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APPLICATI�] FOR CONSTRUGT�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: J GAS '�J ELEC7RIC J —I <br /> 259-8810 <br /> I ! DEMOLITION '_' COMBINATION i � BUILDING I MECHANICAL I I PLUMBING Cl SIGN <br /> CW ER � fdAlLqpDRESS � PHOIJE <br /> /� � �C� y�,,�,�Q�� ;�;,�.. ��. ��. � ��P � 3 353--� ���" <br /> TENANi IdAILApDRES li ZIP PN09E <br /> ARCHITECTORpE51GNER AIAILA�DFE55 CRY ZIP PHCNE <br /> GENERALGONTRACTOR RIqILA0�4iE55 CITY ZIP PrypNE STAiELICENSEM <br /> MECNANICFL CONTqACTOR 61AIL ApDRE55 CIiY ZIV PHpNE STATE LICENSE P <br /> PLUMBINGCONTRFCTOR MAII.A�DRESS CITY 21P PhONE SiATELICENSE> <br /> CONTRACT PRICE OF YJOFN <br /> �ESCRIBE WOFK ANO$OUARE FOO7aGE INVO W CO CONTACT PERSON AND PHONE NO. <br /> / �'°��'�j� i HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS <br /> aAoaoseo use oF euaoiNc APPLICATION AND KNO�V THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS�\ND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCRIPTIONOFPPGPERiY�SNOWNBELOWORATfACHTWOCCPIES7 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT e�a.K oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTFiUCTION.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> vnacei.rnxi.o.ruun�eea APFLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONS�RUCTION L!�AN LENDER.60�FE55,TREPHONE NUMBER <br /> � y/�. ,.�,' <br /> PRO�1 CTA �RE � + sicrvaroa �,r�/ <br /> ',�/ oere <br /> PLUMBIN--j� G�/ atvtuseessucr+y_uo - <br /> . " p MECHANICAL <br /> _N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—NHNDLG 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 /> SHOWEH CLOTHESDRYEFS <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRA'f ' WATER HEATER � <br /> CLOTHES WAuHER � WOODSTOVE ; , <br /> URINAL ; METAL FIREPLACE(WOO�BURNING) —� <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLUOR DP.AIN HEAT PUMP <br /> BACKFLOW PREVENTERS ' GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS —T— EXHAUST FAN <br /> SINK(SERVICE—EtAR,ETC.) <br /> _ <br /> � <br /> � — <br /> _ SUB TOTAL $ ' _ SUB TOTAL $ <br /> PERMIT $ PERMIT $ ; <br /> TOTAL FEE S TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> . FRONT SETBFCN REAR SETB�CK SIDE SETBFCH PLAN CHECK INMBER FEE fiECEIPT N0. <br /> �iyra <br /> usEzone LOTFREA VACANTSiTE FEES VALUATI6N FEE <br /> C YES . � NO CUILDING <br /> i <br /> iVFEOFCONSi NO.OFSTORIES octuvRvcv Voerownur:;���;u5 — <br /> caouv PLUMBING � <br /> SIZE OF pLDG. FIRE SP.9INK�ERS REO'D BASEMENT MECHANICAL � <br /> � YES G NO � <br /> �OLCUPANCY L04D FIRC��qqM f1EOD NEIGNT UMITATION ADDITIONAL PLAN CHECK i . <br /> --- O7HEF1 i <br /> NEASON <br /> STATE BUILDING SURCHARGE � <br /> tNTAHE I1V PLANS APPROVED 9V CITY OF EVERETT PUBLIG WORKS � <br /> LOCAL SALES ' — <br /> onre TAX CODE IS 31D5 TOTA� ; <br /> � <br />