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APPLICATIC 1 FOR CONSTRrJCT'-1N PERMIT <br /> TO BE COMPLETED IN BLACK INK—pLEASE PRINT � <br /> BUILDING DEPARTMENT HEATING SYSTEM: J GAS [J ELECTRIC ❑ <br /> 259-8810 <br /> DEMOLITION ' � COAIBINATION ,� BIJ�LDING i i MECHAPJICAL i I PLUMBING f_1 SIGN <br /> �vN�ur'�y�7'y����� }'�} � NAILqDDRE55 y�q CITY <br /> 713� GI�?�(/Y �V f/K� ��I fU!V� �� 21P PMAONrE� <br /> TENFNi I,�AiLADDRES', ���' - '✓ ��v <br /> �y�Y CITY ZIP PHONE <br /> r`�' LG <br /> ARCMIiECTOR�E5IGNER MAILAODRE55 pTV <br /> ���+�,.��/f�. 11�� � ,ryy/(,�l� pI/J�� y�/��J�{ ��n(�� Z�P PHONE <br /> EFAICOII�-7� ` '-""� �i"�JCv Y��l� t�/✓r9''� JI ��"'��� OL,�j!/ <br /> ��IF�S�PHONE STATE LILENSE x <br /> -UNI�i,�d+-�hl- lN /31b 5 <br /> MECHANICnLCONTRACTOR tdAILADDqESS CITY <br /> Z�P PHONE STATEIICENSEY <br /> PWMBINGCONiRqCTOR MNLqDDRE55 dTV <br /> Z�P PHONE STA7ELICENSEI <br /> WNTRqCT PRIf°CF WOFK �y� � <br /> D C.L(/ ...._ <br /> DCSCflIBE WOPK ANDSCUARE F tAGE INVO ED <br /> IAIA� ������u „� y� ��y^ � CUNTACTPEfl50NANDPHONENO. � <br /> 11l /\fT 11 Z 6 <br /> '(1M7 l�Vr,i'- 4C1�/lC� {gV F.tGI �/ v <br /> AGGC�'h/a�L�M A�NYJ �}�l4t 1�2tjy�> <br /> FROPOSEDUSEOFBUILDING � HEREBY CERTIFY THAT I HAVE qEAO AND EXAMINED THIS <br /> _��� APPUCATION AND KNOW THE SAME TO 8E TRUE AND CORqECL ALL <br /> PROVISIONS OF LqWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LE.ALCES.,RIPTIONOFpqOPERTV�SHOIYNBELOWORATTACHTN'OCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> '. ��0t o�acK oF _ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ���� �V'��� AUTFIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE <br /> � ?7I IJ7 OWNER OF THIS PROPEHTY TO PERFORM THE WORK FOR WHICIi <br /> �naceirnxi.oNur.+eEa APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTO 18.27 RCW AND 296.200 WAC. <br /> CONSTRtICT10N LOAt{AEN�EF,ADDRESS IELEPHONE NUMBEF <br /> K%V ^ �_ � <br /> P�ECT ADORESS sir.u,r <br /> o.rz <br /> nrv isv„suarrsrao <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT <br /> WATER CLOSET(TOILET� FEE <br /> ' A'C—A�HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WqSH BAS�N) UNIT HEATERS—B.T.U. M <br /> SHOWER � CIOTHESDRVERS � <br /> _ KITCHEN SINK 8 DISP VENTILATION FAN � <br /> _ DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAV ; WATERHEATFR , <br /> _ CLOTHES WASHER � WOODSTOVE <br /> URINAL i <br /> DRINKING FOUNTAIN � METAL FIREPI ACE(N'OOD BURNING) <br /> � FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> _ EACNFLOW PREVENTERS ; GAS PIPING <br /> _ ROOF DRAINS—RAiNLEADERS � EXHAUST FAN <br /> SINK(SEFiVICE—BAR,ETC.) � <br /> _ � <br /> -- � <br /> ---- � <br /> _. SUB TOTAL S ' SUB TOTAL $ � <br /> ___ PERMIT $ PERMIT $ <br /> TOTAL FEE S ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SET9ACK REAR SETBACK SIDE SETBACN PLAN CNECI(�MgEH� FEE � �32 �RE/^�,/I <br /> USEZONE �� �y x/ F J �� <br /> Y <br /> LOTAREA VACANTSITE FEES VALUATION FEE <br /> ❑ YES i NO BUILDING � �O i <br /> 1YPEOfCOH57. NO.OFSiORIES acuo�ya xoo�rnnweGUN�.rs <br /> h'c GH�� �wo�o , <br /> (7�� PLUMBING � <br /> SItE OF�LOG. � <br /> IRESPPIN Efl5RE0D BRSEMENT <br /> �GY�lX1� '�•I, f i YES ❑ NO MECHANICAL � � <br /> OGCUPANCVIOAD FIREALA dqEOD HEIGHTLIMITATION ADDITIONALPLANCHECK <br /> r;EasoN O7HER � <br /> STATE BUILDING SURCHARGE � �/� <br /> W iAKE BY �� <br /> PLANSAPPROVED BV CIiY OF EVERETi PU�LIC WORNS � <br /> �M LOCAL SALES `� <br /> onre ��� i9. TAX CODE IS 3105 rorn� � <br /> \h � 9'�� <br />