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A�a�LIC,A�'90'�` f,-=iiR �`aNST1�1JCTl�N PERMIT � <br /> TO BE Cli`.AFL'cTED IN ['�ACK ;NK—PLEASE PRINT <br /> BUILDING DEPARTMENT h�•�TING SYS7EM: �I GAS ❑ELECTNIC J � � <br /> C--- <br /> 259-8810 l�,�iL2����c�'n�c.�.i 32�� -/0.3��"r, �,.��"l� ,�y" 1/��� �.lu�v 9d`C'�'i�/ �/_�3-032y <br /> ❑ DEMOL1TIqN ❑ COMBiN,4TlON ❑ BUiLDING C MECHAN�CAL ❑ PLUMB'ING � SIG�! <br /> OIVNEF ` 1'fRAD�RESS QTV ZIP �HONE <br /> / � ! r <br /> �Ju,OP_,/�rnail/�P� �eve%OoreN C>O^�1 Je�cc��e- — <br /> TE/NF�'�1'- lAAILFODR 5$ CITY ZIY PHON2 <br /> 1..11,Sa�'.� S C-iNOGL' /`C1_ — .__ --_.— <br /> ARCHITECT090ESR.1lER k�ILA6�F'S5 CITY _r �'��G.tc <br /> GEN�qALf,pNTRACTOfl M1f4ILADDRE55 CITV ZIP PHONE STqTELICEVEEC <br /> ,�,� � bb�il-Co,�Sfi ��. _��fNp <br /> MEGHANICPLCf,NTRACTUR 61HILADDRE55 CIN ZIP PHC'�E STATELICENSC: <br /> PLUMBI GCONT \CTOR NAILAD�RESS QTV ) ZIP PHONE RiATEUCENSEa � <br /> _�„r� uMb�N � o��������,,�� �saa��9a�a c�h���Anr o4g��:_ <br /> CQfRRA::T PRICE �WORK <br /> 6� J� ' <br /> 0 CFIgE WORK A11D SOUAFE FOOtAGE INVOIVED COWTALi 7EPSG4 aI:D FHONE NO. <br /> l44 /�/ <br /> I HERE3Y CERTIFY THA'f I HAVE READ AND EXAMINED THIS <br /> PR/O�FOSE�USE OF 9UILOING APPLIC�1'fION AND KNOW TF1E SAME TC BE TRUE AND CORRECT, ALL <br /> /ti✓'D c r /�t.� PROVISIONS OF IAWS AND OHOINANCES GOVERNING THIS TYPE OF <br /> LEG4LDESCRIPT10 FPROPERTV(SHOWNBELOWORA^ACHTWOCOPIES) WORK WILL 9E CCMFLETED WITH WHETH�R 3NEGIFIE!l HEIiEIN OR <br /> NOT. THE CRANTING OF A PERMIT DOES NOT PRESUME TO 31VE <br /> L01'— BLOCK oF AUTHOR'.TY TO VIOLATE OR CAtJCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCP,L LAW aEGULATING CONSTRUCTION OR THE <br /> — PFRFORMANCE OF CONSTRUC�ION.THAT I AM AUTHORiZED BY TIiE <br /> OWfJ[R OF THIS PP.OPERT'! TO PERFORM THE WORK FOR WHiCH <br /> � APPLICATION IS MADE AND I COMPLY WITH THE Sl'.4TE <br /> PAqCELTAkI.D.NUMBER CONTRACT RS iB. RCWAND296200WAC. <br /> CONSTPUCTION LOAN LENDER.ADDRESS.TELEPMONE NUMBER <br /> ,� � i �/ 3 9 <br /> PROJECT D SS N:ruaE � aue _ _ <br /> c� v usu:cssuccr�seuo _ <br /> PLU BIN M CHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NG. TYPE OF°�UIPMENT �EE <br /> WATER CLOSET(TOILET) NC—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIFl SYSTE�AS-8?.0 M E.A. ' � - -��':��"., <br /> LAVATORY(WASH BASIN) � UNIT HEATERS--B.T.U. Iv1 � � � � � �. <br /> T--' <br /> SHOWER CLOTHcS L'ftYERS ' __ <br /> KITCHEN SINK&DISP VENTILATION FAN __^�___ � <br /> DISHWASHER RANGE HOOD ' _ � <br /> LAUNDRY TRAY ' WATER HGATER _ <br /> CLOTHES WASHER � WOOD STO'JE ___ � , <br /> URINAL ' �dETAL FIREPLACE(WOOD BUR�ING) ' ._ �� <br /> DRINKWG FOUNTAIN I FIREPLACE INSERT � � <br /> FLOOR DFAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS GAS PIPING �___ - <br /> ROOF DRAINS—RAINL�AGERS EXHAUST FAN _�__ �� <br /> SINK(SERVICE—BAR, ETC.) I = � <br /> � _ -- <br /> � <br /> SUB TOTAL S SUB TOTAL S , <br /> PERMIT S � <br /> TOTALIFEE 5 —Z��' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBf�CN SI�ESET9FCK PLANCHECKNUh1BER . FEE RECEIPTNO. <br /> t.i � � a. <br /> usezo�+e LOTAREA VACFNTSITF FEES VALUATION FEE <br /> �I YES C NO BUILDING '� - <br /> TYPEOFLOflSi. ND.OFSTOPIES U:CUGAntv Noa�olvFW':GU!:ns � <br /> �"o��P PLUMBING � <br /> SI2[OFBLDG. - FIRESPRI4KlEF5RE0'D �����.�[HT McCHANICAL � <br /> _-i YES '�_ NO ��� <br /> � <br /> OCCUPAKCY LO�O FIREALAFM REO'D HEIGHT L'�1AITATION ADDITI.:NAL PLAN CHECK � _ <br /> OTHEF <br /> REASON � <br /> STATE BUILDSVG SURCH.4RGE <br /> INT;J:"c'u\' PLFNSAPPFOVED6Y CITY OF EVERETT PUBLIC WORKS _ <br /> LOCAL SALES � <br /> on.e TAX CODE IS 3105 TO7AL ; <br />