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�. <br /> P�-� APPLICAT14.d FOR CONSTRUC7 .ON PERMIT �i <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT `��o�r <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS U ELECTRIC ❑ -� <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MAILIIDORESS C�Y iIP PNONE <br /> TN-� BnE iN6 �o. 7'. d. Rot 3707 , M/S .nf-�C , ���7T we q�/zY jY�Z -�P7� <br /> TEN�NT MAIL AODRESS CITY IIP P1qNE <br /> Sb-M��� /fS O t,iN(��L . <br /> �RCNITE� ORDESIONEP M�iL�ODPESS CITY ZIP VHONE <br /> T/f-� �4-✓s�ri.� Co . <br /> OENER�L CONTRACiOR MAIL�DORESS CITY +IP PHONE SUTE UGENSE� � <br /> .:An-iCr /1-5 t7C�FS�bn^�/G <br /> MECNANIC�L CONTRACTOR M�IL ADDRE55 GTY zIP P110NE SUTE LICENSE M <br /> PWMBINOCONTR�CTOR M�IL�DDNESS CITY pIP PNONE S7�fELICENSE� <br /> C1�55 OF WORK <br /> �. � NEW ADDITION ALTERATION . REPAIR DEMOLITION WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br /> CONT�CIPERSON�NDPMONE NO <br /> CONTR�CT PqICE OF WORK 3 e o cu �'O Na/L J T�����C/��/ <br /> 7ERCRIBE M/OfIK�ND SW�RF.F00T�6E INVOLVED - <br /> 2Ec.00�+ .e.s io /�o.� 26[ -;�,1 6� <br /> PROPOSEDUSEOFBUIIUINO I HEREBY CERTIFV THAT I HAVE READ AND EXAMIN[D THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE NND CORRECl.ALL <br /> IEU�lOESCqIPTqNOF PPOPEFTV�5110WN BELOW OR�TT�CMFWRCOPIES� PROVISIONS OF LAWS AND OHOINANCES OOVERNIN6 THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT B�°�K °F NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOHIZED BV THE <br /> OWNER OF THIS PROPERTV .T^ PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> _ x G-�"'.��' 3�z 7 /!�'-� <br /> PRQIECT�OORE55 /� n SM.Neruer, , Mr[ <br /> 3��� �"' `����/�O • � � �—�/ [IIvpU5Mf5SIr1IN5[Nf] <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET) NC-NHNDLG UNITS-H.P. <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> IAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> SHOWEH � CL01HE5 DRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD i <br /> LAUNDHV TRAV WATER HEATEF � <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL METAL FIREPLACE 6 CHIMNEY � , <br /> DRINKINO 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 /> — ' i <br /> , <br /> I ! <br /> -_ <br /> SUB TOTAL S ; SUB TOTAL S <br /> PERMIT S PERMIT S � <br /> TOTAL FEE S TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br />� FRONTSETBACK REARSETB�CH SIDESETHACN PUNCHECNNUMBEF FEE RECEiPiNO <br /> 3 / <br /> USE 20NE LOT�RE� V�L�NT SITE FEES VALUATION FEE <br /> BIIILDING 7 uJJ S � 00 <br /> iVPE01CONI5AllOWABIF lYPE0fLM15iAGIUAI otav�Nn NoarVMiiiMGUMns - <br /> _ + , / ' – + / +ao PLUMBING <br /> /V l /V <br /> SQE �BL00 NO OF 6TORIES B�SEMEN7 MECHANICAL � <br /> OCCIIP�NCYL0�0 FIRESPPNMLERSREO'0 HEIGHiLIMIi�T10N ADDIiIONALPUNCHECK <br /> a vE� SPRINNLER <br /> RE�SON FOR SPPINNLE95 — T– <br /> U(3L STATE BUILDINO SURCHARGE ; Sd . <br /> MTANE BY PLAN �PP@OVEO BV CITY OF EVERETT PUBLIC WORKS ' <br /> � LOCAL SALES � <br /> � �%';'� TAX CODE I$3105 TOTAL �8+ � S o <br />