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APPLICATIO � FOR CONSTRUCT� �N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: ❑ GAS �J ELECTRIC J � <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION ! 1 COMBINATION UILDING I I MECHANICAL PLUMBING SIGN <br />01YNER IdAiLAODFE55 CiY 21P PHONE Z0% '3'�� pO�( I <br />1�..� �.��— S—�-�._� ��_�_ t-� ����z 1� PL. ss c tc g�, ,�� �,� 9xZ� <br />if.N�Ni h1AILP��NtSs QiY 21P PNONE <br />AqFMiTECTORDESIGNER MAILADDRESS CITV Z�P PH�NE <br />r'�w n� , 2 — <br />GENERALCONTPACTOR lAAILApDBE55 CITV ZIP PMONE STATEUGENSE� <br />0 � .J ri�L <br />MECIIANICALCONiRACTOR MAILlODRE55 CITV IIP PHONE STATEUCENSE♦ <br />PLNd81NGCONTR/GTOR MAILADDRESS CITV 2iP PNONE SiATEUCENSE� <br />� 2o U o c� <br />CONTRACT PRILE OF WORK <br />DESGPIBE W ORK nND SOUARE FOOTAGE INVOLVED CONiACI PERSON AND PHONE NO. <br />�� _ . . . _ \ L' . _ _ . .i�.-..- `Z ZC--U�� Cl . <br />PROPOSF.� US[ OF 9WLDING <br />LEGPL DESGRIPTION OF PROPEFTV �SMOWN BELOW OR ATT4CH TWO COPIESI <br />�ot eiocK oF <br />PAPC[LTA%ID NUM�ER <br />CONSTRUCTION LOAN LENOER. <br />OF <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />IAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />TEIEPHONE <br />ITEM <br />PERMIT <br />TOTALF <br />FOR OFFICE USE ONLY: <br />iPONTSETB/CH RCARS[iBALK <br />USEZON[ LOTAREA <br />tYPEOiCONSi. NO.OFSTORIES <br />SIZE OF OLDG FlRE SPRINNLERS REO'0 <br />OCGUF: NGY lnnn FIRE ALARM RE00 <br />INiANE �Y PLAi.: APPROVEOOV <br />onTe <br />0 <br />W � L. �� l—� ` 1� <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 TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHEfi SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUT40RITY TO VIOLATE OR CANCEL THE PflOVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. �/ <br />TYPE OF E�UIPM <br />NC—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />PUMP <br />PIPING <br />\UST FAN <br />il0E5ETBACH PLANCMEC(Nllld ER FEE <br />� 7 ! <br />J �� <br />oacnNtsite FEES _� <br />i� � YES �. NO BUILDING <br />oca�ncr¢r �,�orowuuxcwu�s <br />`� ' PLUMBING <br />BnSEMENt MECHANICAL <br />--- YES . � NO <br />HEIGnT uMRniiOrv ADDITIONAL PLAN CHECK <br />OTHER <br />STATE �UILDING SUFCHARGE <br />CITY OF EVERETT PUI3LIC IVONKS <br />IOCAL SALES <br />TAX CODE IS 3105 rora� <br />TOTAL <br />No <br />0 <br />NN <br />G <br />�� <br />