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APPLICATIC:V FOR CONSTRUC1 .vN PERMIT ' <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT � ' <br /> HEATING SYSTEM: GAS ❑ELECTRIC O ! <br /> BUILDING DEPARTMENT <br /> 259-8810 � <br /> : ' DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN �, <br /> OWNEH AILADDRE55 CITY ZIP PMON � <br /> `{�L1S9w � / �1 i gF�0.D�vR �1/F�� 8 0 -2!I I <br /> TE��v W �/ A4�I IS55 (Jl�vl W�"� 1 RV G/C�/C ZIP �I PH E — � I <br /> ARLNITEL7 OR DESIGNER MAIL ADDRE55 CITY ZIP HONE <br /> GENERAL WNTRACTOR MAIL ADORESS GITY IIP PHONE STATE LIGENSE� <br /> MECH�NICAL CONTHACTOR MAIL A �RESS GTV ZIP PHON STATE L ENSE t '� <br /> Lo P Co. 6C�5 ��� sv✓ �`fu►�wnaD °I8o36 G`x�-�q6� ��oD�sn.rl�k� <br /> PlUM81NGCONTR4CTON MAI �DDNE55 � � _ CiT 21P � PMbNE SiA LI�ENSEn <br /> f1�. <br /> CLASS OF WORK I <br /> ' I NEW �. ' ADDITION �� ' ALTERATION � REPAIR DEMOLITICN � WOODSTOVE/FRPL INSERT BUILUING hELOCATION ' <br /> � I� � LONTALTPERSCD'JDPCrT�I�1��EN I <br /> CONTRACT PRICE OF WORK _ <br /> DESCRIB[WOPN AND SOUARE FOOTAGE IYV LVED � <br /> P.�P[AC� '�(ISTI►� U1�IT FJtT�. �' �. �� � ' <br /> PfiOPOSE0U5EOFBWLDING i HEREBY CERTIFV THAT I HAVE READ AND BXAMINED THIS I <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG/LDESCRIPTIONOFPROP[RTY�SHOWNBEIOWORRTTACNFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF � <br /> WORK WILL BE COMPLETED WITH WHETHER SPECI�IED HEREIN OR <br /> �or eior,K oF NOT. THE GRANTING OF A PCHMIT DOES NOT PRESUME TO G!VE <br /> AUTHORITY TO VIOLATC OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR IOi:AL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER C�f THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRAC O 5 L � 18.2 RCW AND 296200 WAC. <br /> PRQIEf�ADDRE55 xn�rUn o��[ �� � <br /> 2 I W arvouEM[ssi�erNsu�o <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � AiC—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOWC-R ' CLOTHESORYERS <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER RANGC- HOOD <br /> LAUtJDRYTfiAY ; WATERHEATER ; <br /> CLOTHES WASHER WOOD SiOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY _ <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS i GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SFRVIGE—BAR, [TC.) ; �__- <br /> i <br /> i � <br />� SUB TOTAL $ ; SUB TOTAL $ i O ' <br /> PERMIT 5 PERMIT $ /S � <br /> TOTAL FEE $ TOTAL FEE 5 ��' <br /> � FOR OFFICE USE ONLY: <br /> iRONT SETBACK REAfl SF.TBACK SIDE SEiBRGK PLAN CHEGK NUMBER FEE RFGEIPT NO. <br /> �77� <br /> USE ZONE LOT AREA VAGANT SITE FEES VALUATION FEE <br /> BUILDING <br /> 7VPEOfCONTS.PLLOWABLL iYPEOFCON57ACT0Al oauPeNtr NO.dD'M[LLiNGUNirs � <br /> exo��e � pLUMBING � <br /> SREOFBLUG. NO.OFSTORIES BASEMENT MECHANICAL ' <br /> J— <br /> OCCUPANCY LOAD FIRE SPRNKLEflS PEO'0 HEIGHT IIMITAiION /1DUITIONAL PLAN CHECK i <br /> � <br />� SPRINKLER i <br /> PEASON FOR SPRINKlENS <br /> i <br /> S7ATE BUILDINC SURCHARGE <br /> INTANE BY PLANSAPPROVED BY CITY OF EVERETT PU9LIC WORKS i <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL <br />