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APPLICATIOI�FOR CONSTRUCTII~N <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br /> U� AP _ <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> 259-8610 �p <br /> Y OF EVERETT <br /> O DEMnLIT10N ❑ COMBINATION ❑ BUILDING ❑MECHANICAL ❑��1hIP�6Dep}, ❑ SIGN <br /> OWHER WILApDRf$$ yITV ZIP1 PIqNE <br /> George Shuh �J l�i� _ OQGrCUcLL� �,Uf/2�, ��.)� <br /> T[N�NT IMI�AppqES$ GIiV ZIP PlIpNE <br /> Cascade Photographics 3508 Broadway Ev�rett, !�P.. 98201 (206) 259-1215 <br /> ARCIFTFGTORDESpNER MAIL�ODRESS GTY ' 21P %IOHE <br /> 342 INC 3403 16th Street Everett WA. 98201 (206) 252-4911 • <br /> GEMEPKIXINTMLTOR 1MIlAD0f1E55 � CITY ZIP PIIONE STATELICENSE• <br /> (Same as above). � F ' • � <br /> MEpW11G1lLplTMCTOl1 IMIADpIE55 GIiV 21P PIqNE ST�TEIICEHSE� <br /> N./A. <br /> PLUIBkMr CONTRhCTOR 1AAL ADURE55 CITY t!? PIIONE 6TATE LICHISE i <br /> �,t_/° — --- <br /> coNrrucr rn�a wax <br /> /.�OQ - <br /> oescneEware�roosouu+�FooT�wvavEo co"T�cTPEpso"�"or�ro�r+o. pave Seaman (206) 252-4911 <br /> Itistall (1) 3� R 8' Douhle facP fla <br /> on existing pole. (24 sq. ft.). i HEHEBY CERT4FY THA7 I HAVE READ AND EXAMINED THIS <br /> ������ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORC!NANCES GOVERNING iH15 TYPE OF <br /> LE6KOESCRIPTIOkqFPiIOPEqTV�51qWNBEIOWOR�TT�CHTN'OCAPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE�N OR <br /> ior Z� & 28��N 857 � Everett Divieion E. NOT. 7HE GRANTING OF A I�ERMiT DOES NOT PRESUME TO GIVE � <br /> AUTHORITY TO VIOIAT[ OR CANCEL THE PP.GVISIONS OF ANY <br /> OTHER STATE Ofl LIxAL LAW REGULAT�NG CONSTaUCTION Oli THE <br /> — PERFORMANCE GF CONSTRUCTION.THAT I AM AUTHORI2ED B'/THE <br /> � OWNEFi OF THIS PROPERTY TO PEFIFORAI THE WORK FOR NJHICH <br /> APPUCATION IS MADE AND I COM!`LY WITH THE STATE <br /> PARCEL TAIf I.D.NIIAIBEfl GON7 RACTORS LAW iB27 RCW AND 296.20,�WA:. <br /> M4373 57-027 <br /> OOH6TpUCTION lpW lENOER,MpIE ,TELEPHOHE Nl1A1BER ��J�, �. /�� <br /> PRQIECT ADDRE& �<�����L � � a� '�_��/- , <br /> sqru wr[ <br /> 1 J W`YP114ME59lICENSF.ND <br /> PLUMBINO • M[CH�NICAL <br /> NO. TYPE OF FIXTURE OR tTEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � N�lvHNDLG UNITS—H.P. <br /> BATHTUB ' FORCED AIR SVSTEMS--B.T.U. M E.A. � <br /> LAVA70RV(WASH BASIN) ' � UNIT HEATER�B.LU. M � <br /> SHOWEH � CLOTHES DRYERS <br /> K�Tf,HEN SINK b DISP � VENTIUTION FAN ' <br /> DISHWASHER � RANGE HOOD <br /> UUNDRV TRAV � WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS � � GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � E%HAUST FAN <br /> SINK(SERVICE—BAR.ETC.) � ' <br /> ' — <br /> � <br /> � � <br /> ' <br /> � <br /> ' SUB TOTAL S ; SUB TOTAL S <br /> PERMIT S � PERMIT S <br /> TOTAL FEE E ' TOTAI FEE S `_ <br />, FOR OFFICE. USE ONLY: �y <br />� FRONT SETBACI( REM SEtBAtK SiDE SETBACK 1'LAN C ECR NU N FEE PECEIPT NO. <br /> � ,�/» �D l�i <br /> usezoNe LOTMEA � v�cu�is�t[ FEES VALUATION FEE _ <br /> �' _ / p p YES ❑ NO gUILDiNG �J,[ � <br /> rntacoxsi. r+o.oFSTot�t�s arawcr eo.aanuwcumc —�-�� <br /> �O PLUMBING <br /> b�i50FBLD0. FIRESPRIM(lCR5RE0'0 BASf:tAENT MECHANICAL ' <br /> O YES ❑ NO � <br /> OCCIMANCY LOAD FIfiE 14ARM PEOD HEpHT LIMITATK7N ADDITIONAL PLAN CHECK � 2 Z i <br /> �� <br /> {'�cc�i.��J� on+eR <br /> ae�son � <br /> STATE BUILDINCa SURCHARGE i� <br /> RlTN(E BV 1'L APPROVEDBY CITY'OF EVERETT PUBUC WORKS � <br /> �n� LOCAL SALES �— <br /> DATE '� �S l+ TAX CODE IS 3105 TOTAL � 2 �'J+� <br />