ERAMINED THIS <br />�F�� —��1 APPLICATION AND KNOW THE SAME TG BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AN� ORDINANCES GOVERNING THIS TYPE OF <br />p FPROPERTV(SMOWNBELOWORATTACNTWOCOPIES� WORK WILL BE COMPLETED WITH N'HETHER SPEGFIED HEREIN OR <br />NOi: THE GRANTING OF A PERMIT DOES NOT PRESUM[ TO GIVE <br />_ e��K oF �� �� �L� S AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />D ry �, � OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEP,FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />�APPLICAOTIONISISpMADE ANDPE COMPLVH WITOHKT OR STAT[ <br />NU=BlR�� OO� CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />IOANLENDER.ADORE55.TELEPNOHEilUMBER � �i �'/ -V /l � �4-93 <br />�� �.r���� o <br />DAiE <br />SiGN�r �E <br />1DR SS �� � �� . - <br />Ciiv BuSM[55 UC[NSE Iq <br />G � MECHANICAL FEE <br />_ _ __.. «� Na TYPE OF EOUIPMENT , <br />SINK 8 <br />ORAIN <br />ROOF <br />SINK I <br />FOR OFFICE USE ONLY: <br />FRONiSETBACK � REAR� <br />USE ZO <br />7YPC Oi <br />� <br />52E OI <br />INTAK'e OV <br />TOTAL 5 <br />MIT S <br />4L FEE 5 <br />�OT AFEA <br />'+-/ 9 �%S <br />NO.OFSTOPIES <br />I <br />FIRt SPPINKLERS RE�'U <br />FIRE�EO'D <br />�� �� — <br />PLANSAPP IVEOBV <br />V <br />ont[ -7 �i �S � <br />UNIT <br />WOOD STOVE <br />METALFIREPL <br />FIREPLACE IN: <br />HEAT PUMP <br />GAS PIPIIJCi <br />FXHAUSTFAN <br />PLAN <br />:MS—B.T.U. <br />T.U. M <br />VAGANT SITE <br />❑ YES �N� Bl11LDING <br />OCNMNfv NO OfVNELIINGIIN'15 <br />A� r PLUMBING <br />BASEMENT MECHANICAL <br />❑ YES ri NO <br />ME�GMT LIMITATION <br />ADDITIONAL PLAP' CHECK <br />� ' <br />OTHER <br />STATE GUILDING SURCfIARGE <br />CITY OF EVERETT PUBLIC WOFK <br />LOCAL SALES <br />TAX CODEIS 3105 T�TA� <br />FEE <br />E.A. <br />TOTAL 5 <br />NIT 5 <br />1L FEE S <br />1 <br />O <br />T <br />� i� <br />