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pppLICATIC"l FOR COMSTRUCT'.`"fN PERM14 � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT '— <br />259-8810 <br />r, nF�uni iTION � COMBINATION <br />OWNER MAIL DORESS <br />L D •PO Gons �✓ l � <br />TEN�NT MAILAODRESS <br />OR �ESIGNEf <br />a ��� <br />�"� <br />MECHANICAL <br />MAIL <br />=r <br />MAIL <br />AD�FF55 <br />HEATING SYSTEM: ❑ GAS ❑ ELFCTRIC ❑ <br />GONIRAGT PRICF.OF WORK <br />bESCRIBE WOPN AND SOl1ARE FOOTAGE INVOLVED <br />C.Oh S �NGr /%e LJ �o� OO (f� /7D <br />PROPOSED USE OF BII/IID'�ING p /� <br />�' � a-FQ ��1. J�,e�ri�Ll'�C,.0 _ <br />G BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />CITV 21P PHONE <br />a�: �� 4���G'�' 1L'"t�odl.,e// Gv/� �>�oz< <lP1S�- �/��1�/ <br />CITY 21P PHOHE <br />cm ��'' <br />CITV ZIP <br />Da S Er � vd�G� <br />CITV ZIP <br />GT� <br />LEULDESCRIPTIONOFPROPERTY HOWNBELOWORAiTACHTWOCOPIES� t(�� <br />� e�ocK oF Pe .. P.vn,:I/ F/ <br />�os <br />Dr ✓ lL <br />PARCELTA%I.�.NIIMBER <br />GONSTRUCTION LOAN LENDEF. <br />TVPE OF <br />WATER CLO6ET <br />BATFiTUB <br />LAVATORY(WAS� <br />SHOWER <br />KITCHEN SINK 8 <br />D�SHWASHER <br />IAUNORYTRAY <br />CLOTHES WASH <br />URINAL <br />DRINKING FOUD <br />FLOOR DRAIN <br />BACKFLOW PRE <br />ROOF DRAINS— <br />SINK (SERVICE- <br />NUMBER <br />PNONE STATE ll.^.ENSE M <br />ye,^-Y�Yy LGUcoc�i <br />PHONE STRT'c LICENSE a <br />_._.._ —ciircucoM <br />f.ONTACT PEfiSON AhP PMONE NO. <br />�y^e �/�i �.206 � �f8 S- �f..7 5��1 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOVJ 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 />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CCNTRACTORS LAW 18.27 RCW AND 296.2U0'NAC. <br />�J !���� q���/�y <br />Y C�`.�il � � r�� <br />E <br />SGNAiO E <br />FEE N0. TYPE OFEOUIPMENT FEE <br />E OR ITEM qiC—piHNDLG UNITS—H.P. <br />� �� r � FORCED AIR SYSTEMS—B.T.U. E.A. — <br />�� <br />q I II f UNIT HEATERS—B.T.U• M <br />, � CLOTHES DRYERS � — <br />—� VENTILATION FAN <br />� � f RANGEHOOD <br />� i wnTEA HEATER J — _ <br />FOR OFFICE USE ONLY: <br />FRONT SETBA:K REAR SETBACK <br />� �I <br />USE ZO�� LOT A�PEAM� <br />fVP'OFCONSi. I NO.O�STOFIE <br />Z��x ,� , <br />h52. 5F � <br />OCGUPANCYlOAO <br />� <br />REASON <br />INTAKE BY <br />SUBTOIAL ti <br />PERMIT 8 <br />TOTAL FEt $ <br />FIRE SPRINNLGRS REQ'0 <br />� �� <br />V <br />FIRE ALA1`N flE0 D <br />l���i <br />PLANS AP ROVED BY <br />� I� <br />0 <br />HEAT PUMP <br />CAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT $ ' <br />TOTAL FEE g � <br />FEE n RECg PT �--� C�� <br />c� �-�. �- � / �A �� _�� <br />VACANT SITE <br />�YES �-! NO BUILDING <br />OLCOPAM1'CY N� Oi/'IEIIiHGIINIiS � <br />R�� PLUMBING <br />BASEMENT �� MECHANI�AL <br />❑ YES 4fN0 <br />HEiGHTUMiTanoru ' ADDITIO�'ALPLANCHECK <br />OTHER J <br />STATE BUILDING SUHCHARGE <br />CITY OF EVERETT rusuc woaKs <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />Q <br />