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APPLICATION FOR CONSTRUCT. JN PERMIT <br /> she Emgwn TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITY OF _ <br /> everett HEATING SYSTEM: J J ELECTRIC J <br /> BUILDING DEPARTMENT — ---- <br /> 259.8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> WR MAILADDRESS CITY 2iI' PHONE <br /> �IIIFL'N /� LA�ZR✓ /'/'1l SrI �'v LIT �iAA7 c'i 35: 'i7c'9 <br /> TENANT MAR ADDRESS GITY 21P PHONE <br /> ARCHITF.CTOTDESIONER MAIL ADDRESS CITY ZIP PHONE <br /> H _ <br /> T.Trro <br /> LT7 m GENERA CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSE F <br /> z H — err <br /> I'3 N MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE P <br /> r x -- <br /> H a PLUMBING CONTRACTOR MAA ADDRESS CITY ZIP PHONE IK;ENSE F <br /> y zH <br /> F< � <br /> P3 <br /> O0� H-4 cuss a WORK <br /> y H NEW ADDITION ALTERATION X REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> H r CONTACT PERSON AND PHONE NO <br /> O Oy L1�T011 CONTRALt PPY:E OFWOM <br /> DESC AIF WDFITSOUARE FOOTAGE RIVOLVED <br /> wogHm <br /> G1� Ca PROPOSED USE aBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> SFS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> z HTYPE <br /> yzLEGALDESCRIPTIONOFPRDPEnTYISHDWNRELOViORArTACIIraIncOPFs, PROVISIONS OFLAWS ETEDWI ORDINANCES THERSPGOVERNING THISSPECIFIED <br /> REIN OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> I-+ <br /> 1-3 LOT BLOCK _ OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> co AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> H <br /> n lq7 N OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE � <br /> R C, PERFORMANCE OF CONSTRUCTION,THAT I AM AUTHORIZED BY THE <br /> Cy OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> Z H W APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> "3 O Tn CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SICNAIHRF O CONTRACTOR OR AUTHORIZED AGENT DATE <br /> nnaecT ADDRESS <br /> .T <br /> NO ANDBUSMSSNAME <br /> IQ' ST ('/LCTJ' APPI ILANTS..ir•PP.,..FSSIICCHSE <br /> PLUMBING MECHANICAL <br /> o NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> ��sa WATER CLOSET(TOILET) NC—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY GNASH BASIN) _ UNIT HEATERS—B.T.U. M i <br /> T <br /> CLOTHES DRYERS ' <br /> SHOWER <br /> KITCHEN SINK A DISP VENTILATION FAN <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY �— WATER HEATER <br /> CLOTHES WASHER —�� WOOD STOVE <br /> URINAL METAL FIREPLACE A CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> �.�Ar FLOOR DRAIN HEAT PUMP <br /> .... -1- GAS PIPING <br /> BACKFLOW PREVENTERS _ <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> ' SINK(SERVICE—BAR,ETC.) <br /> I <br /> SUB TOTAL E SUB TOTAL E <br /> PERMIT E PERMIT E I <br /> TOTAL FEE E TOTAL FEE E <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REM SE TRACK SNE SETBACK PLMCHECK NUMBER FEE RECEIPT NO <br /> "SF ZONE LOT AREA VACANT SDE FEES VALUATION FEE <br /> BUILDING eo2'J ; 00 <br /> TYPE OF CONTS AUCAMIKI IYA&CMO PALLIUM IYcw . AO MCATwA4UM9 <br /> PLUMBING <br /> SIZE O BlDO NO O STCNU[S BASEMENT MECHANICAL ' <br /> I <br /> OCCUPANCY LOAD F IRE SPRNKLE AS PLOD HEIGHT LIMITATgN ADDITIONAL PLAN CHECK <br /> OTHER i <br /> nEMON FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PLANS APPROVEDSY CITY OF EVERETT PUBLIC WORKS ; <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL 3/ 1 `�J <br />