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APPLICATIC 1 FOR CONSTRUCT �N PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT l HEATING SYSTEM: V GAS J ELECTRIC [► � <br /> 259-8810 / <br /> DEMOLITION COMBINATION ✓ BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER L MFRAL�DRESS �iiV ZiP PHONE <br /> G..R�NO`bA� �(/GRE•'/f-It�/ 96o QcN� Si /GVFKf� 4�a' 9a',�B/ �;ufi•�.f� 56(/� <br /> TENANT y MAIL qDDRESS CITY ZIP PHONE <br /> _�19ne� <br /> ARCHRECTOHDESiGNER MAILApDHESS CITY ZIF PHONE <br /> GENERAL CONTRACTOR MAIL ApORE55 CITY 21P PHONE STNTE LICENSE N <br /> �R��� <br /> MECHANtCr4CONTRACTOR MAILA�DRESS CRY ZIP PHONE STATELICENSEN <br /> �A/t2� <br /> PLUMBING CONTM TOR MAII ADDRESS f,ITY ZIP PHONE STATE LICENSE# <br /> CLSSS OF WORK <br /> NEW � ADDITION '�� ALTERATION � �. REPAIR �. .. DEMOLITION '�.. '� WOODSTOVE/FRPL INSERT I ' BUILDING RELOCATION <br /> O� CONTACT PEq50N AND PHONE NO. <br /> CONTRACTPRICEOFWORK � Ud � �N� Jyl 4KG(/4�. Z3-!� �bJ-� <br /> DESCRIBE WORK qND SpUARE FOOTAGE INVOLVED <br /> Y <br /> i3 �in '�y /� . / �� r��o �/ �p�,-sh_ y _ <br /> aAorosEouseoFew�oiNc. i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> F u�R-�JT � r �o.� . APPLICATION AN7 KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> LEGAL DESCPoPTION OF P PER (SHOWN BELOW OR BTTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OP <br /> WORK WILL BE COMPLETED WITH WHETNER SPECIFIED HEREIN OR <br /> �oT eiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUidE TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> O D - �rl r �vY✓tl�T OTHER STATE OR LOCAL lAW REGULATING CONSTHUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> � R��J� ( ,�¢i d� ��(` OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> .3�1 � r�� �� �tc �r�'<� x ��iii�..��c�. lo -�� — P3 <br /> PFQIECTADD SS �si ruAe p <br /> YUR /�'./��1�. oare <br /> � CIiV BIISINES$LICENSE NO. <br /> � PLUM8ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/�A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> . SHOWER i CLOTHES DRYERS i <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> � _ LAUNDRVTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY —� <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVE ERS GAS PIPING <br /> ROOF DRAINS— INLEADERS EXHAUST FAN � <br /> SINK(SERVIC —BAR.ETC.) <br /> SUB TOTAI $ SU8 TOTAL $ <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACK SIpESETBACK PLpNCH CKNUMB FEE RECEIPiNO. <br /> �����/ { <br /> use zorie �or naen VpCANT SITE FEES VALUATION FEE/�7 <br /> BUILDING �x/ ; Q� <br /> iYVE Of CONTS.ALLOWABtE iVPE OF CONST ACTUPL atcuvnrvcv rvc OFowEwN�uNi*s U <br /> cnouv pLUMBING <br /> SIZEOFBLDG. NOAFStORIFS BASEMENT MECHANICAL L '��C� <br /> U <br /> UCCUPANGVLOFD PIFESPRNKLERSqEO'D HEIGHTLIMITATION ADOITiONAL?LANCHECK <br /> SPRINKLER <br /> RERSON FOR SPRINNtERS — <br /> STATE BUILDMG SUFGHARGE i� <br /> WTAKE Bv � PLANS APPROVEO BV CITY OF EVERE?T PUBLIC VJORKS . <br /> LOCAL SALES <br /> TAR CODE IS 3105 TOTAL <br /> � ; s�� <br />