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. <br /> APPLICATIC I FOR GONSTRUCT �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT I HEATING SYSTEM: U GAS �(,ELEC7RIC J —1 <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING SCMECHANICAL PLUMBING SIGN <br /> OWNER MAiI RppRF55 CItY ZIP PNON[ <br /> M� Dowkll G�>L ��is i3�..rL•5��•S• e ry �aNe� 3 3 �- '3 �33 <br /> tENANT ��MML RODf1E55 CITY 21P PHONE <br /> �RCNREC[ORDESIGNER M�ILAO�RE55 CITY ZIP PNONE <br /> GEN[P�LCONTR�CTOR M�ILA��NE55 � CITY ZIP PHONE ST�IELICENSE� <br /> �Geiv Ol�.tw- ?G'1� rfT /�r.� 5�6 Bv- `j8''h'� 3�>-7�'S ( 6r.o�.-aH.�- chsasr�- <br /> M[LIIAN�Gi CONiR�LTOR MML ROORESS G7Y 21P PIIONE STATE LICENSE• <br /> S 7 Ns�-- <br /> PWIdBiNGLONiR�LTOR IA�ILRDURESS CITV IIP PHONE STAT[LICENSE• <br /> CI�55 OF WORIt <br /> NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEiFRPL INSERT � BUILDING RELOCATION <br /> GONTRCT PERSON�NO PNONE NO <br /> G(MTRRCi PRICE OF WORN <br /> DESCRIBE WORK�NU SOUARE FOOUOE INVOIVED <br /> PRIOP,OSEDUSEOFBUILDINd i HEHEBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br /> N,�uA ��5i`✓,tu p •A APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> lEO�L DESCRIPTIONOF PROPERTY�SNOWN PFIOW ON�T��CNFOURCOPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETEO WITH WHETHER SPECIFIED HEREIN OR <br /> ioT � eiocn oF _ NOT. THE GRANTING OF F f`ERMIT DOES NOT PRESUME TO 61VE <br /> � I/ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> G(�T � O F' `0 T� 'y' 0 P F��Y� n'0�u' O� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> n PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> BJIi NI�I l S S• !� ' OWNER OF THIS PROPEFTV TO PERFORM THE WORK FOR WHICH <br /> - APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> x_.l�L .Q �l�I J.� �r � <br /> PRWECiA �RE55 sK.newn[ M�E <br /> GiV 005ME55 VCFNSf MO <br /> PLUMBIN MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—a'HNOLG UNITS—H.P <br /> BATHTUB FOfiCED AIP SVSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) _� UNIT HEATERS—�.T.U. M �_ <br /> SHOWER CLOTHES ORVERS <br /> KITCHEN SINK 8 DISP ; , VENTILATION FAN ' ; <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAV WATER HEA7ER ' <br /> CLOTHES WASHER WOODSTOVE <br /> URINAL METAL FIREPLACE 6 CHIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT ; <br /> FLOORDRAIN � HEATPUMP <br /> BACKFLOW PREVENTERS GAS PIPING ; <br /> ROOF DFAINS—RAINLEADERS ExHAUST FAN � <br /> SINK(SERVICE—AAR, ETC.) <br /> T <br /> _ � <br /> SUBTOTAL S SUB TOTAL S - <br /> PEFMIT $ PERMIi S - <br /> TOTALFEE $ TOTALFEE S — <br /> FOR OFFICE USE ONLY: <br /> FRONi5E70ACN R[RRSETBACh SIDESETB�CK �UNCMECNNUAIBEJR FEE PECFIPTNO <br /> �����`,� <br /> usezor+e ior�ae� VRCANi51TE FEES VALUATION FEE <br /> BWIDING <br /> !YF[OiLONISAIIOWABLE TYVEOlCON511CIWL IXNo�Nn mIXovrtwNtc4��5 — ---' --- <br /> °""j° PLUMBING <br /> Si7E OF BIDG NO OF STORIES B�SEMEN7 MECHANICAL � � <br /> OCCUPANCYIO�D FIRESPRNNlERSRWD HEIGHIUMIL�710N ADDITIONALPLANCNECK <br /> SPRINHLER � <br /> qCA50NFOq5PRINNlERS -- —�—'— <br /> STATE UWLOING SURCHFRGE <br /> iN1�NE BY �L�NS RPPROVED BV CITY OF EVERE7T PUBLIC WORNS ' <br /> LOCAL SALES � <br /> TAl(CODE�S 3105 ror�� <br />