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APPLICATIC 1 FOR CONSTRUCT )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: J GAS U ELECTRIC U <br /> 259-8810 <br /> I I DEMOUTION I I COMBINATION ��BUILDING ' i MECHANICAI I I PLUMBING � ; SiGN <br /> OWIIER M�I�ADDRESS pi ZIP PHONE <br /> Tlt� Bc��r� c:�•, p. v l��x 37c� ��r�a,�—)4 S�� T�E , t✓� . 9F'iLy u� - 7.r-ti� <br /> , <br /> TENANT M�IL�ODflESS � CIIY —�—ZIP pHONE <br /> �+�+'1� /�'S O:tiN�� <br /> APC�fHI/TEl`C70ROE/S�IGNEH M�RADORESS CILY ZiP PNONE <br /> / /�/ �i �7V.J ��� ��� <br /> GENERAL CONTfl�CTOR AIAII pDORESS QiY 21P PNONE SiRiE LICENSE I <br /> TH� f7vs ri,J o�- <br /> MECIIANICALGONTR�CTOR M111��6RE5S CITY ZIP PIqNE SUTELILENSE• <br /> PLUMB!NOCONTRACiON M�RADORE55 f,ITY zlP PNONE ST�tEIIf,ENSEI <br /> CONIqACT PRif,E OF WON1c <br /> S 0 J (.}_ <br /> DESCNIBE WORR�ND SOU�HE FOOi�GE INVOIVED CONTAGT PERSON�ND PMONF.ryp <br /> �oN;Tn.,�c- .r��-rcc C�C.'ONP2—r� �j-5r�-r„�ra'r��l 7G6-ss"6s <br /> ���"�'�� -e i HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> VROPOSEDUSE OFBUIl01NG APPLICATION AND KNOW 7HE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVEFiNING THIS TVPE OF <br /> IEMLLESGRIPTIONpFPROPERTV�5M0'/013ELOWORATT�CHiWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �nr euicK oF AUTHOPITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW RFGULATING CONSTRUCTION OR THE � <br /> - PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> . . OWNER OF THiS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � — APPLICATION IS MADE AND 1 COMPLY WITH THE S7ATE <br /> PARCEL 7AX 10.NUMBER CUYTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> CONSTROCTION LONI lENOER,A�DHESS.TELEPHONE Nl11ALER <br /> -.,�'/ 1;.��z' �/�/u� <br /> PHOJECT ADDRESS � x�u+�+e t D�IF — <br /> Gv. C,�si,�� �1� , `/� —�3,1 ���.a�„E55,��E�s.� <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FD(TURE OR ITEM FEE NO. TVPE OP EOUIPMENT FEE <br /> WA7ER CLOSET(TOILET) NC—A�HNDLG UNITS—H.P. , <br /> BATHTUB FORCEO AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRYTRAY WATER HEATER � <br /> CLOTHES WASHER WOOD STOVE � <br /> URINAL i_ METAL FIREPLACE(WOOD BUfiNING) <br /> DRINKIN�FOUNTAIN FIREPLACE INSERT ; <br /> fL00R ORAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING ; <br /> q00F DRAtNS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.� <br /> --- � <br /> SUB TOTAi_ $ SUB TOTAL 8 <br /> PERMIT S PERMIT S i <br /> TOTAL FEE $ TO7AL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FPONTSETB�CY RE�RSEIBRCk GIDESETBACri PUNCNECNNJIABER FEE RECEIPTNO <br /> /� �`� <br /> USEZONE IOTAflE� VACANi51iE FEES VALUATION FEE <br /> I <br /> �. � YES � N gUIL01NG q QQU �� ' Ljb <br /> LYPF Cf CONSf , MO OF STONIES a'cov�xv bo tr m,twN,uhns --- <br /> nouv p�UMBING <br /> I�' !\i N/1 �1- z <br /> SREOFBI[10. fIRESPRINNLEN5RE0'D BASEMENi T— <br /> 3��,� �' 7. �. YFS l VES �l NO MECHFNICAL � <br /> � <br /> OCCUPAHCY LOAD VFIPE PUPM REOD HEI(iHi LIINIiATION AODITIONAL PLAN CHECK � �� <br /> � 1 5 � OTHEP <br /> i <br /> HEASON — <br /> UG� STATE BUILDING SUHCHAFGE i s(J <br /> INiAI(F BV PUNSAP q'JV.�BY CITY OF EVEflETT PUBLIC WORKS � <br /> %/1 LOCAL SALES ' <br /> o�re _ Z _ fJ TAX COUE IS 3105 TaTA� �`j��� <br />