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APPLICATIO_i FOR CONSTRUCT. .lId PERMIT ��� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> y n BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC � �" ��.__— <br /> �+ � <br /> � [� 259-8810 <br /> �� H '� DEMOLITION COMBINATION ' BUILDING �CMECHANICAL I PLUMBING SIGN <br /> � H] � O�YNER ) 1 MAIIAD/DRESS 1 C,IT�Y.� ZInP PNONE <br /> H �3 S��F'✓E /-M m^ �c�f/S� S�R i�95�L1.J�uF— c Ii�SC.L�7� 7��� 2 S Z—��� <br /> H z H TENANT AIPILADORE55 CITY 21P PMONE <br /> fC O <br /> H :V <br /> �H� pflCHITECTGR�E5IGNER MRILApORE55 ��TM ZiP PHONE <br /> C/� H <br /> H GITY 21P PMONE STATELICENSEY <br /> �O GENERALGONTRACTOR MAILAODRE55 <br /> HC <br /> O� � MECNANICALCONTRACTOR MALLRODRE55 CITY ZIP PHONE STRTEIICENSE• <br /> ��fg •cvr-��,� <br /> PLUMBINGCONTRACTOR MAIIFODRESS CITY 21P PMONE SiATEIILENSG� <br /> zy� <br /> � H y CLASSOFWOFK <br /> y NEW '� �� ADDITION �, � ALTERATION �. REPAIR . �. DEMOLITION �. � WOODSTOV6FRPL INSERT � BUILDING REIOCAT10N <br /> �..� � ,` �p,y'- CONTACTPERSeO�NAN�PHO -N0. ' 1 I' 7 /�S <br /> � Cy CONiRAGTPRICEOFWOPKI vU �V L~ n"n�_WQ�.]��IK.4� <br /> ��� � �ESLRIBE WOFK AND SOl1APE FOOTAGE INVOLVED <br /> H O cyi� �1 �� <br /> i'FOPOSEDUSEOFOUIIDI '��� � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> IEGALDESCRIPTIO:lOFPROPERiYISh10WNBELOWORATTACHFOURCOPIES) PFOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WOFK WILL B[COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioT e�ocK oF NOT. THE GRANTING OF A PERh11T DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL L�W REGULATING CONSTRLICTION OR THE <br /> PERFORMANCE OF CONSTflUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CORIPLY WITH l'HE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> X L �• z�9� <br /> .,.a:>iv�t— oe.e <br /> � PRQIECTADDRESS �y�' <br /> O � ��D�� �V/L. �G�• rnr oiaoirss��ci�.se na <br /> '�' PLUMBING MECHANICAL <br /> ' ' N0. TYPE OF FI%TURE OR ITEh1 FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET� A C—ANNDLG UNITS—HP. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> ' ' LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHESDRVERS <br /> '�I KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER � RANGE HOOD ' <br /> ' LAUNDRY TRAY WATER HEATER � <br /> ' CLOTHES WASHER WOOD STOVE ' <br /> URINAL METAL FIREPLACE 8 CHIMNEY ' <br /> ' DRINKING FOUNTAIN i FIREPLACE INSERT ; <br /> FLOOR ORAIN HEAT PUMP <br /> ' BACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> �' SINK(SERVICE—BAR,ETC.) � <br /> ' <br /> I�I SUB TOTAL 5 SUB TOTAL S <br /> PERh11T 5 1 PERMIT 5 I <br /> 1�' TOTAL FEE 5 ' TOTAL FEE 5 V <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK RERHSETpAGK SIDESETBACK PLANCMECKNUMBEfi FEE RECEIPTNO. <br /> .� a 9� <br /> USEZONE LOTAREA VACANTSITE EES VALUATION � FE� <br /> BUILOING <br /> iVPEOiLONiS.AlL01VA01E 7YPEOFCONSi.AL7UAL octuvaYv NoaC/+Run4Unns �, <br /> �qp10 ' PLUMBING <br /> NO.OFSTOPIES BASEMENT r� � <br /> SREOFBLDG. MECHANICAL �5O � �— <br /> � <br /> ADOITIONAL PLAN CHECK � <br /> OCCUPANCYLOAD FIRESPRNKlER5RE0'D NEIGHTIIMITRT10N � <br /> � <br /> SPRINKLER � <br /> --T <br /> R6150N FOR SPRINKLERS <br /> STATE BUILDING SURCHFRGE <br /> iNiAnE BY PLANSAPPfiOVEDBY CITY OF EVERE7T PUBLIC WORK$ <br /> LOCALSALES <br /> TAX CODEIS 3105 TOTAL <br />