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i <br /> APPLICAT101 . FOR CONSTRUCTI..N PERMIT <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> IM EYeIP.Nr,•. <br /> CITY OF <br /> everett HEATING SYSTEM ;J,AS U ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259-8810 MECHANICAL PLUMBING SIGN <br /> DEMOLITION COMBINATION BUILDING <br /> OWNER MAA.ADDRESS 3 Z CITYT. .IIP PNONL Q <br /> A. <br /> 1 -lli'M Va rn / LI�Gt /.L7 !`iIP 'l r PHONE, <br /> TENANT MAIL ADDRESS <br /> ARCHITECT OR OESK)NER MAR ADDPESS Lliy ZIP P:WNE <br /> IP PHONE LICENSE A <br /> GENERAL CONTRACTOR MAR ADDRESS <br /> CITY Z <br /> MECHANICAL CONTRACTOR MAR ADDRESS C17Y ZIP PHONE LICENSE F <br /> Crl CrJ /SINK t-A .N <br /> PLUMBNO CONTRACTOR MAR ADDRESS CITY <br /> ZIP PHONE IICENSEI <br /> ,o � x _ ti8S •29o2 <br /> y y cLAss of WORK — <br /> NEW ADDITION T`ALTERATION REPAIR DEMOLITION WOODSTOV&FRPL INSERT BUILDING RELOCATION <br /> N 3 CONTACT PERSON AND PHONE NO <br /> nR< ;Ilti -18s'-4 -? G2 <br /> y 0 CONTRACT PRIG'GF WORK <br /> O0 :G O� DESCRRF VIORK ANDSWAREF/DOTAGE <br /> U1H NJ G/Fi lU.�.>.y.. c �NT) WivIG'C�{•At, <br /> xPROPOSFDUBEOFBU DING 1 HERBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> to (� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> d LEGAL DESCRIPTKXI OF PROPERIYISIIOWNBELOWOR ATTACH FOURCOPICSI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> OH <br /> �y WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> zo O Lot BLOCK a NOL THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> n• c) AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> Z H OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> A z PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> y <br /> t" OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> H y APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> O CONTRACTORS LAW 1S 27 RCW AND 298,200 WAC. <br /> H <br /> d Cn SIONATUREQF CONT ACTOR OR AUTHORREO AGENT GATE y/I S I <br /> .pf/).Fy., <br /> q <br /> H O (AA XA)i2."A $�/ -�Gfl/N� l�tq�rS+s .f Cmsllc .2 <br /> PRO.IELT AGGRE85 .y APPLICANTS CITY BUSINESS LK:ENSE NO AND BUSINESS NAME <br /> �� u� r O MECHANICAL = <br /> aj PLUMBING <br /> FEE NO. TYPE OF EQUIPMENT FEE <br /> NO. TYPE OF 4XTJRE OR REM <br /> ET(TOILET) AC—AMNDLO UNITS—H.P. <br /> WATER CLOS �— <br /> I FORCED AIR SYSTEMS—B.T.U. E.A. ' <br /> BATHTUB _ <br /> s LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLCTHES DRYERS <br /> KITCHEN SINK 6 DI5PVENTILATION FAN � <br /> _ <br /> RANGE HOOD <br /> DISHWASHER ' <br /> 1— LAUNDRY TRAY HEATERWATER <br /> WOOD STOVE ' <br /> qAM' CLOTHES WASHER <br /> URINAL METAL FIREPLACE 8 CHIMNEY ' <br /> _ DRINKING FOUNTAIN <br /> FIREPLACE INSERT <br /> YAC FLOOR DRAIN 1 HEAT PUMP <br /> 1 BACKFLOW PREVENTERS OAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE—BAR, <br /> I ' <br /> 1AYp I <br /> .. I <br /> I <br /> SUBTOTAL f SUBTOTAL S <br /> PERMIT PERMIT f S <br /> l TOTALFEE $ TOTAL FEE f ' <br /> FOR OFFICE USE ONLY: <br /> RECEIPt NO <br /> FRONT SETBACK REAR SETBACK 910E SETBACK PIAN CHECK Nu11BERIFEEUSE ZONE LOT AREA VACANT SITE FEESEVALUATION FEE <br /> BUILDING ' <br /> TYPEOF COAL AALLDWARE TYPE d GOVSI ACIUM a<u+Yc. AoaRMUNcuAn <br /> PLUMBING <br /> SIZE OF BLDG NG.OF STGRIES BASEMENT MECHANICAL <br /> OCCUPANCY LOAD FIRE SPRNKLEPS REOK} <br /> b HEIGHT LIWTATI ADDITIONAL PUN CHECK <br /> i <br /> I OTHER _�— <br /> REASON FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PANS APPROVED BY CITY OF EVERETT PUBLIC WORKS i <br /> LOCAL SALES �1 UU <br /> TAX CODE IS 3105 TOTAL <br />