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APPLICATIC`�`t FOR CONSTRUCT'lN PERMIT � <br /> TO BE COMPLETED iN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM� ❑GAS ❑ELECTRIC J I <br /> BUILDWG DEPARTMENT - <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION : 1 BUILDING ❑MECHANICAL ❑ PLUMBING ❑ SIGk <br /> //JJ n PHONE <br /> 01ypJE�C1�/ I 3,�-v1AlLA��/ �/V / �Q.PLITY ^U �� IP <br /> � �� <br /> TENANT <br /> MAILADDFESS CITV ZIP PHONE <br /> AflCHITECTOHOESIGNER lAAILAODBE55 <br /> CITY ZIP PHONE <br /> GEN LCONTR�CTOR !d ILADDRESS � 1 CITY ZIP PHONE STATELICENSEa <br /> �/�wnn� �pY(�v �'�� S, C�Ss���� Su��-� `� K�ew� q5;0 '3� <br /> - �/�,W PHON[ $TA7E LICENSE R <br /> �.�µ7p��7pq MAIL AODRE55 CIN ZIP ��_ I:��� N����� A` ��IN D <br /> l�J <br /> PLUMBING CONTRACTOR MAIL 4DDRESS <br /> CITV 21P PH01lE STATEUCENSEtl <br /> XGONTRACTPijIfl� Q�-1 mQO 1 O � <br /> Y7' � � <br /> 'OESCRIBEWOflKANUSCU4REFOOTAGE VGLVED CONT�CT�SONANDPHO O 1''� C '� '� <br /> x-- �' � �aa-7 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSEOFBUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL <br /> PROVISIONS OF LAWS AIJD ORDINANCES GOVEflNING THIS TYPE OF <br /> LEGALOESCRIPTIONOFPROPERTYlSNOWNBELOWORATfACHTWOCOPIES) NOT. THELGRAN NG Of A ERMITJDOES NOT PRIESUME TO GNE <br /> ioT e�ocK oF AUTHORITY 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 AUTHORIZED BY TI1E <br /> OWNER OF THIS PROPEFiTY TO PERFORM THE WORK FOR WHICfi <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PARCELTA%�.D.NUMBER CONTRACTORS lAW 1827 RCW AND 29G200 WAC. <br /> CONSTPUCTIONLOANLENDEfl,AODRESS,iELEPHONENUMBEP � ////� � f'�'�/�^9� <br /> V U�I J <br /> OFLE <br /> — SIGNR URE <br /> PROJECT ADDRES��� ` <br /> cm euswEss uccr+se rvo <br /> PLUMBING MECHANICAL <br /> FEE NO. TVPE OF E�UIPMENT FEE <br /> NO. TYPE AF PIXTURE OR ITEM q��q�HNDLG UNITS—H.P. ' <br /> WATER CLOSET(TOILET) ' � <br /> � FORCED AIR SYSTEMS—B.T.U. M F.A. <br /> � BATHTUB ' � <br /> LAVATORY(WASH 6ASIN) � UNIT HEATERS—B.T.U. M ._T <br /> � CLOTHES DRYERS � <br /> SHOWER � ' <br /> KITCHEN SINK&DISP VENTILATION FAN ' <br /> � RANGEHOOD � <br /> DISHWASHER ' <br /> LAUNDRYTRAY ; WATER HEATER � <br /> CLUTHES WASHER � WOOD STOVE ' <br /> � METAL FIREPLACE(WOOD BURNING) ' <br /> URINAL ' � <br /> ' FIREPLACEINSERT � ' <br /> DRINKIN3 FOUNTAIN ' <br /> � HEAT PUMP � <br /> FLOOR DRAIN GAS PIPING ' <br /> DACKFLOW PREVENTERS � EXHAUSTFAN � <br /> ROOF DRAINS—RAINLEADERS � <br /> SINK(SERVICE—BAR,ETC.) � ; <br /> � � <br /> � � — <br /> � � <br /> i , <br /> _ —• i <br /> SUB TOTAL $ ' SUB TOTAL S � <br /> � PERMIT S ' <br /> PERMI7 5 ' TOTAL FEE $ ' <br /> TOTAL FEE S � <br /> FOR OFFICE i1SE ONLY: aEceiarCr+oa�r/� <br /> SI�ESETBACK P�ANCHECKNII E�� FEE ���� /D �i <br /> FqONT SEi6ACK REAR SeTBACK � y, , <br /> FEES VALUATION FEE <br /> ❑SEZONE LDTAREA VAC�NTSITE . GO � � � <br /> ❑ YES ❑ NO g�qLDIN� �l G'G� + � <br /> '� ' <br /> ttPEOFCONSi. �OAFSTORIES OLCUPAGCY Noovo�vFLLnitur:u5 � <br /> ' cnauv '(, pLUM81NG � <br /> .� 3 r � <br /> � <br /> S2E OF BLOG. FIRE SPFINKLERS REO'D BASEMENT MECHANICAL � . <br /> Q'1 ` �I. Y�i ❑ YE6 �N� ' <br /> AD�ITIONAL PLAN CHLCY. ' <br /> OCCUPANCV LOAO FIRE OLAHM RE4'� HEIGHT IIMITFTION � <br /> i <br /> , '�� �t G� r �` OTHER <br /> FEASON s��,l'r� � l <br /> � G'�jJ���JL'�j� GU�-1r�H A����al� �7� ���,� STATE DUILDING SURCHARCE 1 <br /> IPITANE BV PLANSAPPROVED BY CITY OF EVERETT PU�LIC WORKS � <br /> �� LOCAL SALES /� ' G ) <br /> DATE �. � % <br /> TAX CODE IS 3105 TOTAL <br />