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APPLICATI� FOR CONSTRUC7 �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS ❑ELECTRIC ❑_ —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I DEAAOLITION I � COMBINATION �(BUILDING MECHANICAL i I PLUMBING i ! SIf3N <br /> ONTIER �^ MAILAODRE55 � CITY y ZIP PHO)�NEy �y�y'� <br /> �. �1� .� V�—� 1 1 :.4VI� W .�VRC L�Y�� q�9'�/J� �t�..J—I'V{W <br /> R'�I1NT /Mll/.DDRESS CITV ZI PHONE <br /> �Y�2E�'t 'P�F2�'f�FZSAI��111��2711J�d�,�lL�':�. �1B'ZOl �!�3?-F.�b <br /> ARCHITECT OR DESIGNEP AMII AODR'c55 CITv 21P PMOME <br /> uv,�.� III ��Au�+ �i�cK� �.�1 t1ub. q61o4 223-5551 _ <br /> GEIAERALCONTRACTOR MM-/�ODRESS GTY ZIP PHONE STATELIGENSE� <br /> ��l71— GA2�'iJY2,l1-T1Lx1 40 I�C I(G85 P.EiLEV���% Wb� 92id�i /.�1-�CL�7 SbLCD+le�2?,iP�C.� <br /> � MEG/�NICALCONTRACTOli M�L�U�NE55 CITY ZIP PHONE STR[LIGENSEt <br /> µ�k�nn�� Mr�t+ e' o �c �tsc,7 �a v��,>- 9Bt�1- �bZ-3311 Mc.K�N�372N� <br /> � PLUMBIN6CONTRA�70R MNIADDRE55 CITY ZIP PMONE STATEUGENSE• <br /> CLASS OF YIORK <br /> � I 1 NEW I I ADDITION �ALTERATION �. REPAIR � � DEMGLITION ��. � WOODSTOVE/FRPI_INSERT I I BUILDING RELOCATION <br /> , CONTAGT PERSON.WO PHONE NO. <br /> � . � ppNTiiACT PqICE OF\YORK <br /> _ ' � �' � �...'°T�.���.5 <br /> ' . � � DESCRIBE MIORK AND$dI�HF. GE I VOLVED L��jAV�� <br /> � ' C�� RM, C4�21{JETS,� `� �' fJ '�VeC .�b-��'� <br /> rqoroseousEOFeu�on+� ��6SG12 t�'a-• ����'S+«y� i HEREBY CERTIfY THAT I HAVE READ AND EXAMINED THIS <br /> M1X o U�y�����'� � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALOESCNIPTION6FPROPEPTV�SNOWNUEIOM'ORATfACMFWFGOPiES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> '�C WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT.2•J _�JL e�oc�c � oF (�AT� �YF�-1`2�T__� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL L�W REGULATING CONSTRUCTION OR THE <br /> � —' PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAOE AND 1 COMPLY WITH THE STATE <br /> � . � � CON RACTORS LAW 1827 RCW AND 296200 WAC. <br /> � � ��'� � ' X (�J 3 <br /> � - ' SiGN�T D4E <br /> �` � � PROJEyCT WORES�(S���/�p r ���}7�.Yt /� <br /> x !�'. l10 ��fT����"�% �G1 `^'�'"-�"` 1) �l'� • cirve�SmEssuCE�+S[1a <br /> ��8� MECXANICAL <br /> Np. 'ryp£OF FD(TURE OR ITEM PEE NO. TYPE OF E�U�PMENT �E <br /> WATEfi CLOSET(TOILET) � A/�A/HNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER � CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> � RANGEHOOD <br /> LAU DRVHTRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> — METAL FIREPLACE d CHIMNEY ' <br /> JRINAL � � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � � <br /> SUB TOTAL $ ' SUB TOTAL S 1 <br /> PERMIT $ � PERMIT S � <br /> TOTAL FEE $ ' TOTAL FEE S . <br /> FOR OFFlCE USE ONLY: RECEiPT r+o. <br /> FRONT SETB�CK PEAR S TB�CK SIDE SETBA K PLRN CHEC��BEFn FEE <br /> N G ° <br /> VAGAryrsire FEES VALUA710N FEE <br /> USE 2 LOT AR A � <br /> � RD BUILDING n3 L�'��C� <br /> TVPEO� NTS.����'��E iVPEOfLONSi.ACTWI occuosNcv uao�owFiuxouM�*5 � <br /> �°0v � pLUMBING ' <br /> g�pp �pG NO.OFSTOPIE BASEMENT MECHANICAL <br /> �'l G u � ADDITIONAL PLAN CHECK o?I ' <br /> OCGUPANCVLOAD FIRESPRNKLERSREO'0 NEIGMTUMITAT�ON � <br /> +�lC'T1�do SPRINKIER � <br /> RE�SON FOR SPRINKLEHS ��� <br /> STATE BUILDING SUFCHARGE <br /> IMAKEBY PLANSAPPROVEOBY CITYOfEVERETT PUBLICWORKS ' <br /> LOCAL 311LES ; <br /> �� TAX CODE IS 3105 TOTAL � <br />