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APPLICATIC'1 FOR CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: J GAS J ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />i� DEMOLITION COMBINATION {� BUILDING ❑ MECHANICAL J PLUMBING u SIGN <br />�O/�y1N R N1"A MRILAD'D/PE55 I G�TY' Z�P PNONE <br />T!`���tl"(LY/l/�( f�MAll/X��J �(/�/Kf�� C�/�(.� l��.Jv�.L17`'�V`N�� <br />T <br />ARCNITECTORUESIGNEF MAILADDRE55 CIiY ZIP PNDNE <br />�ENERAL [�NTR�CTOR MARADORESS GTV ZIP PMONE STATELIC[NSEs <br />s.�� , /3ya.� �o�%�ldi �f�� ���7 7�S-/955/ ,C,r�,r/f060�VR <br />��i��iirt� <br />MEC4ANiCAICONTqPCiOR IAAILADpRE55 CITV ZIP PMONE STATELICENSE♦ <br />PLUMBiNGfONiRALTOF MAILApDFESS LITV ZIP PHONE STATELICENSER <br />CONTRPGi PRICE OF \YORN <br />,� s��o — <br />DESGR�BE WORK AND SOUARE FDOTAGE INVOLVED <br />PNOPOSED USE OF BUiLDiNG <br />LEGAL �DESpCFIPT�I�ON OF PROPERTV I�SH�O/WN BELOW OR <br />l0T—d-L� � BIOCK �-.O_ OF � <br />\ /PARGELTA%ID.NUMBER <br />` 1LP7R'—Olg—DU S(-DD J 3 <br />^,ONSTRUGTIONLOANLENOER.nUDNE55.TElEPNONE NOMBEP <br />P190JECT AD RESS <br />FLUMBING � ��� <br />N0. '�: %PE OF FIXTU9E OR ITEM <br />WATER CLOSET (TOIIGi) <br />BATHTUB <br />LAVATORY (WAg�, gASIN) <br />SHOWER <br />KITCHEN SIN� 8 DISP <br />IAUNDP'I TRA <br />CLOTH�_S WA; <br />URINP L <br />DRINK NG FOL <br />FLOOR ORAIN <br />BACKFLOW PF <br />ROOF DRAINS <br />SINK ISER\'ICI <br />$Ub'� <br />PERMIT <br />FOR OFFICE USE ONLY: <br />WNi�CT PERSON ANp PHONE IJO. <br />5 <br />I HEREBV �ERTIFY 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 TO GIVE <br />AUTHORITV TO VIOIATE OR CAN(;EL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTflUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNEF OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC70RS LAW 1827 RCW AND 296200 WAC. <br />NO. <br />AIR <br />UNIT <br />VENTILATION FAN <br />AANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FlREPLACE � <br />FIREPLACE INSERT <br />NEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />-i� <br />FRONTE:iBFCK RE�RSE�O /r SIDES[TpnC�� � �L�NCHFCy��H <br />� ' v `���1� <br />USE 20NE LOT AFEA VACANT SIi[ FEES _ <br />�-! YES G NO BUILDING <br />TYPEOFCO 7 NO.OFSTOFIES OGcrireuGv rv0o�owFw�icenn� — <br />� <br />SRE OF BIOG. <br />�� <br />OCCUPANCVI <br />� <br />REASON <br />INTAKE BY <br />FIRE SPFINKLEPS RE00 <br />Nn <br />FIqE AL�RIA RE00 <br />A10 <br />ev <br />r,4oao PLU�dBING <br />onSEMENT - / MECHANICAL <br />�.-: YES .v NO - <br />NEIGHTuuiTatioy ADDITIONPL PLAN CHECK <br />/ <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT ruouc woaHs <br />LOCRL SAIES <br />TAX CODE IS 3105 TOTAL <br />FEE <br />M E.A. <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />FEE <br />� <br />�N <br />tl <br />