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APPLICATIQ -' FOR CONSTRUCT'`lN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE P�..NT <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOUTION ❑ COA/81NATION <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />❑ BUILDING <br />❑ MECHANICAL <br />❑ PLUMBING <br />❑ SIGN <br />GENERALCONTPACTOR MRILpDDHE55 CITY ZIP PHONE STATELICENSE� <br />�( G tunC�t� <br />MEGNANIGALGONTRACTOR MAIIADDRE55 CIN ZIP PHONE STATEIICENSEa <br />PLUMBINGCONTRACTOR h1AILpDDRE55 CITY 21P PHONE STATEUCENSE� <br />CONTRRCT PRILE OF WORK <br />�ESCRIBE WORK RND SOUARE FOOTAGE INVOLVED <br />Q �1Ck1 ",(� SU <br />PROPOSED IISE OF BUIL�ING <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIES) <br />�or eiaK oF <br />PARCELTAXID UMBER O^ �nG� <br />��T �%�/��3 � �� � - _ <br />CONSTRUCTION LOAN IENDER. AODRE55. TELEPHONE NUMBER <br />PROJECT�DD�E�S ���_ 1 � <br />L` 7 <br />PLUMBING <br />N0. TYPE OF FI%TURE OR ITEM FEE <br />WA7ER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SNOWER � <br />KITCHEN SINK 8 DISP � � <br />DISHWASHER ' <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL i <br />DRINKING FC'UNTAIN <br />FLOOR DRAIN � <br />BACKFLOW PREVENTERS � <br />ROOF DRAINS—RAINLEADERS <br />SINK (S'RVICE—BAR, ETC.) <br />SUB TOTAL S <br />PERMIT $ <br />— TOTALFEE 5 , <br />FOR OFFICE USE ONLY: <br />FRONTSETBRCK REpR; <br />lISE ZONE <br />7YPf OF GOH9. <br />SIZE OF BLDG <br />OCCUPANGVi <br />REASON <br />INTAKE Bv <br />LOTAREA <br />NO OF STORI[S <br />FlRE SPPINNLERS REO'D <br />FIRE PLARM REO'D <br />PLANS / �'��OVED BV <br />OATF. <br />SIOE SEiBACK <br />VACANT SITE <br />[- YES - NO <br />oc:u�<rvc xo o� oNnuxcuxns <br />6u0d' <br />BASEMENT <br />i _ YES _� NO <br />MEIGMT LIM1IITATION <br />CITY OF EVERETT <br />LOCAL SALES <br />TAx CODE IS 3705 <br />CONTACT PEBSON AND PMONE N0. <br />i HEREBY CERTIFV THAT I HAVE REPO ANG 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 P[RMIT DOES NOT PPESUME TO GIVE <br />AUTHORITY TO VIOLATE Ofi CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTHUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BY 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 18.27 RCW AND 296200 WAC. <br />FORCED AIR SYSTE <br />Ui:1T HEATERS—B.1 <br />CLOTHES DRYERS <br />VENTILATION FF�fJ <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE i <br />FIREPLACE INSERT <br />FAN <br />NUMBEi1 <br />BUILDING <br />PLUMBING <br />tdECHANICAL <br />ADDITIONAL PLAN CHECK <br />OTHEF <br />STATE BUILDIA�G Sl1RCHARGE <br />aUBLIC N ORKS <br />TOTRL <br />M E.A. <br />� <br />SUBTOTAL $ <br />PERMIT S � <br />TOTALFEE 5 <br />REGEIPT N0. <br />VALUATION FEE <br />23 � <br />i <br />� <br />