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APPLICATIG.J FOR CONSTRUCT" 1N PERMIT � <br /> TO BE COMPLETED IN BLACK IHK—PLEASE PRINT <br /> BUILDING DEPAFTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> 259•8810 <br /> [ 7 DEMOLITIOH �i COMBINATION ❑ BUILDiNG ❑MECHANICAL C PLUMBING J)S"SIGN <br /> OVMER M�ILApOFE55 CiTV 21P PHONE <br /> P«.I l�,�n�—bSD� Yo,�L��� /��, C� 9�,3� 3 8�— // 9 C� <br /> TENFNT MRILRq�RE55 CITV 21P PNONE <br /> / A� ��l' 1 i}' )/ � <br /> ARCHITECT OR DESIGNER M�IL�bDflE55 GITV ZIP PHONE <br /> c,�q�-�Z�a <br /> r�GENERn GOYTRnCTOR MAIL ADDRE55 LITY ZIP FHONE STATE LICENSE/ <br /> n�, I�sl.,, zl 2 S' �u-�� �//�,�1R,., �,�, sq�zL, cus�oi4 � �ym/� <br /> ME:H�NIG�LCO�N AT GTOF MAILADDRE55 GITY IP PNONE STATELICENSE� <br /> PLUMBINGCONTRRGiOR MRILADDRE55 GTY ZIP PHONE STATELICENSE� <br /> CP.IR�CT PRIGE OF W��� <br /> DESCRIBE WOAN�ND SOU� FOOT�GE INVOLVED CONTACT PERSON�ND NONE <br /> � <br /> / ` I <br /> � � <br /> i HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> rRovose us oF euaoir+c APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> � � � PROVISIONS OF LAWS AND ORDINANCES GUVERNING THIS TVPE OF <br /> LEG�LDESCPIPTqNOFPR �PEFTY�SHOW` BELO'NORA GNTWOLOPIES� WORK WILL BE COMPLETEG WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT eiocK oF AUTHOHITY TO VIOLA7E OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> P�RCEL TRX ID.NOMBER CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> CONSTBUCTION IO�N IENDER.�DORE55.TELEPHMJE NUMBER ����� <br /> ,� � 9��• ��/ <br /> PROJECT ADDRESS s'� u"F � o��� <br /> W LRVBUSWESS��CEN �Iq <br /> p�,�� MECHAXICAL <br /> NO. TYPE OF fl)CTUFE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—NHNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> IAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> � <br /> SHOWER CLOTHES DRYERS ._. <br /> KITCHEk SINK 8 DISP � VENTILATION FAN � <br /> —r— <br /> DISHWASHER RANGE HOOD _ <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE _�_ <br /> UP.INAL ' METAI FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAM HEAT PUMP <br /> BACKFLOW PRtVENTERS GAS PIPING � <br /> T <br /> ROOF DRAINS—RAINL[ADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.� <br /> � � <br /> � <br /> SUB TOTAL $ SUB TOTAL S <br /> PERMIT $ PEIiM1T $ <br /> TOTALFEE $ TOiALFEE $ <br /> FOR OFFlCE USE ONLY: <br /> FRONT SETBnCK �� RERR SE�T �/�� J SIDE SETBRCN PLAN CNEC Uh��F FEE ^�� REGEI�N_O. �/ <br /> � S 7 �C) <br /> USE ZONE lOT PREA VRCINT SITE FEES VALUATION �_ <br /> LZ� -� YE$ '7 NO ' <br /> �G ' aui�oiNc / �CXJ <br /> iYl'f 01 CLNST. NO OI STORIES D[Cuvµcv MO M owEwnG uM'q � <br /> 49f^'° PIUMBING � <br /> SIZE OF BIDG. FIRE SPRINYLERS FEO'D BRSEMENT MECHANICAL <br /> ❑ YES L NO <br /> OCCUPANCY LORO FIRE ALRPM REO'0 HEIGHT LIMITATION ADDITIONAL PIAN CHECH <br /> OTN=R � <br /> REASON <br /> STATE BUILDING SURCNARGE �y�.� <br /> �` <br /> INTAI'E RV �LANS RP OVEO BY CITY Of EVERETT FUBLIC'NORNS i <br /> LOC11L SIILES --T <br /> oqrE ����,S TAI(CODE IS 3105 rou�. /'>% ; �7 <br />