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� ARPLIG.ATIO:' FOR CONSTRUCT��N PERMIT � <br /> l TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />[ �HEATING SYSTEM: ;J GAS �ELECTRIC U _ � <br />' BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION �COMBINATION �:,gUILDING MECHANICAL PLUMBING SIGN <br /> 01YN6P MRILADDRE55 CITV ZIP PMONE <br /> S�fgvrfl��rhiicrn�r 57031�L_e� /�+iiti. �vCreff� cv� 9��a� �s3-ss3� _ -- <br /> TEN�NT MAIL0.DDRE55 CITV IIP PNONE <br /> SlLn1 P/ .Scv�y��/ — <br /> FfiCMITCC�OR DESiGNER MAIL AD�RE55 LITY ZIP PNONE <br /> Fp�„� (�.rPP/t /��H 7�!2 i3averlul3lr./- ,E1^LrN�; lvA. y8ac :s 3sS-a�fj(� <br /> GENERAL CONTRRCiOR � MRIL A�DRE55 U ��T� Z�P PHONE SiRTE UCENSE� <br /> /��r�f2�� ���c t^y�r�Yr �F�`�f✓,�iF AY:;� :';y cE;.'� l/lr�,�/r��9��3 <br /> MECM�4'ULCONTRACTOR MMIADDRE$S GTY 21P PHONE SiATELICENSEk <br /> PIUMBiNGGONTR�CTOP MAILADDRESS CI1V ZiP PNONE STATELICENS[� <br /> CL��S$OF WORK <br /> N�W � ADDITION � ALTERA?ION REPAIR DE��OlIT10N WOODSTOVHFRPL INSERT BUILDING RELOCATION <br /> —� CO�:f�Gi f'ERSON AND PHONE N0. <br /> coNTa�-r raice oF�.voRK ���d�v 1��'P.{ TU, �n�r 3S 3-�1,5r17 <br /> DCSCRIBE WORN AND SOl1ARE FOO AGE INYOLVED <br /> i5oo s � �� Gtdd�'fiex � ha���1 — <br /> PPOPOSEDU OFBUILDING i HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> L �/ PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �ecnioesc vnor+ F�ROPE OOO D�O2��STS"7, y/c�f'S T�'C'ioL WORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> �pT e�ocN 7F NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> — H�� ��S OTHER STATE OR LOCAL LAW REGULATING CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAi I AtA AUTHORI2ED BV 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 1627 RCW AND 296.200 WAC. <br /> � /1 /7/1�A,✓ ���a_�-- <br /> $IGNRtIIAE d'� JAIF <br /> PROJECTAODRE55 <br /> 5� .1 )�/ T �� � ! f.iiVPU5MCS5liCCYS[NO <br /> J N/ �i MECMANICAL <br /> PLUMBING <br /> NO. TYPE OF FD(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) Q A�C—A�HNDLG UNITS—H.P. _. <br /> BATHTUB _ C FORCED AIR SYSTEMS—B.T.U. M E.A. _ <br /> LAVATORY(WASH BASIN) �f UNIT HEATERS—B.T.U. M �._ <br /> '� SHOWER CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN __� <br /> Q DISHWASHER RANGEHOOD <br /> WATER HEAiEfl <br /> LAUNDRYTRAY ; <br /> CLOTHES WASHER WOOD STOVE �— <br /> METAL FIREPLACE&CHIMNEY <br /> URINAL <br /> DRINKING FOUNTAIN 7 FiREPLACE INSFRT <br /> FLOOR DRAIN <br /> HEAT PUMP -- <br /> BACKF:OW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN � <br /> � i—_ <br /> SINK(SEFVICE—BAF,ETC.) � — <br /> �� +• P MAI3AJM � <br /> L -�/ <br /> SUB TOTAL $ <br /> SUBTOTAL $ — <br /> PERMIT $ <br /> TOTALIFEE 5 TOTALFEE 8 ' <br /> J��•�v <br /> FOR OFFICE USE ONLY: aecEmT r+o <br /> FEe _ p <br /> FRONTSETBACK REAPSETBAG' SIDES��K PLANCME�Y�BER �, �� 7,�v <br /> SLv -3-3 <br /> 7�' z� � -- �` FEES VALUATION FEE <br /> USE NE LOT FREA VACANT SITE <br /> —� " L U .u� � <br /> BUILDING '�1j,�7Z .J 3 I ��'—' <br /> IYPi�Of CON�S PLLOWAOIE iYPf 0i L NS1.PC1UAl oruirnr:cv x�a�V++¢u':=�•�^s �—T �I <br /> �N �A ' j / PLUM�INC s <br /> IV � <br /> r'�Z��F 0� �l��i, NO OF STORIES BASEME�J MECHANICAL �� <br /> L" y 17�/ i 7 01 <br /> ADDITIONAL PLAN CHECK _ <br /> pCGUP4N VLOAD FIRESPRNKL[RSR[OD N[IGN)T�lIyM1AT10N � <br /> � �% `[.% SPRINKLEFi _ � <br /> REa50N FOR SvnINKlERS $TATE Bl11LDING$URCHARGE J � <br /> INTANE BY PlANS APPROVEO�Y (��TY OF EVERETT PUBUC WORNS , <br /> LJCkI SAlES �C�1 ;��' <br /> � J TAX CODEIS 3105 T�TAL <br />