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aHI-I <br />H <br />K � <br />0 hd <br />AA 1-A <br />H3 <br />E� o <br />00 <br />OH <br />Nog <br />0 N CA <br />F1 <br />x H <br />H <br />HH <br />gcl) <br />H <br />n�y <br />O <br />iC <br />APPLICATIO :" FOR CONSTRUCTi N PERMIT <br />TO BE COMPLETED IN'.NK-PLEASE PRINT n <br />"Evwgwn <br />CITY OF <br />evere tt HEATING SYSTEM: GAS ❑ ELECTRIC El --- <br />BUILDING DEPARTMENT �-r womv�1T <br />259.8010 �►�`�"" � <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />ONTlER MAIL ADDRE 55 CITY ZIP PHONE <br />flolsl s I For i'1% ;LAIR '�8206 Lsoc) s4'1 • ►q44 <br />.cwur WIL ADDRE55 LITV <br />LICENSE <br />RUMBPIO CONTRACtOR MAR ADDRE55 <br />CIiY IIP PHWE <br />CLASS OF WORT[ � / wMneTnVFIFRPI INSERT BUILDING RELOCATION <br />NEW ADDITION 7, ALItRA(TUn <br />----- <br />-- <br />CONTACT PERSON AND PHONE NO �N <br />CONTRACT PRICE OF WORK <br />— <br />DESCRIBE NORK AND SOUAHE FOOTAGE <br />(NV <br />�M;Ro�IEjMIL�1T F���% <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROIbSED USE OF BUAi11Np <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />I� <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />IEGAI DESCRIPTIONa PPERTBELOWOR ATTALHFWRCOPIF.61 <br />OP YISROYM <br />l <br />LOT �Z� ZS BLOCK OF <br />NOT. THE GRANTING 0 F A PERMIT DOES NOT PRESUME TO <br />AINY <br />AUTHORITY TO VIOLATE OR CANCEL HE PROVISIONS OF <br />THE <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />�d�Iy 5X IT <br />PERFORMANCE OF CONSTRUCTION. THAT 1 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 />-�i�Z <br />—"J <br />CONTRAC ORS LAW 1 C AND 296.200 WAC. <br />SpN�NIIE CONTRACT` U�ORIZED AGENT DATE `1 ! V <br />1� <br />1 1 <br />5zo I <br />PRQIECT ADDRE55 •.' <br />A -EI Ln <br />APRY-ANTS CITY BUSINESS LICENSE NO AN BUSINE E <br />u• a -- <br />S SMA <br />PLUMBING <br />FEE <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />AlC—A/HNDLG UNITS—H.P. <br />WATER CLOSET (TOILET) <br />I <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />i <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />I <br />' <br />HEAT PUMP <br />FLOOR DRAIN <br />; <br />OAS PIPING <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />I <br />I <br />SUB TOTAL S <br />i <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTALFEE S <br />TOTAL FEE $ <br />FOR OFFICE U51: <br />FRONT SETBACK <br />UNL.T: <br />REARWRACK <br />� <br />610E SETBACK <br />PHE K FR i , 30 <br />RECEIPTNO <br />7eO <br />_ <br />UK. =ONE <br />S <br />LOT AREA <br />VACANT SITE <br />) <br />FEES -VALUATION <br />FEE <br />/ <br />I <br />r <br />BUILDING <br />az <br />TYN OF CONTS Att"ABLE <br />TYPE OF CONST ACTUAL <br />a[wAMY <br />IR ddH,~ftI1 <br />•� <br />PLUMBING <br />s KR <br />dl 2 <br />MECHANICAL <br />' <br />SUE OF SLpO. ND OF BTDRIES BASEUENI _ <br />ADDITIONAL PUN CHECK <br />; <br />/ <br />•14 333 Z <br />OCCUPANCY LOAD FIRE SPRNKL RS REOD HEIGHT LIMITATION <br />+'S <br />OTHER <br />i <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />REASON FOR SPRINKLERS <br />INTAKE BY <br />PUNS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TOTAL <br />'� i ; Y7 <br />TAX CODE IS 3105 <br />