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APPLICATIdh FOR CONSTRUCI%N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT OL <br />BUILDING DEPARTMENT HEATING SYSTEM: LI GAS JELECTRIC u <br />2E9.8810 <br />DEMOLITION COMBINATION__ XBUILDING MECHANICAL IPLUMBNIO SIGN <br />NE OMR wZW-4,45 CITY ZIP PMY4 <br />KOu TLAS <AND co. ,w/t 3/_�( QvtBas 6yeaFrr ..A 1/2e/ ZSL-372S <br />TENT YAL{DDRESS CITY 71P PRONE <br />/iL VO/Zp-aECEAALOse.J ""AAr• F1,/vY/r2 /IPA""," -A F9227 73Y--3y6o IILvIaac7YLe-- <br />MECNwCUCONTRAC1oR wL.DDAESS con, ZIP MWE STATE LCEMM. <br />PLUYRNG OCNTINCTOR wL ADDRESS CITY IIP PRONE STATE LCENSE. <br />CLASS UP NOR[�J j NEW ADDITION ALTERATION REPAIF. DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />uT'IT 27300 <br />cWTRAOI PRCE arrGRK #/2,000 <br />CONTACT PERSON AND PROOF NO <br />Sco Ar_ve aICED M.Dte""I 4NAr. <br />DESCRIBE MVRI( AIA SWARE FOOTAGE INYIXYEP <br />/yModFRPr pace N-DX A00I7`7eIJ <br />73Y- 3Y/0 <br />PROIOSED usEaBOAOAU <br />STOR ATE <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 />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TM 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 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IS7 RCWA D2962 WAC. <br />�o�� sz <br />LEGU DESCRIPTION M PROPEATY(a BELav OR ATTACK FOUR CO,IFSI <br />,w O. <br />LOT BB- / 9 BLOCK 001 DF S A a <br />A/ AD p I e t'[Ar <br />epws PTN VAS Ac y ADS) <br />AGc+F $ B- - / - o00 <br />PROJECT ADDR[ss <br />3824 RJLKi/L •tizt.crr, ".-A. <br />- ^"TS" °'II <br />1.1. A,R„IA,I,:,„M No <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A,C-A'HNDLG UNITS-H P <br />BATHTUB <br />FORCED AIR SYSTEMS-8 T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATER 13T.Ul M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK S DISP <br />VENTILATION FAY. <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />_ <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />I FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />SACKFLOW PREVENTER.i_ <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR. ETC.) <br />SUBTOTAL $ <br />SUBTOTAL S <br />PERMIT S <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />TPpQ 5E11AUK <br />PEAR KTRE6t <br />SIDE SETO <br />PUN CRECK NU R <br />fEE <br />RECEIPT NO <br />3 <br />USE ZONE <br />_ <br />LOT AREA <br />VA AN sIrfY <br />yu <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />27/ !JD <br />T <br />nM Dr CpH1s UL0WAN[ <br />� <br />TYPE IN IXMST KILO <br />� <br />ttllna'. <br />`'""iO <br />SIZE OF BLW NO OF STORIES BASEMENT <br />Igppr,F .F 4 <br />OCCUPANCY LOAD FIRE SPRNKLERS REDD NEIG11i NI[MKM! <br />NO 1 <br />REASON FOR SPRINKLERS <br />MECHANICAL <br />ADUITIONALPLANCHECK �. <br />SPRINKLER <br />STATE BUILDING Su* ROE <br />MAKE er <br />Puxs APPRDvEUBY <br />g 9L <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUtlLIC WORrc S� <br />TOTAL <br />7 I <br />