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APPLICATIQ�? FOR CONSTRUCT""�N PERMIT � <br /> TO BE COMPLETED IN BLwCK INK—PLEASE PRINT <br /> BUILDING DEPARTIv1ENT HEATING SYSTEM: ']GAS ❑ELECTRIC ❑ <br /> zss-ssio 7L// l�e�'ncns�.�, �y ,c�Jtnxnc� G '��„ � -�s <br /> !; DEMOLITION i_� COMBINATION i_7 BUILDf�IG lJ MECHANICAL �LUMBING ❑ SIGN <br /> OJJNEa IAAILADDRESS CITY 21P PHONE � <br /> Tr�2R F,�z��,� ne.d L.7'D 5nv 9d 29� 7'�3 ss�c <br /> TE NT MAILADDRESS CITY 21P PHONE <br /> �'R��- Gi�P�Fi in� Id7�� 4,�2c�pen w Eoe�eth 9820�/ Sl� - �5'1' / <br /> ARCHITECTORDESIGNEF MMILADORE55 CITY 21P PNONE <br /> GENERALCONTRACTOR MAILADORE55 CITY ZIP PHONE STATELICEN3EN <br /> MECHANICALCON�RACTOfl MAILAUDRE55 '� y� CITV ZIP PHONE STATEUCENSEN ' <br /> L�-(�/�/-Y M/,7 /°L y//3 6 Z.GYo .5-5'" sT .oAnYtr',�cE 98'x 7�' 33 H s'o3S /°Y��4^��° l3//'� <br /> PLl1MBINGCONiRACTOR MAILADDFE55 CITY ZIP PHONE STATELICENSEN <br /> CONTRACT PflICE OF WORK � <br /> y <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVO�VED CONTACT PERSON AND PHONE NO. <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSEOFBUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCFIPTIONOFPROPERTY�SHOWNBELOWOflATfACHTWOCOPIES) WORK WILL BE COMPLETED WITH W4ETHER SPECIFIEL` HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE . <br /> �or BLOCN 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 THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> - - APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.L00 WAC. <br /> CONSTPUCTION LOAN LENDER.P�DPE55.TELEPMONE NIIMBER <br /> � <br /> PROJE DRESS �� * o�*e <br /> biY 9USME55 LILENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR REM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�,'C—FVHNDLG UNITS—H.P. I <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHESDRYERS �— <br /> KITCHEN SINK&DISP ; VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATERHEATER ; <br /> CLOTHES WASHER WOODSTOVE � <br /> �— <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPLACF.INSERT ; <br /> FLOOR DRAIN � HEAT PUMP T- <br /> BACKFLOW PREVENTEFS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADER� � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � ; <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PEFMIT $ 2 PERMIT $ <br /> TOTAL FEE $ 3 TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK FEARSETBACK SI�ESETBFCK PIANCHECKNUMBEF FEE RECEIPTNU. <br /> 115EZONE LOTAREA VACANTSITE FEES VALUATIOl1 FEE <br /> -: ves C No eui�oiNc I <br /> ttPE0FC0YSi NOAFSTORIES amvu:tt u0.orew[umcwms i <br /> °BOOP pLUM61NG <br /> SREOFBLOG. FIRESPRINNIERSREO'D 9ASEMENT MECHANICAL i <br /> ❑ YES G NO <br /> OCCUPANCY LOAD FIRE ALARM REO'D HEIGHT UMITATION ADDITIONAL PLAN CHECK i <br /> OTHER <br /> REASON <br /> STATE BUIL�ING SURCHARGE ; <br /> i <br /> INTAKE6Y PLANSAPPROVEDBY CITYOFEVERETT PUBLICWORKS ' � <br /> LOCALSALES � <br /> onr� TAX CODE IS 3105 rorn� � <br />