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APPLICATIC'"'1 FOR CONSTRUCT'"1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />�EATING SYSTEM• ❑ GAS ❑ ELECTRIC ]�C�!/��d ['� I! ��'` � <br />BUIIDING DEPARTMENT <br />259-f;610 <br />i DEMOLITION L 1 COMBINATION BUILDING ! MECHANICAL I i PLUMBING f 1 SIGN <br />p Eq MRILADDRE55 GTV ZIP PMONE C C -� �� <br />i � Y <br />TENRNi MRIL ADORE55 CITY Z�P PHONE <br />RRCIIITECTORDESIGNER MRILAD�FESS CITY ZIP PNONE <br />GENEPALCONTRACTOR MAII/•DDRESS GiV ZIP PNONE STATE UCENSE• <br />_U `�� PNONE STATELICENSE <br />MECMANICALCONTRACTOR M�IL/�DFESS GTY ZP <br />PLUMBINGCONTRRCTOR M�ILAODRE55 <br />CITY ZIP P1104E STATE LICENSE • <br />GONTR/.CTnCEOFW OD 0 � /� /_��� <br />�l <br />DESCRI9E W0 K N� SW�RE FDOTAGE MVOIVED I WNTAGT PERSON AI PHONE NO — <br />LEGAL DESGRIPiION OF PROPERTY �SHOW'1 BELOW OR RiTACN iW0 COPIE51 <br />LOT BLOLK OF <br />PRRCELTAXID <br />� <br />CONSTRUCTION <br />WATER CLI <br />BATHTUB <br />LAVATORY <br />TRAY <br />FOUNTAIN <br />ROOF <br />SINK ( <br />FOR OFFICE USE ONLY: <br />FRONTSEiBACK RERFS.E-T�BA^CK, <br />� � C� <br />USE 2 LOT RREA <br />�2_ �! �,,a <br />iVPE OF CONST <br />52E OF� <br />�u1L ' <br />PEASON <br />MTAKE 0� <br />FIRf SPPINNLERS RE00 <br />►lo <br />onre <br />i HEREBY CERTIFV TNAT 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 HEFiEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUC710N OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />� o"' iE <br />+[ssu�rrvsE rvo <br />\NICAL <br />TYPE OF EUUIPMENT <br />NC—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATEIi HEATEF <br />WOOD STOVE <br />i�1ETAL FIREPLACE (WOOD BURNING) <br />F�REPLACEINSERT <br />HEAT PUMP <br />GAS PIPWG <br />O`� S+�Kv (,��,SC-`(J�S 121� <br />SIDE SETBACR PLAN CHECH� Ny MBEP FEE <br />S' �`y /'� � <br />` vnr,nNr siTe FEES <br />P L YES '� NO BUILDING _ <br />acu�.xn xa a mvEwxcux��rs <br />°��� PLUMBING <br />BASEMENi ./ MECHANICAL <br />- YES - NO <br />HEIGHT LIMITATION ADD�T�ONAL PLAN CHECK <br />�' _ <br />OiHf_R <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBI IC WORNS <br />. r YOCOIIF CL'i105 TOTPL <br />TAL FEE <br />6L <br />� <br />Co� <br />i(�a. <br />