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APPLICATIC 1 FOR CONSTRUC7 �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTL"M: J GAS J ELECTRIC U _ <br /> -- _ -- - - --1 <br /> 259-8810 <br /> DEMOLITION COMBINATION _ BUILDING MECHANICAL PLUMBING 91GN <br /> OWNER uaii nooness crtr nr rHorir <br /> Th� goFiNh. co . � o. �dx 3�a l� �r- -�� S�R�w9 9�y 3`/z—?33� <br /> TENANT MAlIAflDak55 ' Cii ZIP PIID E <br /> .�A�m�- A= �r,�N F-a- � -- <br /> FRLHITECTORDESIGNER MntLADDRESS G�! ZIP PMONE <br /> � �.I�Lur� fi ort. olts <br /> OE f.ONTRRG MRIL RDORE55 GLV 21P PHONE SLUE LIG� SF I � <br /> 2 <br /> OR IARIL�D�PE55 GtY ZIP PHONE STATE LICEn �� <br /> PWMtlINGCONTMLTOR MAllr100PES5 CItV ZIP PHONE SiATEUCENSEt <br /> UOSOi WOPK <br /> NEW AD�ITION � ALTERATION flEPAIR DEMOLITION W07DSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTfl�CT PRICE OF WORN <br /> � r � �- `�Tp�vPl�'�Qi DPMON NO (� /' • !ati/" 2�c —3.r� <br /> OE'3CRIBE WORK RND SOUARE FOlI.�OE INVOI EO <br /> I' l � • <br /> PROPOSEUUSEOFBUILDING i HEREBV CERTIFY THAT I HAVE HEAD AND E%AMINED THIS <br /> 6/,v 66/�I^+c T�J T FrY�r L i T APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECL ALL <br /> LEGALOESCF�PTIO"OFPROPENTV�SIIOWNBELOWOPAT7�CNlWRLOPIES� PROVISIONSOFLAWSANDOROINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot eiocK oc IJOT. THE GRANTIN6 OF A PERMIT DOES NOT PFESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS UF ANY <br /> OTHER STATE OR LOCAL LAW flEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY TH� <br /> OWNER OF THIS PHOPERTY TO PERFORM TI1E WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STA�E <br /> CONTRACTORS LAW 18.27 NCW AND 296200 WAC. <br /> „l�r,.,,�.�{ • l��r�^'r``' /� 3 <br /> VRQIEGT ADDRES'S� • /� (� �[ ronE wrE <br /> W, lipJ���✓n �'l• ��- T � arveus�MEssiw[Nscra <br /> PLUMBINO � MECHANICAL <br /> NO. TYPE OP fOITUNE OR REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) IVC-NHNDLG UNITS-H.P. � <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M ; <br /> SHOWER CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER HANGE HOOD � <br /> LAUNORV TRAV ; WATER HEATER <br /> C�OTHES WASHER WOOD STOVE <br /> UHINAL METAL FIREPLACE 8 CHIMN � <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEA FiS E%HAUST FAN � <br /> SINK(SERVICE-BAR. C.) ; ' <br /> —'T � <br /> I <br /> � ' <br /> T <br /> 1 <br /> 1 <br /> SUB TOTAL E SUB TOTAL E ' � � " <br /> � <br /> PERMIT $ PERMIT S <br /> TOTAL FEE E TOTAL FEE $ � <br /> FOR OFPICE USE ONLY: <br /> FPONTSETBAGK NEAPSETBALN SIDESETB�CR PLANCHEGKNUMBEN �EE RFCEIPTNO. <br /> �_ - _ � _ �3_ 5� <br /> USE/2►0�NE IOTAREA VAC�NTSITE FEES VALUATION FEE <br /> / ��2 BUILOING � � <br /> iYVfOiCONiS/�IIOWABIE fYVEOfLONSi. CfUAt aro�� N)atMtwN4uMn5 <br /> °" PLUMBING -�--� <br /> �' 3 <br /> SaF.oFOtoo NOOFSroA:ES BSEu J MECHANICAL -r� <br /> �(�-`q-'+�--��� SP,Fr. 3 <br /> OCCUP�NGv lOAO fIRE SPRN<LERS REO'� NEIGNi LIMI7ATION ADDITIONAL PLAN CHECK S� O � <br /> i <br /> / � <br /> � ��S � SPRINKLER <br /> ReASON FOR SPqINNLENS � <br /> CO��S STATE BUI�DING SURCHARGE i� <br /> INTAKE OY PLANS N BY CITY OF EVERETT PUBLIC WORK$ --r-- <br /> LOCAL SALES <br /> TA%COOE IS 3105 TOTAL �� <br />