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-*.. <br /> APPLICATIOf FOR CONSTRUCTI �N PERMIT � ' <br /> TO BE COMPLETED IN BLACK INK—PLEASE I�RINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ;] � <br /> 259-BB10 <br /> DEMOLITION COMBINATION �BUILDING MECHANICt1L PLUMBING SIGN <br /> O\YNER AUi��0�RE55 CiTY DP PNONE <br /> �j0�/N6 e,a, Po. �o� 3� a'7 , �s o�--�3 Ss��rcE wA • 4P�L� 3�Z-�339 <br /> TEN�Nr ut aoDRE55 Gtv � ziP N�ov[ <br /> I,�L�/N6 • <br /> .__-_.—___—._—__._.. .. ..___._— _ _. . _ . .. .___. _._. . . .. . .. <br /> nnGaiGCfOnpESGHER �AN�ApURESS I.ilv [i�' I�NNI <br /> (joL�.n1G. _ <br /> [ENER�I CONLRACIOR MAiI�O.DFE55 CiTv Z�P ���phF SiAif Uf.[NSf� <br /> .(�r✓�+'/C�A-s��1 /"`+'8/C'� <br /> Id6LHRNILALCONTRACTOR MAIIADDAE55 GITY IIP �110NE SLr1iELICENSE� <br /> PLUMPiNGCONiRACTOR IdRiL�DORE55 CRv bG �'��ONF Si�tEIIGENSE� <br /> CONTR�CTPRICEOF WORN f� ��M <br /> V <br /> OESCRiBE WOAN RND SOU�RE FOOTAGE�NVOLVED CONT�Gt PEPSON ANO PHONE NO <br /> /LGLo�ATL 'TR-/1��.SR— � Q�f� �/Gc� Ltso,✓.►n,p /JSTEM.13oitsk/ 266 .-3SG� <br /> �00� I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDlISE OF�UiL0�N0 APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GO\'ERNING THIS TVPE OF <br /> lEO�lDESCRiPTIONOFPROPEAT�ISHOWNBELOWOpA'T�CHiWOCOPiE51 WORHWILLBECOMPLFTEDW17HWHETHERSPECIFIEDHEREINOR <br /> NOT. iHE GRANTING OF A PERMIT DOES NCT PRESUME TO GIVF <br /> tot e�aK ov qU7HORITV TO VIOLATE OR CANCEL THE PROVISIONS OF PNV <br /> OTHER STATE OR LOCAI LAW REGUTATING COYSTRUCTION OR THE <br /> — PERFORAIANCE OF CONSTFUCTION. THAT I Ah1 AUTNORIZED BV THE <br /> OWNEF OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPIICAT10N IS MADE AND I COMPLV WITH THE STATE <br /> r�nCE�rnz i o NURi�ER CONiRACTORS LAW 18.27 RCW AND 296200 WAC <br /> COhSTAUCTIO�llOANIENDEA.��DRESiTEIEPHONENUMBER �,�,� ��� �� � <br /> PROJECT ADD/{��ESS/ s'c""10R1C_S2'E= ' � o.ie <br /> 3�O W• VTS/NO �'!, �� / � O CirvRo5mE55iKENS�NO <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P � <br /> BATNTUB FORCED AIR SVSTEMS—B].U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWEF CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUP:DRV TFAV WATER H'ATER <br /> CL07HE5 WASHER WOOD�.OVE <br /> URINAL METAI FIREPLACE(WOOD BURNING) <br /> ORINKING FOUNTAIN FIREPLACE INSERT � <br /> —T— <br /> FLOOR DRAIN f1EAT PUMP _ _ <br /> BACKFLOW PREVENTEAS GAJ PIPING � <br /> T <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAF.ETC.) <br /> SUB TOTAL $ SUB TOTAL 5 <br /> PERMIT $ PERMIT $ <br /> TOTA�FEE S TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONL SEtB�CK REAR SETBRCN SIDE SEi�AGK PLRN CHEC NUMBER FEE AECEIPT NO <br /> r�/��� <br /> usezor+e �o*ene� wc�NTsrte FEES VALUATION FEE <br /> . � VES ^ NO BU�LDINC+ <br /> irVf Of CONSt NO Ov SToniEB tta.o.nc+ ro aow�wncu+ns <br /> caou= p�UM�ING <br /> SREOFBl�O FiqES�AiNNLER5RE0'fl B�SEMENT MELHANIC4L <br /> '-� VES .� NO ---- <br /> OGCUP�NC�LoaD FIRE�L�RAIREOD HEiGHTuuiT�non ADDITIONALPLPNCHECN <br /> OTHER <br /> _ __T— <br /> REASON <br /> STATE BWLDING SU�iCH4RGE <br /> iNiAnE Av �lANS�PPROVEO BV CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES <br /> o,,rE TAX CODE IS 3105 TOTA� ' <br />