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APPLICATIC� FOR CONSTRUCT`"1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ —� <br /> 259•8810 <br /> ❑ DEMOUTION I_1 COMBINATION 'j( BUILDING L i MECHANICAL iJ PLUMBING ❑ SIGN <br /> W��HCi EM�W'{EES M�ILdDDRESS piY 21P PHONE <br /> ce�iT vwon� 12'+70 c�vT�wy.� DfL. TUKWI�.n 98ico8 q.�-�y89 <br /> TENANT M�ILAODflE55 CITV ZIP PNONE <br /> SAN1G AS qboVL <br /> AFlLHITECTORDESIGNER MNLA��RE55 / CITY ZIP PMOfI[ <br /> GALusor� PARTMFRSHIP l4ZO F�F�H AVGNtJL�SJI'f[..7AU0 S�g��_��?jf01 LZ3-A�b4Cs <br /> GENERALCONTFqCTOR MNL�DORESS GiY ZIP PHONE STATEIIGENSEa <br /> SD� L�I�t�zonor� 315o R.141ARAS 7D���jEL1EWE gg o05 �o,rn, -9voo C�oo2i7� 3 <br /> MECHqNICALCONTRACTOF MFILADORESS CITV ZIP PNONE SIATELICENSEb <br /> PLUMBINGCONTRACTOR IANlA�01iE5S CI'Y ZIP PHONE ST�TELICENSE# <br /> CONTPqCT PRICE Of tVORK <br /> w 3�Doo ,oov. �o <br /> DESCRIBE WOPK AND SOIIFFE FOOT�GE INVOLVED CONTACT P'eRSOR AN�PHOtvE NO. <br /> �fA�CDNSiYJuf10N ZZ 8,3�] j.F. FINAN �if �IA - � <br /> ��� �� I HEREBY CERTIFY THAT I FIAVE READ AND EXAMINED THIS <br /> aeoPoseo use oF em�on+c APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC'i.ALL ��I <br /> G�PII- �UION FIN[�IJGIAL $ERV IGE <_'E►.l'f� PROVISIONS OF LAWS AND ORDINANCES GOVERNWG THIS TYPE OF �� <br /> LEGALDESLRIPTIONOFPHOPEFTY(SHOWNBELOWOR�iTACHTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEqEIN OR � <br /> LOi — BLOCK -- OF NOT. THE GRANTING OF A i�ERN1T DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> _,., S�E 6�c-S',uGN�D OTHER STATE OFl 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 TA%ID.NUMBEF CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> � � ��7 <br /> CONSTRUCTIONLOANLENDER-A OA,ESS,�NONENUMBER <br /> PROJECTAD�RESS `� s;m+nrwe ���� 5/��/9� <br /> E <br /> N•E• GO�.'.�E�, O EVE�ZEEN WA !�2*S cir.eusiHessuce�se�,o -- �'� �r <br /> PLUMBIN� MECHANICAL <br /> NO. TYpE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> _ WATER CLOSET(TOILET) A/C-AIHNDLG UNITS-H.P. <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. —�- <br /> LAVATORY(WASH BASIN) UNIT HEATERS-B.T.U. M ; <br /> SHOWER CLOTIiFS DRYEHS �-- <br /> KITCHEN SINK&DISP VENTILATION FAN � <br /> DISHWASHER RANGE HOOD T- <br /> LAUNDFY TRAY ' WATER HEATER �� <br /> CLOI'HES WASHER � WOOD STOVE <br /> URINAL ; �AETAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN ; FIREPIACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE-�AR,ETC.) � <br /> — __� <br /> � <br /> � � <br /> _ SUB TOTAL $ ; SUB TOTAL $ <br /> PERMIT $ PERMIT S I <br /> TOTALFEE S ! TOTALFEE S <br /> FOR OFFICE USE ONLY: d�j'p/, „?o <br /> FPONT SETBACN qEAR SEtUACK Si�E SET�FCK PLAN CHECN NU ABeR FE[ RECEIPT N0. <br /> G �� � �, -� � D8 <br /> u zoNe �oraaen vncnNrsire FE S VALUATION FEE <br /> - � " ves ❑ No eui�oiNcCK� !�<� =1., � 6 5(�8 ,�� ' 7iT <br /> TYPEOfCONSi / NO.OFSTORIES oC[w+cCr rqG��r+nuucu'eis <br /> �y ��po�n PLUMBING <br /> "2 <br /> SIZEOF�LDG. FIRE;PFiIp1K�ER9RE0'D B�SEMEIJi i <br /> 2� ��� �/r� V MECHANICAL i <br /> 1 F ''^: YES i� NO <br /> OGGUPFNCYLOAD FIREALARlAREOD IIEIG9TLIMITATION ADDITIONALPLANCHECK i <br /> �� g 5 — <br /> OTHER <br /> REASON (� _ � <br /> U p�' � GIZ� � g °L - �� �- STATE BUILDING SURCHARGE �� i��1 <br /> INTAKE�V P�q qPPROVED BV CITY OF EVERETT PUBLIC WORKS � <br /> Irh LOCAL SALES ' - <br /> onr� �_ j� ,S�3 TAX CODE IS 3105 rorn� g���,�� ; `�,� <br />