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pppLlC�!°['IG_J FOR CONSTRUCT.�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: ❑ GAS <br />BUILDING DEPARTMENT <br />259•8810 <br />J DEMOLITION i COMBINATION X BUILDING MECHANICAL K PLUMBING SIGN <br />OWNF�R �MAILADDRE$$ CITY 21P PHONE <br />i�h//�P 1 Hi��/ ?9v8 /9'�' st Ever� uJa 98zo/ zsL-6ztr.� <br />TENRNT MAILAODFESS CITV ZIP PMONE <br />� I i a . N� e/ 9e 7't' S'� .. ,, •� <br />AFCHITECTORDESI1GNER MAILAODiiESS CITV 21P PHONE <br />t(Ir J, Yi��ce� �. .. • �. �i <br />GENERALCONTRACTjOR �MA14ADDRESS qTV ZIP PMONE STATELICENSE• <br />YVI l�/!� V Ei�C� i'���%%! ) II Ir /. i� .I i/ �� <br />MECHPNICALCONTRACTOR MAILADDRESS CITY 21P PHONE STATEUCENSE/ <br />/� rr .� ., t i• � _ <br />�� PMONE STATEUCENSE/ <br />PLUMBINGCONTRACTOF MAILA�DRESS CITY Z�P <br />� ir Ii ii ii �. <br />ri �� ii �� <br />LLASSOFWORK " <br />f I NEW X ADDITION i I ALTERATION 7(' REPAIR .'� DEMOLITION � WOODS70VEIFRPL INSERT �. � BUILDING RELOCATION <br />CONT�CT,PERSON �N� PHONE NO. <br />___.. � �� �ti�.� ,.<J� //.:. �lAaies �11�.�c1 � s 2 -�Lys <br />DESCFIBE WORK AND SOUARE <br />A PYGY. � S <br />PROPOSED USE OF BUILUING <br />LEGAL DESCRIPTION OF PFlOPERTY (SHOWN BELOW OR ATiACH I <br />WT 3; y BLOCK v�_ OF /�nQ <br />—�—�-- <br />%�cn n v /a,v.� C��_ �: <br />PRQIECT <br />NO. TYPE <br />/ WATER CLOS <br />BATHTUB <br />i LAVATORY(N <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />URINAL <br />DRINKING FOl <br />FLOOR DRAIN <br />BACKFLOW PF <br />�� <br />OR ITEM <br />SUB TOTAL S <br />PERMIT 5 <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: , <br />FRONT SETBAGK FEAR SETBACK <br />a' 70 � <br />USE ZONE i0 AREA <br />�`� O <br />lYPEOFCON75.ALLOWABIE 7YPEOiCONSiACiUAL <br />��� <br />SIZE OF BLDG. NO.OF STORIES <br />o AO � <br />OCCUPANCY �_OAU FIRE SPRNKLERS RE <br />�I, /a N' <br />gy PLANS APPROVED BV <br />� �i -, l� � <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE kND CORRECT. ALL <br />coaiesl PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OF <br />NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br />T AUTHORITY TO VIOLATE O�l CANCEL THE PROVISIONS OF ANY <br />O / O/ OTHER STATE OR LOCAL LAW fiEGULATING CONSTRUCTION OR THE <br />PERFORMANCE. OF CONSTRUCTIGN. THAT 1 AM AUTHORIZED BY THE <br />GWNER OF TFiIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />%/. <br />, x - .��> - f.zP> J7-�.�d v,��_vN�e <br />sicvnruar o�.e <br />FEE N0. � _ TYPE OF <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS _ <br />VENTILATION FAN <br />WATER HEATER <br />WOODSTOVE <br />METAL FIqEPLACE t <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />/ EXHAUSTFAN <br />SUB TOTAL S I ��/J �� <br />� PERMIT $ <br />, TOTALFEE $ <br />)G�.iG7oe�� �f Z lo U 3c. .5d'cSC•tpa2i-� <br />-rPLAN CHECK NUMBE�i FEE � RECEI�T <br />�—' 3'1.35�� I <br />VACANT SIiE FEES <br />�� BUILDING <br />O[COP14tv NO OfpN'F0.�NGIIN.15 <br />I9°� � / PLUMBING <br />K. <br />BASEMENT MECHANICAL <br />NEIGHTUMIT�ioN ADDI710NALPLANCHECK <br />SPRINKL[R <br />STATE BUILDING SURCHP.RGE <br />CITY OF EVERETT PUdLIC WORNS <br />LUCAL:ALES — <br />y TAX �ODE iS 3105 TOTAL <br />0 <br />� <br />