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APPLICATI�N FOR CONSTRUCT''ON PERMIT � <br /> TO BE CUMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS U ELECTRIC U <br /> 259-8810 <br /> f=1 DEMOLITION U COMBINATION I I BUILDING �MECHANICAL I.I PLUMBING IJ SIGN <br /> OWNER MAILAODRESS CITV 21P PMONE <br /> �O!Sin/6 CO. c=✓E?F_ �` 4l� 95203 <br /> iEN�Ni MAILADONE55 GIIV ZIP PIIONE <br /> ARCNIfkCTOHOE5IGNER MAILAODRE55 CITY ZIP PNONE / // // <br /> GNE AW?IN CCJ. F.O.�lUJC 23S 7 E't,i�2GR7P l..1f1 9$203 ( 2Ub) 2pO - pppp <br /> fENEpALGONT0�CT0(1 MA�AbD'��Su �ITY (IP PNONE SI�fGLICENSC� <br /> ,r.�. c.. ctr�. i?v. �3ox i6cCs ac�ttFr.t�' uA y�tx�7 (zo5) 6q9 • 9cno <br /> MECIIANICALCONIRACTOR M�ILADDOE55 CITY 211' PIqNE ST�iELICEN5E1 <br /> LJ6t�F?�1/ J0�9p51'FhE p�G,EC'�ilU� � 7ioz ��^-'fx.�-.�.._�;.�-o�cx.e.u�.51Pr�sz cia6�,r9�-oian c„r�'r�ErF��6oF <br /> PLUMBINOLONTR�CTOR MAILAODRESS LITY ZIP PIIpNE ST�fEUCENSE� <br /> CONTR�LT PNICE OF Wp11 <br /> �' JA2/i�LT2J' <br /> DESCRIOE WORN ANO SOU�RE FOOTAGE INVOLVEO CONTACT PER�N AND PHONE N0. <br /> M/9Ri J �H__ &iV/ - dlO� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> rnoaoseouseoFaunowa APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> C�eL�/`7�'C/aC {,�J'PF'�/E ? r�o-�e-is pROVI510NS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEd1LDE6LPIPTIJNOFPRpPE1itt�5NOWN0ELOWOPATTACHTWOLOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or oiocK aF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> . AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW qEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PHOPERTY TO PERFOFM THE WORK FOR WHICH <br /> PARCEti�%I.O.NUMOER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 29G.200 WAC. <br /> CONS111UGINk1 WAN LLN�CII.AUUIIL&5,ILLFI'110N1 NUMOLII <br /> P r�/ ra/nt <br /> s o��[ <br /> 'Z! �- S .I arvmAswersir.rHv:xn -' <br /> MECHANICAL <br /> NO. TYPE OF FIIfTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE'f) � AIC-AIHNDLG UNITS-H.P. <br /> BATHTUB ; FOFlCED AIR SYSTEMS-B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) UNIT HEATERS-B.T.U. M ; <br /> SHOWER � CLOTHES ORYERS �— <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> ' DISHWASHER RANGE HOOD , <br /> IAUNDRY TRAY ' WATEH HEATf:F � <br /> CLOTHES WASHER WOODSTOVE ; <br /> URINAL METAL FIREPLACE(WO00 BURNING) � <br /> DRINKING FUUNTAIN FIFiEPLACE INSERT � <br /> � FLOOR DRAIN � HEAT PUMP , <br /> BACKFLOW PREVENTEFS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS � EXHAUST FAN , <br /> SINK(SEHVICE-BAR,ETC.) � <br /> --r- � <br /> � �— <br /> � <br /> _ ' <br /> SUB TOTAL 5 ' SUB TOTAL S ' <br /> PERMIT S � PERMIT E � <br /> TOTAL FEE E TOTAL FEE E � <br /> FOR OFFICE USE ONLY: <br /> FOONTSETB�CK IIUOSEi��CK SIDCSGTOACN PUNGII'GNNUMOCfi fE[ OECEIVTryp��� <br /> USF ZONE LOT MIE4 V�CANT GITE ` 1 j7� (J <br /> FEES VALUATION FEE <br /> r] VES f I NO OUIL�ING ' <br /> � <br /> IYP[OfLONSf. NO.OFSTORIES omurwcr µ�ppy�i�NGuru15 <br /> cnnm pLUML1ING � <br /> i <br /> SRE Of OLDf. Flf1E SPOMNIEfIS fIGO'O Uns[rn[Nr MECHANICAL <br /> f-I YES Il NO <br /> OCCUPANGY I.OnO FIIIC�L�I1M NEOD 11[IGNT LI61ItntION ADDITIONAL PLAN CHECN � <br /> OTHER i � <br /> f1FnSON � <br /> STATE OUILDING SUHCFIAfiGE � <br /> INI�kC11Y rinNs �r iovcum CITY OF EVERETT PUULIC WOIIHti � <br /> LOCAL SALES ' <br /> o�r� �. � ,S TAX CODE IS 3105 TOTAL ' � <br />