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__ _ <br /> APPLICAT�G J FOR CONSTRUCT_ �I� PERIIAIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �r� <br /> BUILDING DEPARTMENT HEATING SYS7EId: ' AS ❑ELECTRIC � <br /> 259-6810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> �NT�ER MAIL ADDRE55 �?Y ZIP PHONE <br /> o?��'' J� o�,P� ��c Po i3ex 27s9 A�,� ,e 9Po 7� <br /> TENANT MFILqDDPE55 CRy Zip <br /> PHONE <br /> �n�oo,r�r� ',r1�E,P,v �6a6� �oLSY �� 4JA 9�?v/ �S9o7a7 <br /> hPCMRKT di DESIGNER MAIL ADDRE55 � CITV ZIP PNONE <br /> s�L� <br /> GENERALCONTrRAL/tOR+ MAiIA��RE55 LITY 11P PMpNE SiRTELICENSE� <br /> �e L'T <br /> MECHANiGAL CONiFACTOF MFIL ADDRES$ GfTY plP PHpNE STATE LKENSE� <br /> S��'�' <br /> PLUMP CONTFACTOq MAIL ADDRESS CITv 21P PHONE STlTE LICENSE� <br /> �L F <br /> CUSS OF WORK � <br /> NEW ADDITION �J{LTERATIf�N REPAIR OEMOLITION WOODSTOVE%FRPL INSEtiT BUILDING RELOCA710N <br /> �`'. . <br /> /}-� t CONTACT PERSpN AND PHpNE NO. <br /> � '�:. . � CONTRACT PRICE OF WOFK l7 v�/� <br /> i.J, ,' , <br /> � n.� OESC E WORH RND UARE FOOTAGE INVOLVEO , , � � ; . <br /> I , � /�a � <br /> PAOPOSEDUSEOF ui�oiNc, i HEREBY CERTIFY THAT 1 HAVE �EAD AND EXAMINED THIS <br /> '�I �Ec.a�o��IONOF PROP[RTV�SHOWNBELON OR RTTACHPWRCAPIES� PROV S ONS OF AWB AND O DANANCES GO ERN NG TOH S TY E OF <br /> }d� .. _ <br /> t' �.�": WORK WILL BE COMPLETED WITH WHETHER SPECIFlED HEREIN OR <br /> � @-���� � �ot e�ceK oF NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br /> � AUTHORITV TO VIOLATE OR CANCEL THE PRO✓ISIONS OF ANV <br /> 1:`�� . <br /> � I�� OTHER STATE OR LOCAL LAW REGULATIIJG CONSTRUCTION OR THE <br /> ;� PERFORMANCE OF CONSTRUCTION. THAT I AM AUl"HORIZED BY THE <br /> � '� OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> i.: <br /> ;;�'� APPLICATION IS MADE AND I COIdPLV WI�fH THE STATE <br /> �{" , CONTRACTO W 78.Y7 RCW AND 296.200 WAC. <br /> .. .. x �c�tG�>y�� /1� <br /> PROJ[LT qDDHE5�5)n /� �.,�>ri�n: <br /> �VO �y_ n m*[ <br /> L2LL' <br /> ryv RVSx��yc�itFN i�Nn <br /> PLUMBING MECHANICAL <br /> HO. TYPE OF FlICTURE OR ITEM FEE NO. TYPE UF EQUIPMENT FEE <br /> WATER CLOSET(TOILET� N�A'HNDLG UNI75-H P <br /> BATHTUB FORCED AIR SVSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS-B,T.U. M <br /> SHOWER CLOTHES DRYERS -� <br /> KITCHEN SINK 8 D�SP VENTILATION FAN <br /> DISHWASHER � RANGE HOOD -�- <br /> LAUNDRYTRAY � WAT[R HEATER <br /> CIOTHES WASHER � WOOD STOVE <br /> UfiINAL ME7AL PIflEPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT?UMP --T <br /> 84CKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAItJS--RAINLEADERS C-XHAUST FAN �— <br /> SINK(SERVICE-BAq,ETC.) — ; <br /> i - <br /> __� <br /> SUB TOTAL $ SUB TOTAI. $ _� <br /> PERMIT $ PERMIT $ � <br /> TOTAL FEE $ TOTAL FEE $ � � <br /> FOR OFFICE USE ONLY: <br /> FqONT SETB4CK REAR SETBhCK SIDf SETEACN P�AN CHECH NUMBERyn FEE f1ECEIPT IIO <br /> � 4 / <br /> 11SEZONE LOTARER VACANTSt1E FEES VALUATION FEE <br /> BUILDING <br /> TYVEO�fAHiSQl➢W�BLE hPEOfCONST.RLTWI at[uv�r2r Noaw�euNcuNns . <br /> �pWv � pLUMBING <br /> SIZEUFBLIX3. NOAF6iOqIES BASEMEM MEGHANICAL /� � <br /> •f�r <br /> OCCUPANGY LOAD FIPE SPflNNLERS PEOD NEIOMT LIMRATION ADDITIONAL PLAN GHECK � <br /> � <br /> SPRINNLER � <br /> REASON FOR SPRMNLERS i <br />� STATE BUILDING SURCHARGL <br /> iNinkc tav rinr�snrrnoveuer CIiY OF EVERETT PUBLIC WORKS <br /> LOCAL CALES <br /> TAX CODE IS 3705 rorn� 3� ; � <br /> , <br />