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� � <br /> I\�PLICATION FOR CONSTRUCT�ON PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDING DEPARTMENT I HEATING SYSTEM: ]GAS ❑ELECTRIC ] I <br /> 259-8810 <br /> X DEAAOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> ONTIER M0.ILIWDRE55 CITY Z�p pMCt�E <br /> Ev��t�rT AAur�,,�-L 5uw►.z5 81c i s�� wa� S7RECT ,�v n►JF 9�2oi �s� �4s <br /> TENANT MAILADCRESS ��Ty z�p PH� <br /> ARCMREGT OB DE5IGNER IAAIL RDDFE55 CITY 21P PHO.VE <br /> . GENER0.CONTR�CTOti M�iL ADDRESS GITV ZIP PHONE SiRE L�CENSE t <br /> -r b..._ — - ,... ,.._._ �CIN L�Urr�fl ,.�7'1 t!�xn�c�� �l �u 9a � <br /> MECHANIG0.CpNTR�C,pq MAILI�DORE55 GITV ZIP PHONE � STATEI.ICENSEf <br /> PLUMBMG CdiTR�CTOR MML ADDFE55 CIIY ZIP PHONE ST�TE UCENSE Y <br /> G1A550F WOPN <br /> . ; NEW ADDITION ALTERATION pEPAIR �(DEMOLITION . WOODSTOVE�FRPI INSERT BUILDING RELOCA710N <br /> LONTAQ PERSpN�.ND PHONE NO <br /> CONTqACTPPICEOFWORK L � � <br /> DESCRIBE WORN AND$OUqRE FOOUGE INVOlVEO �D�7 L�Iy� <br /> PROPOSEDUSEOFBUILDING i HEREBV CERTIFV THAT I HAVE READ ANO EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> LEGALDESCRIPTqNOFPRpPERTY�SHOWNBELOWORATT�CHFOURCOPIES� PROVISIONSOPLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or�_ etxK � oF NOT. THE GRANTING OF A PEAMIT DOES NOT PRESUME TO GIVE <br /> . AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW R[GULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNEF OF THIS PROPEFTY TO PERFORM THE WOiiK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 782;RCW AND 29fi.200 W�C. <br /> x 1�11'(�_3/IhEt2 <br /> PROJEGT RDDRE55 s�a �t n�rp �—' <br /> 2 � cnvauemrssuur+sr� <br /> ����� MECNANICAL <br /> NO. T1'PE OF FlI(TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � ,VC—NHNULG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) UIJIT HEATERS—B.T.U, M <br /> SHOWER CL07HESDRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN � � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ; WATEF HEATER - <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL � METAL FIREPLACE 8 CHIMNEY <br /> _ DIiINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR ORAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS . GAS PIPlN, • <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> SUB TOTAL E SUB TOTAL $ � <br /> PERMIT $ � PERMIT $ <br /> TOTALFEE $ TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAq SET9ACN $IDE SETBACK PLqN CHECN NIIMBER FEE RELEIPT NO <br /> ✓ <br /> use zorve LOTARER vncnNt sire FEES VALUATION FEE <br /> BUILDING <br /> TYPEOfCONTb RLLOWABI[ TYPEO(CON57 ACTUAI attuMxcv NO IX(MTurM,uxns <br /> �"0°� PLUMBIhG <br /> SIZE OF BLIX3. N0.Of STORIES BASEMENT MEGHANICAL i <br /> OCCUPRNCY LOA� PIPE SPRNKLERS REO'D XEIGHT LIMITATION ADDITIONAL PLAN CHECK <br /> SPRINKLER � <br /> pERSON FOR SPPINKLERS —�— <br /> STATE OUILDING SURCHr1RG[ i <br /> INT�ME BY PUNSAPPROVEDBV CITY Of EVERETT PUBUC WORKS � <br /> LOCAL SALES �— �— <br /> TAl(CODE IS 3705 ror�� <br />