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>:;q <br /> y <br /> APPLICATIOC'"FOR CANSTRUCTI��N PER��:I4 ��" .f <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC iJ _ _ — <br /> BUILDING DEPARTMENT <br /> 259-8610 <br /> DEMOLITION COMBINATION 'J� BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER 1ANlADDPE55 CiTY ZIP PH04G l <br /> ��r� �C�� Crc ` � u�la- forc�� l�� E�/t���fi G�G �r6�0� a-Sa-�6�5 � <br /> TENANi M ADOFE55 QiY ZIP PHONE <br /> I� M <br /> W ro <br /> p M FRCHITELi OR pE51GNER MAIL���RESS QTV ZIP PHON[ <br /> � N ow� e� <br /> GENERALCONTRALtOR MAILADDRE55 CITV ZiP PHONE STFiEIICENSEs <br /> � ���jji 04JV1�� — <br /> O �.j y MECHANICALCONTRACTOq 61ARADORE55 GITY ZIP PHONE SiFtELiCEtlSER <br /> �U F1� � _ <br /> L] M PWM6INGCONTRACTOP IAALLAUDRESS GITV ZIP PHONE StATELICENS[n <br /> � �y ��y CLASSOFWORN <br /> � � � . ��. NEW I �: ADDITION ALTERATION REPAIR DEMOLITION �� WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> Hr CONTACT PERSON AN �HONE NO �-� <br /> / N CONTRALTPRICEOFN'pPH � Oy� �G� // ��n ' r�-�� /"" �� - <br /> �ppp �y DESCPIBEWORKANOSOUAREFOOTAGEINVOLVED <br /> � vN �AJ`�i e 2 � � <br /> C PROPOSEDUSEOF.�UII�ING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> al �^ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � r�n' S`�o.^asr �GGf ,�e o <br /> LEGAL�ESCRIPT!ONOFPROP[RT1'(SHOWN�ELOWORATTACHFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WOPK WILL BE COMPLETED WITH WHETHEP. SPECIFIED HEREIN OR <br /> �or oiocK oF _ NOT. THE GRANTING OF A PFRMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE FROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTf+UCTiON.THAT I AM AUTHORIZED BV THE <br /> OWNER Or THIS PROPERTY TO PERFORM 'fHE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> X " /��-�-� 3-i c-9a <br /> PROJECT ADDRESS / s�cnn*une �»E <br /> ��1 Forc �" Qn 6vefe'1-'I- (l�G. "Ip��� CRVBlI51NES5liCEN5E110 <br /> -.,,_ PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> `C,; �� WATER CLOSET(TOILET) NC—NHNDLG UNITS—H.P. <br /> �,. BATHTUB - FORCED AIR SYSTEMo—B.T.U. M E.A. <br /> t � LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWEF CLOTHES DRYERS <br /> '__' �, KITCHEN SIMK 8 DISP % / VENTILATION FAN <br /> i : DISHWASHER % RANGE HO00 <br /> � LAUNDRY TRAY � WATER HEATER � <br /> � CLOTHES WASHER WOOD STOVE .� � <br /> I I '' _ URINAL / `dFTAL FIREPLACE 8 CHIMNEY � <br /> � DRINKINii FOUP:TAI FIREPLACE INSERT / <br /> . FLOOF DRAIN HEAT PUMP <br /> ' � BACKfLOW P �VENTEFS GAS PIPING / <br /> � ROOF DR S—RAINLEADERS EXHAUST F/1N <br /> �II _1� � SINK( RVICE—BAR,ETC.) <br /> � <br /> � <br /> I �=' ' _ <br /> i . SUB TOTAL $ SUB TOTAL $ <br /> . PERMIT $ PERMIT S <br /> '�'_� � TOTAL FEE $ TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> � FRONTSETB�CN REARSETBACK SI�ESET�AGK PL/NCNECKNUTApEB FEE REC IPTNO <br /> �, � '� �lyG�i� �� S • /C� � JaLD� <br /> USEZONE LOTAREA � VACA4TSIiE FEES VALUATION FEE <br /> —� kt7'ti �i�l��:'� N� euaoiNc g ,o ,� �o � <br /> TVPEOFCONiS.AlLO hBLE iYPEOICONSI.hLiUA� acurnr¢v NOaUw[uinau+aR <br /> v ,� ^� 'A°"° � PLUMPING <br /> SREOFBLOG. NO.OFStOflIES tlASEMENT MECHANICAL � <br /> $� �4.�� � — ' <br /> OCCUPANGYLOAD FIRESPFNKIERSR[O'0 HEiGNTtIMITATION ADOITIONALPLANCHECK <br /> � . � 1 � <br /> SPRINKLER ' <br /> RdA5G.1 iOR SPRINKlEPS ' <br /> STATE BUILDING SURCHARGE i�O <br /> INTANE BV PLA RPPROVED BY CITY OF EVENETT pUBLIC WORKS � <br /> �]_ LOCAL SALES T— <br /> '/h TAX CODE IS 3105 TOTAL �'$ ; SG <br />