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��y ° <br />O �f x <br />C N <br />9 H !A <br />��yC <br />HxH <br />�H� <br />O x O <br />�t~pMrr <br />�O� <br />OM <br />��8 <br />Q. O <br />t"y� <br />HH <br />gy <br />H <br />��N <br />HOf�yn <br />� <br />i <br />I �� <br />�� <br />I '� <br />APPLICATIO►_ FOR CONSTRUCTI..N PERMIT �� <br />TO BE COMPLETED IN BLACK INK�PLEASE PRINT �"��TT <br />..— – �- ---- . . <br />— –� ------ I <br />[ HEATINGSYSTEM�. GAS JELECTRlC J.__ .—_ -------- <br />BUILDING DEPARTMENT j <br />259-6810 } <br />nCE�f111TIf1N (:C1M61NATION BUILDING 'MECHANICAL PLUMBING SIGN <br />� r.�ni�nuoness <br />i L� r l. �.;r_ <br />,., s, <br />MAtLA DRE55 <br />i� />�, <br />s <br />IAAIL A�ORE55 <br />I.ull qODRE55 <br />n <br />NEW ADDITION <br />�rnnr.r vaicE oF w0ar <br />PRonoSEo usE oc eui�Drt+G <br />IEGRL �ESCRiPiION OF PROPER�V <br />�Oi BIOCK _ <br />ac <br />REPAIR <br />�— <br />nirna�Foua <br />Gi� <br />/ � „ <br />��'� C ��_TQ� x;/ / �G� . c' l su't'7J f-!-! <br />PLUMBING � <br />NO. TYPE OF FIXTURE OH ITEM FEE <br />WATER CLOSET ITOILET) <br />BATHTUB <br />LAVATORV�WASH BASIN) <br />SHOWER <br />KI7CHEN SINK & DISP <br />DISHWASIIER <br />LAUNORVTRAV <br />CLOTl1ES WASHER <br />URINAL <br />DRINKING FOUNIAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS _ <br />ROOF DRAiNS—RAINLEADERS <br />SINK ISERVICE—BAR. ETC.) <br />SUBTOTAI $ <br />PERMIT 5 <br />FOR OFFICE USE ONLY: <br />PRONi5E19l.CK REPRSEiOACK <br />USE ZONE LOT AREA <br />tVFEO�LONtS �LLOI4ABlE tYi'EOfCON51 Ptilut <br />5¢E OF BLDG NOAF STORIE.S <br />OCCUP�NCYIORD FlRESPRNHLERSREO� <br />REASON POR SPRMKLERS <br />wtnKeSr ���nnsnr�=noatoor <br />SID[ SEi�ACN <br />ZIP <br />21� <br />zm <br />�� <br />PHONC STATE UCENSE• <br />� -y,[ TAiCLICE45E• <br />•(f�'� P�'/ � C?�5:�/ <br />vrc.r� stnrE �iccr�sc . <br />DEMOUTION WOODSTOVE�FRPL INSERT BUILDING RELOCATION <br />I corvract rcnsor� nNo w�o�+c r+o � ,_ �. \ <br />.� <br />-- � � �GfF �'� _ <br />i HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW TN6 SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK VlILL BE COIdPLETED WITH WHETHER SPECIFlED HEREIN O+ <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TC GIVE <br />AUTHORITV TO VIOLATE OR CANCEL 7HE PROVISIONS OF ANv <br />OTHER STA7E OR LOCAL LAW REGULATING CONSTRUCTION OR 71iE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THL <br />OWNER OF THIS P(70PERTY TO PERFORM THE WORK FOR WNICH <br />APPLICAiION IS MADE AND I CO�•�PLY WITH THE STA7L <br />CONTRACTOFS LAW 182i RCW �ND 296200 WAC <br />x ,.,..(./ ' l�7..':� %�i7r-,�' <br />—Y.;�, — �=��� r,�i �.- <br />� +w`"(r :%'---' �'"5l , ' 1.� F � <br />MFCMANICAL ' <br />NO. TYPE OF EOUIPMENT FEE <br />A C—A HNDLG UNITS—H P �+. «;�'i _ <br />� FORCED AIR SYSTEMSZ �''.�r' _M1� E_A. ' _ <br />UNIT HEATERS—BS.U. Id _ <br />CLOTHES �RYEPS _ <br />VENTILATION FAN � � _ <br />F7ANGE HOOD _ <br />L j� WATER HEATER _ <br />WOOD S70VE ._ <br />METAL FIREPLACE 8 CHIMNEY _ <br />FIREPLACEINSERT <br />� NEAT PUMP _ <br />� GASPIPING ��JS� <br />4— — <br />E%HAUS7FAN __ <br />SUBTOTAL a <br />PERMIT 5 _ <br />TOTAL FEE 5 . <br />n�nvcr�ccKr�uraora I F�e � a��cm�mo <br />BUILDING <br />rccuw.xa xomwrtu�xsc.i= — <br />camio p�UM�MG <br />OASEMENT MEGHANICAL <br />NEIGHiuMItATiON ADDITIONALPLANCHECN <br />SPRINNLEH <br />STATE �UII.DING SURCHARGE <br />CITY OF EVERETT auauc wonks <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />—1 -.--.. .__.i.. <br />