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APPLICA'�'10. _ FOR CONSiRUCTI - N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: j;1 GAS ❑ ELECTRIC J_ � <br />BUILDING DEPARTMENT - <br />259-8810 <br />I� DEMOLITION C_] COMBINATION ��`BUILDING I_' 9ECHANICAL fvPLUMBING ❑ SIGN <br />OWNEF MAILA[1pRE55 CIiY ZIP PHOtlE <br />�±�IaN-ScitucFC I�G�I•dk M.[.� IP�' Snch• �i�a90 33</-CP/7 <br />TE'Ii:H� MAILAO�RCSS CITV 21P PMON[ <br />ARCHITECTOROESIGNER IdAILADDFiESS <br />uENERAL CONTRAf;TOR <br />PLUMBING GONTP�CTOR <br />S��-.��e_ I <br />' PROP SEDUL'EOF�UILOING <br />•% �JI W <br />LF.GAL DE9�,FIP710N OP PROPI <br />� LOT '�' BLOGK <br />MML A��RESS <br />�s�ai• u k M.Gc. I� <br />IdFIL ADDRE55 <br />/s��s P�.G o,,. %' <br />MdIL ADDRE55 <br />�_;,,, , 5 �� 9 SG'� F^^o <br />�63 <br />FOOTAGEINVOLVED <br />� <br />�� <br />�/ <br />d �� <br />�SHOWNBELOWORATTACH�VlOCOPi 5 <br />�ia = w� <br />OF <br />PARCELTA%I.p.NU1d8[P <br />CONSTRUCTIONLOANLENDEF.POCFESS.TELEPNONE <br />N0. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) � � <br />� F3ATHTUB � <br />� LAVATORY (WASH BASIN) ; �/// <br />SIIOWER <br />/ KiTCHEN SINY.B DISP <br />� DISHWASHER <br />LAUNDRYTRAY <br />/ CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRA;N <br />B.4CKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK ISERVICE--BAR. ETC.1 <br />— �— <br />FOR OFFICE USE ONLY: <br />FFONTSETBFCK REApSET�ACe <br />Zo � Zc' <br />U':E20NE LOTAREA <br />-� f � --6 � <br />iYPE OF CONST NO.OF SAiORIE: <br />� /.� %. <br />F�ASON <br />INrnkE ev <br />SUB TOTAL $ <br />PERPAIT 5 <br />TOTAL FEE 5 <br />FlRE SPRMNLERS REO'D <br />G� <br />FIRE �LARh1 FEOD <br />�O <br />PLAMS APPP�VED �Y <br />�� <br />onre � � /,—� /� <br />CRY 21P <br />CITY .'.IP PHONE STATELICENSEa <br />�nah- �r8a9d__3�S`-riY/7 ilAfa�15 oGs Nl j <br />CITY ZIP PHONE STATE LICENSE a <br />�li� �Rz.33 7s� ��o� I'i k1= ('i� �v6C� <br />CI ZIP PHONE STAT"cUGENSEu <br />�5:��:.q{' 98�yz �S�a-7�rn S�u�n cYD•IS?ohJ <br />-r . <br />I_ <br />�.✓ <br />ANO <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND XNOW THE SAME TO BE � RUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMaLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOFS NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEf. ThE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEqFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFOPM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITIi THE STATE <br />CONTRACTORS LAW 16.27 RCW AND 296200 WAC. <br />�6- � - v s� <br />Sb� NRE 00iE <br />Ci1V pU51N[SS LIC[nSE NO <br />MECHANICAL <br />NO. TYPE OF E�UIPMENT FEE <br />A/C—A/HNDLG UNITS—H.P. <br />1 FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br />UNIT HEATERS—B.T.U. M ; <br />y CLOTHES DRYERS �— <br />VENTILATION F,4N ; <br />J RANGEHOOD <br />WATER HEATER � <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) � <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />/.1F EXHAUST FAN /// I <br />SIOESETBACK PLANCHECKNUtd6ER FEE <br />, <br />S' '7 � <br />VAGANTSRE EES <br />%YES ..� NO BUILDING <br />C.C,r�Srr 'ACfU::[iV•:G6'd:5 <br />_/JJ. PLUMBING <br />BaSEk1ENT . / MECHANICAL <br />. �. YES I�IJO <br />HEIGHt lIA�1TAT10N ACDITIONAL PLAN CHECK <br />OTHEP I )�U�I/V <br />STF!E BUILDING 5!!RCHfd�GE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CqpE IS 3105 TOTAL <br />SUB TOTAL $ /��);_ <br />PERMIT 5 <br />TOTA! FEE S �— <br />PECEIPT N0. ^ <br />� ���L� <br />VALUA'tiON FEE <br />�J� O �(J � <br />7 � <br />� <br />i� <br />� <br />� � <br />/ / .; `� � �� � <br />