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APPLICATIC 7 FOR CONSTRUCT' )N PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ —� <br /> 259-8810 <br /> ❑ DEIdOLITION ❑ COMBINATIO� ❑ BUILDING �MECHANICAL ❑PLUMBING G S!GN <br /> SKa7 D�4` A?ov�"�iE�s a9io ��vci�.�E t't�Ellk�rT 4'�b(NE __—_ <br /> IE��WT MAIIAUDRE55 Cltt ZIP PIIONE <br /> .�T�z �a�K aA�_(�y ,4.�E . �✓��r�l 4g� 1 _,__ <br /> ARCHITECTORDESH'iNEF MARAOD ESS CITY ZIP PHONE <br /> GENERKCANTMCTOP MAILADDRE55 CIIV ZIP PNONE STATELICENSE� <br /> M�1�1��zl�l�cS`rRY..a.�(��' �X ��5�'07 .Sf�Q?tl� _ `t� (c�� 7l� 331� /i7T����E�3T��d <br /> PLUMBINCCONTPAGTOO MAILADDRE55 CITV ZIP PIqNE SL\TELICENSEt <br /> I:ONTpACTPflICEOFWORN � 1�SDOO `— <br /> P <br /> UESCPIBEWORKRlDSOU�REFOOTAGEINVOLVED � � � CON*ACTPERSON�N�PMON@NO. � ��• <br /> ♦�� <br /> �o,o l �tw dY. �x � ' 7l� - xgcq <br /> O G C= ( � G VQY� QO S • I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINEO THIS <br /> PHW+OSED USE OF BUILDNGD�� 4�� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LF6ALDESCRIPiqNOFPFOPERTY(SHOKNeEI ONATTACNTWOGOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> i.or BLOCK pF — 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 LOCA�LAW REGULATING CONSTRUCTIGN OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PEPFOFM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TA L�.NUMBEp CONTRACTORS lAW 18.27 HCW AND 296.200 WAC. <br /> � <br /> CONSTPUGTION LOAN LENOER,ADDRE55.TELEPHONE NUMBER �yj�(/��,�� //� /7'(y <br /> ` V�•"'�0� TJ' (/ `� . <br /> PROJECTAODRES�S�� �y� J /����/J s e r. � oere <br /> _ ��S C.�fsT ��� �, ��r{�(/{!i� TY SMVSFLCfMGfNO <br /> I ` <br /> PLUM8ING HANICAL <br /> NO. TYPF OF fl%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn � A/C—A/HNDLG UNITS—H,P. � <br /> BATHTUE ; FORCED AIR SYSTEMS--B.T.U. M E.A. <br /> LAVATORY(WhSH flA51N) UNIT HEATEFS—B.T.U. M ; <br /> SHOWER ' CIOTHESDRVERS <br /> KITCHEN SINK 6 DISP � � VENTILATION FAN ; <br /> � DISHWASHER � RANGE HOOD � <br /> LAUN�RY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE <br /> URINAI METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT ; <br /> FLOOR ORAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF ORAINS—RAINLEADERS EXHAUST FAN � <br /> �SINK(SERVICE—BAR,ETC.) ; ' <br /> � <br /> � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL $ Q' <br /> PERMIT $ �— PERMIT $ ��� <br /> TOTAL FEE 3 ; TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REAqSETBRCK SIDESETBAGN PLANCH[CNNl1MBER FEE RECEIPTNO. <br /> �_3� �2, <br />� usezone LOTAREA VRCANTSIiL ' FEES VALUATION FEE <br /> ❑ YES ❑ NO BUILDING � <br /> iYPEOfL�NST. NO.OFSTOFIES OCCUwKY W.uoMlliNGUNns � <br /> �aaP PLUMBMG . <br /> SIZEOFBLDG. FIRESPRINKLERSqCOD DASEMENT MECHANICAL � <br /> ❑ YES ❑ NO <br /> OCCUPANCY LOAD FIRE AURM REOD HEIGHT LIMI7ATION �DDI710NAL PLAN GHECK j <br /> i <br /> OTN[R � <br /> — —' i <br /> REASON �— <br /> STATE BUILDING SURCHARGE i <br /> INTANE BV PLANS APPROVEO BY CITY OF EVERETT PUBIIC WORKS � <br /> •. UYI LOCRL SALES <br /> J <br /> onre "� TAR COOE IS 3105 TOTAL � <br />�� _ <br />