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7� , <br /> APPLICATIO. . FOR CONSTRUCT1.iN PERMIT L <br /> TO BE COMPLETED IN INK—PLEASE PRINTN {mow feD� <br /> the EYPIORNKI IA _ <br /> CITY OF "— <br /> yx30 everett HEATING SYSTEM: OGAS ❑ELECTRIC - -- <br /> [R y BUILDING DEPARTMENT <br /> Io� Gd 259-8810 MECHANICAL PLUMBING SIGN <br /> t"H Ca DEMOLITION COMBINATION BUImDINO zP PHONE <br /> IH'3 EonwoER/I�F MAIL ADDRE56PL 51E <br /> DL6Tr t203 34/9 <br /> RfIRW�LL Olipr <br /> P OpE <br /> •� TENA•rt MAIL ADDRESS _ <br /> m z ~ ARCHITECT OR DESIGNER MAIL ADDRESS <br /> DITY 21P PHONE <br /> `L IIP PHONE LICENSE R <br /> MAR ADDRESS CITY 1 <br /> HR 1 <br /> I'] L7 a CO Tw— to f ed►^St-td wso/ PN. <br /> O n �VtIQtfT OJfLDttf G!✓GRLAtow VM ✓µFASTT d ZIPS PHONE LICENSER <br /> r(��I MAIL ADIA CITY <br /> I"I CC MECHANICAL CDNTMCTOR <br /> •Z H CITY <br /> IIP PHONE LICENSER <br /> RUMema caNTRuron MAC ADORE SS <br /> F4 H <br /> y H CLASS OF WORK <br /> O N C NEW X ADDITION AIT ALTERATION ' REPAIR DEMOLITION NO <br /> PERsaN AWNOOIOwSNEOE/FRpL INSERT- BUILDING RELOCATION <br /> CONTACT <br /> CON"C <br /> ([LL(x/� CONTRACT PRICE OF WORN V 7 42 <br /> F3DESCRIBE WORK AND SOLJARE FOOTAGE INVOLV F_A((,LJfE GAAAR7 )oL) <br /> tXTRtNvD f.=�G s F 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> PwPoseD usE a evADwa APPLICATION AND KNOW HE SAME TO BE TRUE AND CORRECT.ALL <br /> /SL0/pgRvcE PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> i LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW ORATTACHFOUR COP@SI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> -OooF SULNCGR LeN NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> /,j BLocK 000.0 <br /> LOT AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW TING CONSTRUCTION OR THE <br /> RTDGE <br /> PERFORMANCE OF ONS RUCT ON.`THAT II 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 /> ��/� <br /> CONTRACTORS <br /> OF CONTRACTOR OR AUTHORIZED AGENT A . <br /> E <br /> DATE <br /> cT #yoio-N/F/(/-o/3-Gdo <br /> PROJECT ApOR[65 APPLIC TS CI USINE55 L(CENSE NO AND BUSINESS NAME i <br /> 02 79"_'✓ P/ `�¢r /f AIARL`T7 MECHANICAL <br /> /0 <br /> PLUMBING FEE N0. TY <br /> FEE <br /> E PE OF EOUIPMENi <br /> d NO. TYPE OF FIXTURE OR ITEM AIC—AIHNDLO UNITS—H.P. 1 <br /> WATER CLOSET(TOILET) <br /> FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> TA. BATHTUB UNIT HEATERS—B.T.U. M ' <br /> !�I LAVATORYIWASH BASIN) <br /> I <br /> SHOWER <br /> KITCHEN SINK <br /> ISR DISHWASHER Z TALY,6D <br /> Ie_I LAUNDRY RAV ' <br /> CLOTHESWASH He, SAID HE 1.11L.L 8(✓ EI�GLOSING CARPO(Lt <br /> '�. URINAL <br /> DRINKING FOUN (JAN I)E IZ SA M PtM I 1 ' <br /> FLOOR DRAIN � ) <br /> BACKFLOW PRE' <br /> ROOF DRAINS— EIAICIAsE CWOC� 30O <br /> SINK(SERVICE- SSJp @ �; I(o N t Wel ' <br /> GA2AGE ADD17ia14 � <br /> � 2908 <br /> tA <br /> For "c.wslN� its. cA¢Po�r ALS45" oN 'THE010-6X BETtiIr s <br /> GGvPwA7iooG A CARG[IIZACeb`(l�1 <br /> FOR OFFICE USE ONLY: EEE RECEIPTW <br /> SIDE BETBAC� RAN GNECM NUMBER <br /> FRONT SETBACK REAR SETBAC,I , 6s <br /> zo 20 S FEES 10 VALUATION FEE <br /> USE ION <br /> LOT AREA VACANT 6ITE I <br /> � <br /> -r ,Z NwnuwaPn n BUILDING <br /> WABD,FAKSI AC1UM ) <br /> TYR OF CONTS ALLOH IVR— Liz eau•LNa a a ' <br /> cKa• �• PLUMBING <br /> i <br /> NO.CF S10RIES BASEMENT MECHANICAL <br /> SIZE a BLDG l I <br /> D KNI L CHECK ' <br /> NE <br /> FIRE 6PRNKLER6 ROTJ gM(IMITATION I <br /> OCCUPANCY LOAD ETL I <br /> 00 OTHER ' <br /> REASON FOR SPRINKLERS STATE BUILDING SURCHARGE ' <br /> OWE, upT A/i C41WR t VER TNS m <br /> INTAKE BY BANS APPROVEDBY CITYOFE ETf rulr,worixs <br /> LOCAL SALES -73 : <br /> 45 <br /> 3�� TAX CODE IS 3105 TOTAL <br />