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APPLICATIG.� FOR CONSTRUCT . �N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PHINT � <br /> BUILDING GFPARTMENT HEATING SYSTEM: fJ GAS ❑ELECTRIC p � <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING /SIGN <br /> OWNER MqILADDRESS CITV ZIP PHONE <br /> �sCo NGU �o/ v.v/o.v s.— s� zr� S�� y�jvi y�Z _���a <br /> 1ENqNT MAILADDRE55 HONE <br /> gP z7 d.�u�Cvi �f ��,�/.� 719�2���z�a) S�S �fo�7 <br /> ARCIREGTOqDESIGNER MAILAODR65S J �ITY ZIP PHUNE <br /> �GEN[qALCONiRACTOR MAILADDRE55 GITY 21P PNONE STATEL�GENSE! <br /> ��.r1��- �6t/ �� �/33 36�=ozs�z 5ss.�-c.r i3/ ca <br /> IdECH ICAL GONT ACTOR MAIL ADDRESS QTY IIP PMONE SiATE UCENSE t <br /> FLUMBINGCONTRACTOR MqIIADOPESS CI7Y 21P PHONE STATEUCENS[I1 <br /> CLAS�WORK <br /> �EW �� . ADDITION ALTERATION REPAIR i '� DEMOLITION . WOODSTOVE/FRPL WSERT BUILDING RELOCATION <br /> �y� W CONTpCT EqSJN AN�P�1ONE� 36 S" �! L <br /> GONiqACTPRICEOFWOPK �yVv ��f/f �������y���„� ��� <br /> �^�: qIBE WORK UAR FOO7AGE INVOLVED / <br /> oniE DL-t'�Ft_ C �j S �/Cj/C/ GG� <br /> �/aGsf _CZ <br /> PCROP��O,S.EuOUSEOFBUIt01NG i HERL�BV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> J�1�'aG �s1 .US APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGAL DESCRIPTI(91 OF PROPERiV�SHOWN DELOW OR ATTACH FDUqCOP1E5� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OP <br /> �or9��eiocrc I Z oF � (Jf � �'�'ORK WILL BE COMPLETED WITH WHETHEFi SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVE - <br /> � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �. �S% �'�Q/TJ(�j(J OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTfiUCTION.THAT I AM AUTHORIZED OY THE <br /> 6(f YT��'r�J�j'fj�fQj(J OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COIdPLY WITH THE STATE <br /> Q` ����^ ��� ��� CONTRACTORS LAW 78.27 RCW AND 296200 WAC. <br /> J <br /> x � � �6/3�g' <br /> PROJECTADDRE55 �r � �unc onre <br /> �OZ� pd11fT1}>lfl �y 2Z — <br /> � .P��t�,:�,�,,�,�����„ <br /> PLUMBING ECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT PEE <br /> WATER CLOSET(TOILET) � ArC—A:HNDLG UNITS—H.P. <br /> l3ATHTUB ; FORCEDAIRSYSTEIdS—B.T.U. M E.A. �— <br /> LAVATORY(WA.iH BASIN) i UNIT HEATERS—B.T.U. M � <br /> SHOWER � CLOTHES DRYERS , <br /> KITCHEN SINK&DISP ; VENTILATION FAN � <br /> DISHWASHER RANGE HOOD T� <br /> LAUNDRYTRAV ; WATERHEATER <br /> CLOTHES WASHER WOOD STOVE � <br /> URINAL METAL FIREPLACE 8 CHIMNEV � <br /> DRINKING POUNTAIN I FIREPLACE INSERT � II <br /> FLOOR DRAIN � HEAT PUMP , i <br /> BACKFLOW PREVENTERS GAS PIPING � I <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ; ' <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � � I <br /> � <br /> SUB TOTAL S ' , � <br /> SUB TGTAL $ <br /> PERMIT S PERMII' S <br /> TOTAL FEE 5 ' TOTAL 1=EE $ �— <br /> FOR OFFICE USE ONLY: <br /> FRONTS[TB�GK qEARSET�ACN SIOESETBAf.K PLANCHEC NUh R FEE R[CEIPTNO. '� <br /> � (v� � . �4� <br /> USE20NE �OTAREA VACANTSITE F ES VALUATION FEE <br /> J r BUILDING �-)(� ��J� I <br /> ttPEOiCONiS.ALLOWABI@ TYPEOFCONSiACiIIAI OtcUwrvcr NOovmv[WNGU4u5 J <br /> Gpa'P PLUMBING � <br /> SIZE OF BLDG. NO,OF STORIES BASEMENT MECHANICAL <br /> OCCUPANCYLOAD FIRESPRNKIERSREO'D HEIGMTLIMITATION AD�ITIONALPLANCHECK � <br /> SPRINKLER ' I <br /> REASON fOR SPRINKLERS <br /> STATE BUILDING SURCHARGE ' � <br /> INTANE BV PLA APPROVED�Y CITY OF EVERETT PUBLIC WORNS i <br /> �' h� LOCALSALES � <br /> ' _ �� y 1 TAX CODE IS 3105 TO7AL <br />