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APPLICATIQ��I FOR CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: ❑ GAS ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8610 <br />Ll DF.MOLITION I7 COMBINAl'ION i I BUILDING I J MECHANICAL l I PLUMBING f 1 SIGN <br />py��;pq M�ILADORESS GTV 21P CHONE <br />�� �ir/rT <br />TENnNT MRIL pDORESS CITY 21P PNONE <br />.i 4�tf5 �)Art2l dU �o sT�rrE S: �'uw.�Y S 8a0/ �259- 35��5 <br />ARCHITECiORDE5IGNER % MAILADDRESS GITY 7iP PHONE <br />GENERALCONTRACTOF AIAILA�ORESS CITY ZIP PMONE STATELICENSEa <br />Pctzr�ck �rbo �Ar.a- `%9 Pt ' — <br />MECNANICALCONiRRCiOR MAIL4�DRE55 � CITY 21P PMONE STATELICENSC <br />PLLIM9INGCONTq�CTOP MRILADDRE55 f,ITY ZIP PNONE STATEIICENSEt <br />GONTRACi <br />OESCRIBE WORK AND SOUARE fOOTAGE INVOW ED <br />� <br />QSt a0.'� <br />LEGnL DESCRIPTION Of PPOPERTY �SNOWN BELOW OR AtTACN TWO COPIES� <br />LOT BLOCN OF <br />PARGELTA%LO.NUMBER <br />CONSLflUCTIONIOANLENOER.ADORE55.TELLPMONE <br />PROJECT ADDRESS <br />aV ro srare sr <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITE <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASH <br />JG FOUNTAIN <br />DRAIN <br />FOR OFFICE USE ONLY: <br />FRONTSETBFCN REARSETBAGK <br />� n� 1 <br />�— <br />uco muo LOT AREA <br />R��I <br />7VPE af LON51. <br />size <br />INTAKE UY <br />NOAF STORiES <br />�— <br />FIRE SPRINlKLErRnS REOG <br />� <br />RRE ALARM RE00 <br />ND _ <br />PLpNS APPfjOV�D BY <br />J F� <br />�ATE ��I% /� <br />S <br />$ <br />S <br />SIDE SETDACg <br />7 J <br />VACANT SITG <br />n ves �o <br />ocwv�xw xoorowru�vcuw�s <br />SEMhNI � <br />❑ VES V'P10 <br />CITY OP EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />CONTACT PEPSON AND PNONE N0. <br />0 <br />I HEREBY CERTIFY 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 NPE OF <br />WORI( WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATC- OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOFIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPL\' WITH THE STATE <br />CONTR1CTORS LAW 7827 RC'N AND 296200 WAC. <br />S�GII�tOP1�-.-I-�.�•�� D�IC <br />fRY0051YF55l�CFNS[ NO <br />TYPE OF EQUIPMENT <br />AMNDLG UNITS—H.P. <br />:ED AIR SYSTEMS—B.T.U. M E.A. <br />HEATERS—B.T.U. M <br />HES DRYERS <br />1LATION FAN <br />WATER <br />METAL FIRE <br />FIREPLACE <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTf� <br />S <br />S <br />SUILOWG � -� � <br />P W MBING <br />MECHANICPL <br />ADDITIONAL PLAN CH[CK <br />i <br />OTHER <br />STATE BUILDING SURCHARGE ' <br />PUBI IC WORKS <br />/j � <br />TOTAL J `f � i <br />