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APPLICATIC ) FOR CONSTRUCT' 1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � _--------- - <br /> BUILDING DEPARTMENT HEATING SYSTEM: J GAS J ELECTRIC J _____ _ ] <br /> 259-8810 <br /> DEMOLITION COMBINATION ,�' BUILDING MECHANICAL PLUMBING SIGN <br /> nwNFn M4�1 AooREss c�rv 11P PMONE <br /> y'µt QaE�rrG Co. � Y. e. 'aox 370'� nti/S D!�-/Z .$EA7r�.E � WA. 9f/tY 2L�-7i� ? <br /> iEN�NI M�II�ODRESS Ci1r JiP P��pNE <br /> SA++E /fS ow✓Eti <br /> 4RCHRECfONDE5IC.N[R MRILADpFE55 ❑iY ZIP PNONE <br /> (�a�lNt, <br /> GFNERqlCON1R4CLOR RIAI�RppqE55 CITY ZIP PNONE SUtEUCEN5E1 <br /> �"�2��,� ^'"d�� � 111 I a r rn 7 <br /> 6 F C� 44iCAl CONIRR(,TOR M�il pDURE55 QTV 21P PNOryE S`A1E LICENSE• <br /> FWMBIN6CIXJTRACTOR IA�IL�DDRE55 CIiV IIP PNONE STATELILENSE� <br /> LONTRIL7 PRICF.OF WORN <br /> DESCRI�6 WORK�ND SOU�RE FOO1�fE INVOIVE� CpNTaCi PERSON AN�PHONE NO <br /> �6C.00A?E TI1All.EA2- y�—yZ�l FA-n�. Ns�sµ CA�/I �GNAM1i.� �S7'Cti�goK.zkl Z�.(i-3SL3 _. <br /> 70 SOVTM C,p�pPuf � /L6�VI,ag6�i TO r1 —S5 G i HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> aaoroseouse or ewioiNa APPUCATION AND KNOW THE SAME TO�E TRUE AND CORRECT AlL <br /> ��LE(N F.jR6Ak TR./�/l,E'2 PROVISIONSOFLAWSANDOFDINANCESGOVEFNINGTHISTVPEOF <br /> LEG�lDESCPIPiiONOfPFJPERtV�SMOWNeELOWOR�TT�CNTWOGOPIE51 WORN WIIL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or BIOCK - pF NOT TN'e GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AU1110RITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANV <br /> OTHER STATE Ofi LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PRJPEPTY TO PERFORM THE WORK FOR WHICH <br /> P�RCELT�NIDNUMBER APPLICATIOIJ IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 qCW ANU 296.200 WAC. <br /> CONSTRlICT10NlOANLEN�ER.�DDNFSS.TEIEPMONENUMBER I <br /> ,/ ��a.�.� % a� <br /> PROJECTADDRE33 ��.H'���� _ ( 3 2 9 _ � <br /> 3�1 (.i. Gssr,.io hD �FS- SS<i ���.���s�ti�ss���,�,�, .�-, — <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FU(TURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—A�HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORV�WASH BASIN� UNIT HEATERS—B.TU, M <br /> SHOWER CLOTHES DRVEFS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN �� <br /> DISHWASHER RANGE HOOD . <br /> LAUNDRV TRAV WATER HEATER I <br /> CLOTHES WASHER WOOD STOVC <br /> URINAL METAL FIREPLACE(WOOL BURNING) � <br /> DRINNING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR ORAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK�SERVICE—BAR.ETC.) — <br /> SUB TOTAL S SUB TOTAL S <br /> PEFMIT a PERMIT � <br /> TOTAL FEE S 70TAL FEE S II <br /> FGR OFFICE USE ONLY: <br /> f �r115EtBACK RE�RSEiB�CN SIOESEiBACN PUNCMECNNUUHfR fEE PECEIPiNU I <br /> � L <br /> use zoNe ior naee .,_..�:r sire FEES VALUATION FEE � <br /> ` � VES . NO BUILDING �' M <br /> IYP[Of LONSI NO OF STORIES t t;��qc. na oi mvkonr�i.r��s — — �L) <br /> � — r� � O��Oi�� PIUMBING <br /> /) <br /> —�— <br /> SIZEOfflllx. FIR✓E$PRINNlER5RE0�� O�SEMENT � MEC4ANICAL <br /> /,jvV � 7 [�� VES v'NO -- -- <br /> UCCUPANCVIOAD fIRERURAIREOD MHGHTIiA1RATION ADPITIONALPI.ANCHECK i <br /> � ��� . OTHER ' _ <br /> PEPi�N <br /> —�'_ <br /> StAtE�UILOING SURCHARGE � J�� <br /> iNu�c F�� �i n 'Jprnovrn er CITY OF EVEflETT auauc wonKs <br /> ���� LOCAL SALFS ' <br /> uA,=_ _ a _ 9 TAX CODE IS 3105 TotA� ��c�/ i�� <br />