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APPLICATIC '�1 FOR CONSTRUCT ��)1� PERMIT �✓� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATiNG SYSTEM: ,�G S:] ELECTRIC J _ _____ _ _ � <br /> 259-8810 <br /> DEMQUTION COMBINATION I I BUILDING �ECHANICAL !1 PLUMBING SI��N <br /> OWNEfI M�It ADOPESS /� GITV ZIP /J PHOHE �7 � <br /> � � ' .�C i � L�� � i�. Ff .Y O� �/'�� � V7�Q —_—_ <br /> EN�NT /� MRR RpURESS CITV i�P PHOhE <br /> / J/' 1 L _ —"_.. <br /> �NCHiTECiORp S�GNER M�ILRUO��ES$ GITV 21P PNONE <br /> GEME��,AT v�A�il(�D�f��, I� GIiY 21P PMONE ,/� STATE LiCENSE• <br /> n[w i r w ----�_����Y(e��'-- <br /> MECH O m f . CITY IiP PMONf STQE LICENSE• <br /> __�����i'_— _ — <br /> �IU6IBMGL TRANGTJO.}R� M�RAppHESS LI7V 21P PHOVE SiATELICENSE� <br /> /�/C __ <br /> CONTF4CIPRiCEOFWOR � <br /> �U O � — <br /> DESCHIBE YR%NR�ND SOURRE F007PGE iNVOIVE� GONT9LT VERSON R�f J�10NE N �� <br /> -- �£n��� ����/a._�7 3��1- �fl/ <br /> /,�5�/IGG ,T,7r � : s -- <br /> �I � � J�_�Q�G �,! /P �F� i HEFEBY CER(IF� THAT I HAVE READ AND E).AMINED THIS <br /> PPO°OSFO USE OF BU:LDING APPUCATION AND KNOW 7HE SAME 70 BE TRUE ANC�CORREC7.ALL <br /> PROVISIONS CF IAWS AND ORDINANCES GOVERNIN3 THIS TVPE OF <br /> lE(i�LDESI:RIPTIONOFPROPERTV�SNOWNBEIOWOH�TTACH7WOLOPIES� WORHWILLF.ECOMPLETEDWITHWHETHEHSPECII'IEDHEREINOR <br /> NOT. THE G'�iANTING OF A PERMIT DOES NOT PP.IcSUME TO GIVE <br /> tor eiac� oF AUTHORIT'/ TO VIOLATE OR CANCEL THE PROVISIONS OP ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTfiUCTION OR THE <br /> PERFORMANCE OF CONSTRUC170N.THAT I AM AUTHORIZED BV THE <br /> OWNER 'JF THIS PROPERTY TO PEFFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WI1H 7HE STATE <br /> PA9CEl TAM 10 NUMBER CUNTPACTOH 2J RC 296200 WAC. <br /> �,s}X �oj -UO � �U00 �_ � <br /> COh57PUCTIONLO�NIENDER.ADOAESS.TELEPHONENUMBER _// � �/ '� <br /> !� /l <br /> 1 _ l <br /> PROJECT ADDRESS �- s�cr� iunt -{e -I T�- <br /> F� .� ��l CIIYBU 6lNSf NO � — <br /> PLUMBIN6 MECHANICAL <br /> NO. 7VPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILETi A�C-NHNDLG UNITS-H.P. <br /> BATHTUB ' FORCED AIR SVSTEMS-B.T.U. M E.A. _ <br /> LAVATORV(WASH BASIN� UNIT HE,4TEfi5-B.T.U. M __ <br /> SHOWEF Ci!?THES ORYERS _ <br /> KITCHEIJ SINK 8 DISP VENTILATION FAN ' <br /> _ T_- <br /> DISHWASNER � RANGE NOOD _. <br /> _y__ <br /> LAUNDRV TRAY WA'f[R HEA7ER i__ <br /> CLOTHES WASHER -T WOODSTOVE _.. <br /> URINAL ' METAL 71REPLACE(WOOD BURNINGI __ <br /> ORINNING FOUNTAIN --�_ FIREPLACE INSERT I <br /> _ __ --T.. <br /> FLOOR DFIAIN � HEA7 PUMP _ <br /> � � � -- --- --J •) GASPIP4NG <br /> BACKFLO�N.�REVENTERS . ___ _--._. <br /> ROOP DFAW.^>--RAI;JLEAUEFS � E%HAUST FAN � <br /> SINK�SERVICE-AP.H, [TC.� ' �1�1'�I L. � �__.y_. <br /> — ��-- --.--i- - —'----- �—-- <br /> --- --- - -- ---F-.... <br /> SUB TOTAL $ SUB TOTAL $� f_ <br /> — - -------P[R6qT -$ --�-----�- ------ PERMIi f� -�-- _. <br /> TO1��fEF $ TOTALFEE S _ <br /> FOR OFPICE USE ONLY: ^ _ <br /> iPONTSEIBRCN REAfISETBACN SIDFtiF1PlCM PIR4f��F�� NU'dPLR—_ fFE RCCEIVfNO <br /> ���� <br /> ❑SF20NE LOL�REA wcnNrrere FEEG ____ VALUATION FEE _ <br /> . . V�35 ' NO ew�oiN� <br /> irvf OI LOH51 NO QF S;ilRIE5 rcr�rn�.rI vo�rnownu4c'i:r��s ----- — �"---� <br /> r,na:o I — PLUMBING __ __ __ <br /> L_— <br /> SizEovBLW �iRESPaiNKienSFEOU B�SE�AEbt MECHANICAL �— <br /> . . yE:S � NO .-- --i_. <br /> �KCl/PANCVIO�D FIREM�RMIIEOD MEKMTIIMIT�TiON �DDITIONALPIANCHF.CK _— _ <br /> ______ __ OTHfR <br /> _ __ .'—' ___—_-r_ <br /> HFASON <br /> STATE BUILDING SURGNARGE <br /> — '___ — <br /> ' __—. _.— _'_ __ _ ._...___. __ ' <br /> iNiAKE Nv PUt15�PPP.OVE�B� CITY OF EVERETi PUBLIC WOFKS <br /> LOCAL SALES - <br /> o..� TAX CODE IS 3105 Tor�� <br />