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APPLICATIC 7 FOR CONSTRUCT �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> 13UILDING DEPARTMENT HEATING SYSTEM: J GAS ' LECTRIC J —� , <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MAllq�pRE55 CRV ZiP PHOHE <br /> Ni� �w�rl ��.,/�e ���ti f�a� S% •s• t � ����� 33y- 9�3� <br /> TEN�Ni � MAIL�ODRF.55 CRV pIP <br /> PHONE <br /> RRCHITECiOR�E510NF.R MRIIADDRE55 CIIV IIP PHONE <br /> GENERAICONIRIGTOR M�IIAppRESS . / CiiV ZIP PNONE ST��ELICE115EI <br /> JM <br /> � ��w d�sr.� �b 0�- 4�_ �c. S. 6 �v 98'7-o r J37-3�s ) Gc..�vor+Qlo��-T✓i- <br /> MF.CHRNICAlCON1R�CTOR M/IL�ODRESS CI1V ZIP PHpNE SiATELICENSE� <br /> PWMBINOCONiR�CTOR M�IL�D�RE55 CIIY ZIP PHONE SiATEIICENSE� <br /> LU1550i WONN — — _ <br /> �NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br /> CONi�CT PENSON ANO PNONE NO <br /> CONTRAf,i PqILE OF WONk <br /> OESLR19E WORn�NO SW�PE FOOUOE INVOlVEO <br /> PROPOSEDUSEOFBUILOING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> (�.(�5�` G JK � � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> IEGAl0E5CRIPTqNOFPROPERTV�SMOWNBELOWORRTf�CHFWRCOPIE5� PROVISIONSOFLAWSANDORDINANCES60VERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHEq SPECIFIED HEREIN OR <br /> �o� BLOCN ov NOT. THE GAANTING OF A PERMIT DOES NOT PRESUME ?O GIVE <br /> "" �� AUTHORITV TO VIOLATE OR CANCEL THE PqOVIS10NS OF ANV <br /> I�T 3 Op' �r 7� d P C� � /�Ov/li OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> p � PERrORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ('P W(/ N�<<S S • � OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> x ��Q,c�.2.-�.' <br /> PROJECiAD�RESS � � saN��une wrF <br /> ��� LiiVBlI51HE65��CENSE NO <br /> PLUMBINQ MECHANICAL <br /> NO. TYPE OF FII(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—AiHNDLG UNITS—H.P. —T— <br /> BATNTUB FORCED AIR SVSTE��S—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHES DfiVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD , - <br /> LAUNDRV TRAV ; WATER HEATER � <br /> CLOTHES WASHEF WOODSTOVE <br /> URINAL � METAL FIREPLACE 8 CHIMNEV —� <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> _ ROOF DRAINS—RAINLEADEFS � E%HAUST FAN , <br /> SINK(SEHVICE—BAR.ETC.) <br /> —�— <br /> SUB TOTAL $ SUB TOTAL $ — <br /> PERMIT $ _ PEFMIT y Jh ; — <br /> TOTALFEE $ TOTALfEE S � � — <br /> FOR OFFICE USE ONLY: <br /> iRONT5Ei8�CK qERF5E78AGK SIDESETB�CN PLRNCHELRNUMBER FEE REGEIPLNO <br /> J:; ? <br /> use zorie LOT�PEl1 V�CANT SRE FEES VpI.UATION FEE <br /> BUILOING <br /> iYffOICOHI5A1.101V�Blf tVPEINtON51�t1U�l amwvcr xaamnu�x5ue��5 ---� _ <br /> wthie <br /> PWIdBING <br /> SIIEOFBlUO NOOiSiOR�ES B�SEMENT MECHANICAL <br /> IOCCOFANCV IOAD FlRE SPRNKlEPS REU'0 HEIGNT IIMIT�TION ADDITIONAL PLAN CHECN_ <br /> SPRINKLER ' <br /> II 9E�fUN iOR SPRINMLEPS _____ __�_ <br /> STATE OUILDIN.FUfICHAR6E <br /> W�AME BV P��NSAPPROVED9v CITY pF EVERETT PUBLIC WORK$ <br /> LOCAL SALES ' <br /> TAX CODE IS 3105 TOTAL <br />