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APPLICATIO� FOR !�ONSTRUCTIAN PEF�MIT � <br /> TO BE COMPLETED IN ! LACK INK-PLEASE PRINI <br /> BUILDING DEPARTMENi� HEATING F rSTEM: ' GAS U ELC�TRIC J --� <br /> 259-8810 <br /> O DEMOLITION ❑ COMBINATION I .I BUILDING �ECHANICAL ❑ PLUMBING ] SIGN <br /> OW R MAI ADDRE55 <br /> CITY '21P aHONE <br /> �n GIG�� 3�5�.�i �� ��( ��c. �����.�� o� ��a -�� 4� c� <br /> TENFNT MAIL pDOPESS �ITY ZiP <br /> � 1 � PNONE <br /> I <br /> AflCM EC ORDESIGNER MAILADDRE55 CITV ZIP PHONE <br /> � <br /> GENERALCOJlTRnCTOR MRILA�DRESS CITY ZIP PHONE STATEIICENSEI <br /> �I�; 1.� <br /> MECH�jICA�i�pR MAII ROORESS LIiV ZIP <br /> PHONF. STATE LICENSE Y <br /> \ � <br /> PjUM814GCONTP�CTOR MRILADDRE55 Giv 21P PNONE SiAtEUCENSE• <br /> � � 4�� <br /> C AGTP F YORK <br /> ���.� <br /> DESCRIBE WORN AND SOURRE FOOTAGE INVOLVEO CONTACT PERSON ANU PHONE NO <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS �I� <br /> PROPOSE �,B Nc APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORqECT.ALL , <br /> � �— PiiOVISIONS OF LAWS AND ORDINANCES GOVE9NING THIS TYPE OF <br /> �EGALDESCRIPTIONOFPROPERTV�SHOWNBELOWORTTTqCNTWOCOPIE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT THE GRANTING Of A PERMIT DOES NOT PRESUMF TO GIVE <br /> ior BLOCN oF AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF qNY <br /> OTHER STATE OR LOCAL LAW REGULATING CJN>TRUCTION OR THE <br /> -- PERFORMANCE OF CONSTRUCTION.THAT I AM dUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTV TO PERFOFA7 THF. WORK FOR WHI;'.!�. <br /> APPLICATION IS MADE AND I COMPLY tVITH THE STA'iE <br /> PARpELT�I%I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> CONSTRUCTKKJLOANIENDEfl.ADORE55,TELEPNpNE NUMBER �. �/n/ <br /> PROJ � SS � Xti.������ ,�3��I���,E� <br /> ` �'Y - . c� I�V�. — - <br /> ..A��s,.,.;���E,;�.. <br /> PLUMBINO MECHANICAL <br /> N0. TVPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—AMNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SVSTEMS—B'.U. M E.A. <br /> LAVATORY IWASN BASIN) UNIT IIEATERS—B.TU. M ; <br /> SHOWER CLOTHE�DRYEflS <br /> KITCHEN SINK 8 DISP \'E�+TILATION FAN <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPIACE(WOOD BURNINGI � <br /> DRINKING FOUNTAIN FIREPLACE INSEFT <br /> FLOOR DRAIN • HEAT PUMP <br /> BACKFLOW PFEVENTERS GAS PIPING <br /> ROUF DRAINS—RAINLcADERS � EXHAUST FAN <br /> SINK(SERVICE—BAFi,ETC.) ���� �� — <br /> SUB TOTAL S SUB TOTAL 5 <br /> PERMIT 5 PEFMIT S <br /> TOTAL FEE 5 TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FqONTSETOA�K REARSETBFCK SIOESETOACK PUNCNECNNUAIBER FEE AECEIPTNO <br /> L/� ���� <br />, use zone tOT�REa VACANT pltE FEES VALUATION FEE <br /> �� YE6 . NO Bwi.OiNG ; <br /> MEOfCOHSi. NO.OFSiORiES ttC:aax;r AOO�UxtluhG�'.�t5 <br /> i <br /> �aW� 1 PlJh181NG � <br /> S�ZEOF&DG. FIRESPRINKLERSREO'D BASEMENT �ECHANICAL r; �'� <br />' (- YES - NO <br /> OCCIIPANCY LO�� FIRE�LPRM REOD HE�GNi ubuTnnOH ADOITIONAL PLAN CHECK � <br /> OTHEF , i <br /> PEASOh <br /> StATE BUIL�ING SURCHARGE � <br /> INTRNEBV PLANSRPPROVEOBV CITYOFEVERETT PUBLICIYORKS <br /> LOCAL SALES <br /> DATE TAX CODE IS 3105 TOTAi � ' <br />