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APPLICATION FOR CONSTRUCTION PERMIT ��� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � <br /> BUILDING DEPARTMENT HEA7ING SYSTEM: ;�GAS J ELECTRIC ;� _ J <br /> 259-8810 <br /> yC DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OMMER MA�L ADDRE55 CiTV ZIP PHONE <br /> C-�e�trMur�SMr�u�is � I�io2 111N.1_s1iz�T �v.. ►W.� 962ni 25�6-�5 <br /> TENRNT MqLA0D9E55 GTV zlP pHpNE <br /> ARCHREGT OR�ESK.NGP MRIL�DDRE55 GTV 21V PHpNE <br /> OENERILLCONTRACTOR MAILFDDHESS GfiY ZIP PHONE STATELICENSE• <br /> �O p��hft�NL� <br /> MECNnNIGAL CONiRnCTOR MAIL RDDRESS LITY ZIP PHONE 5TATE LICENSE� <br /> PIUMBING CONTPAGTOR MAIL M�RE55 CRY 21P PHONE STATE IICENSE• <br /> C1A550f WORK <br /> � NEW . � ADDITION ' � ALTE�iATION REPAIR X DEMOLITION WOOOSTOVE�FRPL INSEHT BUIIDING RELOCATION <br /> CONtACT PEHSON RND PNONE NO <br /> GONTRACT PRICE OF WOR1t _�,� L,p�,�-, �'a� <br /> DESCRIBE WORR pND SOURNE FOOTAGE INVOLVED <br /> PROPOSWUSEMBUILDINC� i HEREBY CERTiFV THAT I HAVE READ ANO EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> LEGAL OESCRIPTIONOF PROPERTV ISNOWN BE�OW OR RTTACH FpUR WPIE6� PROVISIONS OF LAWS AND ORDINANCES GOVERNING TNIS TYPE qF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT 2� �0 _ e�oc� �25 or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GWE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK fOR WHICH <br /> APPLICATION IS IdADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW�8.27 RCW AND 296200 WAC. <br /> � � �b� LiN��k�2 <br /> PROJEGT ADDPESS �-x"%'� '� oAtE <br /> 2 r r.mr.vr:s,ic�rt v� <br /> PLUMSINO MECHANICAL <br /> N0. 7YPE OF FlI(TURE OP ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEH CLOSET(TOILFT) � A�C—A'HNDLG UNITS—H.P. <br /> BATHTUB FORCED AiR SVSTEMS—B,T.U. M E.A. <br /> LAVATGRY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWEFi :LOTHES DflVERS <br /> KITCFIEN SINK 8 DISP � VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV � WATER HEATER <br /> CLOTHES WASHER —r WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV � <br /> DRINKING FOUNTAIN i FIREI�L/iCE INSERT <br /> — �— <br /> FLOOq DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING ; <br /> flOOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SEFVICE—BAR,ETC.� <br /> — � <br /> _ <br /> I <br /> —; — <br /> SUB TOTAL $ � SUB TOTAI $ <br /> PERMIT $ � PERMIT $ <br /> TOTAL FEE $ ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FqONT SETBRCK RERH SETBRCK $IDE 6ETBRCK PI AN CHECN NOMBE FEE PECEIPI NO. � <br /> a <br /> use zor+e LOiANEA wcnrvt sire FEES VALUATION FEE �i <br /> BUIIDING <br /> 7YPE OI CONiS AILOWABLF TY14 0F GONSi AGiU4L o[aw4[r 'ia 0f VNF1nMGUnirS — — <br /> �A� � PWMBING <br /> 52E OF BLD3 OF 570RIE5 9ASE'AENT MECHANICAL � <br /> � <br /> OCCUPANCY LOpD FIRE SPfINKLERS PEOU HEIGIR UMITATION ADDITIONAL PIAII CHECK <br /> _ <br /> Sf'RINNLER <br />� NERSON FOR$PRINKLEPS --- <br />� STA7E BUIL�ING SURCHAAGE <br /> — i <br /> i4TqK[BV PLRNSAPPRGVED BV CITY OF EVERETT PUBLIC WOFIKS <br /> LOCAL SAt.ES —r <br /> TAX GODE IS 3105 I TO''AL � — _ <br />