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APPLICATIC" l FOR CONSTRUCT'�lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ;�GAS J ELECTRIC U <br /> 259-8810 <br /> i-1 DEMOLiTION ❑ COMBINATION ❑ BUILDING I ] MECHpNICAL ❑ PLUMBING �� SIGN <br /> OWNER IAAIL ADDRESS� CITV��v�ZIP��� PHONL ���-O��� <br /> M 6 M.,� 8. 3Zo �0� A� � �4d� <br /> TENANT �� �.. MAIL�DORE55 GTY ZIP PHONE <br /> e�-u.�►*�.Rs 4q Z5 Ev£R�REEri wA L.V���IT' °18 20 3 <br /> AFCHITECTORDESIGNEP fdFILf.ODRESS GTV ZIP PNONE <br /> N OTJ£ <br /> GENER4Ly,ON7RACTOfl h7AIL ADDREA/S� cirv ZIP PHONE STATE LICENSE a • <br /> �p /�i� � c� (.mo4-m-�i1Cc� .L,m� <br /> ldECNFNICALCONTRACTOfl MAILACDRE55 CITY ZIP PHONE STFTEUCENSEA <br /> PLU�ABING CONTPACTOfi l.IFIL AD�RE55 GiY ZIP PNONE STAiE LICENSE k <br /> GONTR�CT PRICF OF YlORK <br /> # /4'. �i0o� <br /> OFSCRIBE WORK FN�SOUARE 600iAGE INVOLVED CONTACT PERSON AND PHONE NO. �� �jV A <br /> ��V <br /> i3g4 SF 450-24oq ��vu� <br /> V'1�1TGN( �NIOR��ESC���T�ON O�( QLAT(S I HEREBY CERTIFY T4AT I HAVE READ AND EXAMINED THIS <br /> PROf'OSED USE OF BUI�DING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �TA�(„ PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGFLDESGRiPT10NOFPROPERN�SNOWNBELOWOflATfACHTWOCOPIES) WORK WILL BE COMPLETEO WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A ?ERMIT DOES NOT PRESUME TO GIVE <br /> �or o�ocK aF - AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ,��A` � ����� OTHER STATE OR LOCAL LAW HEGULATING CONSTRUCTION OR THE <br /> PEP.FORM1IANCE OF CONSTRUCTION.THnT!AM AUTHOR¢ED BY THE <br /> n':JNER OF THIS PROPERTY TO PERFORM 1'4E WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAPCEL TAX I.DIN�UMBE� _ O,,,Z- O�Q CONTRACTORS L�W 18.27 RCW AND 296200 WAl'�. <br /> �GL� <br /> CONSTRUCTIONLOANLENOER,AODRESS,TELEPHONENl11ABER � � /G�/ /��/ <br /> SEAF�RST �� ve�roK 35�b• 3619 �(�ax �,���- �r� ��-- <br /> PROJECTADDRESS �rvnrune �"�� _�_ <br /> �qz rE �t 982.0 ��,.o�,��E55���«�=�„o ._ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> � � AIC—AMNDLG UNITS—H.P. � <br /> . -� R CLOSET(TOILET) � <br /> -- . � FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> ,WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SH�... i; ' CLOTHESDRYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRY TRAY ' WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ! <br /> DRINKING FOUNTAIP! � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' _ <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETCJ I <br /> � ' <br /> � <br /> ; <br /> � <br /> � <br /> � <br /> i ' <br /> SUB TOTAL S ' SUB TOTAL 3 ' <br /> PERMIT 5 ' PERMIT 5 � <br /> TOTALFEE 5 ' TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SE]BAGK REAR SETBACK SIDE SETBACK PLl�N CH CK NUMBEfl� FEE ���! R/EIPT �:.�J� <br /> O � �� ..� <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION fEE _ <br /> `� ❑ YES ❑ NO BUILDING �J� ' ��� <br /> iYPEOFLONSi NO.OFSTORIES o[tuvnqcr n00fDtvE0.niGurvrtS � <br /> �Ziv 1 6°` ,� � <br /> 2 PLUMBING � <br /> SREOFBL�G. FIRESPRINKIERSREO'D BASEMENT MECHANICAL ' <br /> 13C ��i • I. �> ❑ YES X No � <br /> OCGUP�NCV LO�D FIRE AIARM REO'D MEIGHT IRAITAT10N <br /> ADDITIONAL PLAN CHC-CK � <br /> �w, L, i <br /> �2 11�' ��/'/ OTHER <br /> RE�SCN i �� <br /> �A�1�t/ STATE BUILDING SURCHA(7GE <br /> v� � <br /> INTNNEev PLl1NSnPPF�VEDBv CITYOFEVERETT PU�LICWOFKS 1 <br /> JM LOCAL SALES <br /> DAiE �� Qj � TAX CODE IS 3105 TOTAL s ;S[� <br />