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P� APPLICATIOr� FOR CONSTRUCT�JN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> I HEATING SYSTEM: U GAS U ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> I I DEMOUTION I I COMBINATION �BUILDING I I MECHANICAL I I PLUMBING I I SIGN <br /> pWry[�� M�RAD�RE55 CItV 21P PIIONE <br /> �E ��N� co. R o� (SoX 3'7u7 M�S �F -76 sE�-�rc.E,w�. 9��L� 3�Fz-�339 <br /> iEN11NI MAILA DRESS � CIiV IP PNONE <br /> SRmE I�-5 o�.�n��R. <br /> ARGHI7ECTOHOESIGNEB MAll�00RE5S ��i� ZiP PHW�E <br /> "�d'� A'�ST//J GG ' <br /> dENERQ CONiMCTON MAl A�OOESS CIIY ZIP PIIONE ST�TE LICENSE� <br /> S/�Yr'�� r9'S l�Esi t i✓�ti <br /> AIECNANICAL CONTR�CTOfl MMl ADONE55 CIIY 21P P1qNE ST�TF l ICENSE 1 <br /> PWMOINGCONTR�CTOII MAILADORE55 dfY ZIP PIIONE ST�IELCENSE� <br /> CLASSOF WO11K �/ <br /> I I NEW I I ADDITION �I AL?ERATION i I HEPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I I DUILDING RELOCATION <br /> CON1�Ci PEIi50N AND PHONE NO <br /> CONTMCTPRICEOFWORN O OUA [�ON/9�ti� �,r1f'1QO�sk• Z(r�-3r63 <br /> OESCRIBEWORNANDSOUAf1EF00UG INVOLVED <br /> _�5 Acl- CN-��L L STdn.F}6C C2i8 <br /> PPOPOSEDUSEOFBUILDINO 1 HEREBY CERTIFY THAT I HAVE READ AND ExAMINEO THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LENILDESCRIPTqNOFP110PER1VI5110WNBELOWOHRTT�CNfOURGOPIES) PROVISIONSOPIAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior eiocK oF NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME 70 GIVE <br /> AUTNORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> �— APPLICATION IS MADE AND I COMPLv WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> X �--� J. 1��� gi�/�- <br /> PNOJEC!AODPE55 SaN��wE wtE <br /> � w, c�s,�� e�, yo-36. � �,�.o„s�,E=s��E,�E� <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF P�XTUNE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � lVC—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH UASIN) � UNIT HEATEFiS—B.T.U. M i <br /> SHOWER ' CLOTHES DRVERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATEH HEATER � <br /> — , <br /> CLOTHES WASHER � WOOD STOVE _�_ <br /> URINAL ' METAL FI{7EPLACE 8 CHIMNEY ; <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS i GAS PIPING � <br /> � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN _.�_ <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � <br /> � _;_ <br /> — � <br /> _ � <br /> � � <br /> — ' � <br /> SUB TOTAL S ; SUB TOTAL S <br /> PERMIT E � PERMIT S � <br /> TOTALFEE S ' TOTALFEE E ' <br /> FOR OFFICE USE ONLY: <br /> FRONi5f:T0�CK PEAflSEIOACK SIDESETBACN PIANCHECR/NUMB-7ERQ FEE nECEiPiNO. <br /> 37(O J ✓ <br /> usetor+e LOiARE� VAC�NTSITE FEES VALUATION FEE <br /> BUILDMG �0 Oe� .�y9 ;So <br /> IYPfO�LOHIS.�I .�Blf IYPEOICONSI. UAl 1 otmvucr HonU+�lu�NtUM�lS �- i <br /> _ N M1 I - N �I n'/ �p�� PLUMBIN� i <br /> i <br /> i or o�oo. r+o.oF sroni s BASEMENT MECHANICAL ' <br /> i p <br /> OLCUPANCy LO�D FIII�PRNRLERS NEO'U HEIGNI LIMIIRIIOf1 AD171T10NAL PLAN CHECN � i �p <br /> P�(� UP,� 14�:f'�A r'S SPRINNLER � <br /> � <br /> OEASON fOR SPI11N�lFNS <br /> --i— <br /> `Z�(�('} STATE BUIL�ING SURCHARGE � �Sa <br /> i <br /> INi�I(E OY PUNS �P VEOOY CITY OF EVEHETT PUBLIC WOHKS i <br /> ' LOCAL SA1.ES <br /> J�� TAI(CODE IS 3105 TOUL /� ; /� <br />