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APPLICATIC�`I Fbi� C�NSTi�UCT�;�! PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PiiINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑Gr'.S ❑ELECTRIC _❑ <br /> 259-8810 <br /> ❑ DCMOLITION ❑ COMBINATION )CI 3UILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER 1 " M�ILADDFESS d.,, CIT�Y � ,�! 21P PHO4[ <br /> �.� �,c 27.Z � 1n�8�'Y✓�GrG r�•L Cwm�fl 9�Z�� ,�'�Z�V <br /> 1ENFN MAILAD�RE55 CI ZIP PnONE <br /> �p,��,�.,��J�,,, �o. S,k Zz21 Ev�y�Zo3 Zs-ni37 <br /> AC.CHITECTCROESIGNER MAILFUORESS CITV ZIP PHONE <br /> GERERFLCONTRACTOR ' D - S CITV ZIP PHONE STATELICENSEa <br /> ' �o. C�.x zzz7 L=y{,t+f� �j$�d3 Ts"�o137 N/A <br /> � MECHAN:CALCONTRACT R MAILADDRESS CITY ZIP PHONE STAT LI:ENSEa <br /> PLUM9INGCONTRACTOR MAILADDRESS CITY ZIP PHONt STATELICENSEx <br /> �C TRqCT PRICE OF WOFN ' <br /> f S D 0 0 f' ' ,�'G�✓ 252 -4/3� <br /> OESCRI9 WORH AND SOUAFE FOOTr1GE INVOLVED CONTACT PER50Y AND PHONE NO. <br /> I HEREBY CERTIFY THAT I HAVE READ AND EaAMINED THIS <br /> � ` �. PPOPOSED USE OF BUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRtCT.ALL <br /> ✓ ✓ Y / d �iLLI� PROVISIOtJS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � � LEGALDESCRIP IGNOFPROPEFTV(SHOWNBELOWORATTACH oc Pesi WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> /�1 OT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT �9' frZ e�ocK�pofJ qUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION C?THE <br /> ��`• �- — PERFORMANCE OF CJNSTRUCTION.THAT I AM AUTHORIZED BY THE . <br /> � r �:� <br /> x OWNER OF THIS PROPERTY TO PERFORM THE WOflK FOR WHICH <br /> ' �.;�����'. APPLICATION IS MADE AND I COMPLY WITH THE STATE � <br /> ' PAFCELTAX I.D.Nl1M8ER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> � CONSTq CTIONLOANIENDER,AD�RE55.?cLEPHONENUMBER � n ,/� _ <br /> l /�� 3�- %y <br /> PRO ECT DR SS /, /1 su""'""`QZZ342 onre <br /> ' �/V� CIiY9U$INESSLICENSENO. <br /> PLUMBING ^ MECHANICAL <br /> NO. TYPE OF PIXTURE OR ITEM FEE NO. TY E OF EOUIPMENT FEE <br /> � WATER CLOSET(TGILET) � fVC—AIHNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) i UNIT HEATERS—B.T.U. M i <br /> SHOWER ' CLOTHES DRYERS � <br /> � KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> � DISHWASHER � RANGE HOOD � <br /> • LAUNDRYTRAY ; WATER HEATER ' _ <br /> '� CLOTHES WASHER � WOOD STOVE � <br /> — --r <br /> � URINAL ; METAL FIREPLACE(WOOD BURNING) � <br /> ORINKING FOUNTAIN � FIREPLACE INSERT . ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; <br /> i � <br /> , � <br /> , — <br /> SUB TOTAL $ ; SUB TOTAL $ ; <br /> PERMIT $ � PERMIT $ <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOH OFFIrE USE ONLY: <br /> F�ONTFET6dCK HEARSETBACK SI�ESETBACK PLANCJ�CKNUMBER FEE �y� RECEIPT 0.,� <br /> C ��, /� <br /> � 7 <br /> USEZONE LOTAREA VPLANTSITE FEES ` VAIUATION FEE <br /> ❑ YES � h� BUILDING " ) JS ' <br /> PEOFCONST. NO.OfSTORIES OCcuPANCr rmtioWELUNGunrtS i <br /> ✓� � GP02 PLUMBING i <br /> SIZEOF�B7LJDG�1 FIRESPRINKLERSflEO'D BASEMENT MECHANICAL � <br /> _I�DU ' " `+ � N J ❑ YES G�'FJO � <br /> OCCUPANCVLOAD FIREALARMREO'D HEIGHTLIMITATION ADDITIONALPLANCHECK __— i <br /> �_ NJ <br /> OTHER � <br /> flEASON <br /> STATE BUILDING SUflCHAPGE / i � <br /> INTA':E BY PLANS P�VEO BY CITY OF EVEftETT PUBLIC WORKS 3�� i <br /> LOCAL SALES <br /> DATE ��/_ � TAX COOE IS 3105 TOTA� 'J� <br /> , <br /> ,�,.,.,...�, <br />