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APPLICAT10,�1 �OR �ONSTRUCT"*)N PERMIT �� <br /> TO BE C�.rAPLETED IN BLACK INK—PLEASE PAINT � <br /> BUILDING DFPARTMENT � HEATING SYSTEM: �GAS ❑ELECTRIC ❑ I <br /> 259-8810 ,/1/� �� ��-�'�1 l� _J <br /> , DEMOLITION � ', COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> ����IC {�e�J-I ��.e� ennnFcc G ,.,,r i��• P„ ---- <br /> , �2 /'� /�,/ / ar�e ' I ) ) <br /> TENANT IJ � MRILAO�RIE55�� � U L.LJ�/F'�'1l� 1'(-�/. J �el,l7�r � ��o'C�,� ✓ ! /' ( C�/1 I <br /> 11��('� � CITY ZIP FnJNE <br /> � V Y� <br /> Ai12HITEC� DESIGNER MAILADDR"SS pTY IIP PMONE <br /> � <br /> �GE�ERAI COYTRACTOR l,1AIL A�DRE55 �iTv ZiP FHONE STATE LICENS�v <br /> _NC'�r��<< �Sa l.la��� I�;�,C;� �IICi -�i�� �a ��c �rr� .��i9-J 33� }�^IZT�����/U� ��'�2 <br /> MECMANICALCONTRACTCR MAIIAD�RE55 C�TY ZIP PHONE STATELICENSE/ <br /> 1 <br /> PLUMpINGCONTRACTOR AIAILA�DRESS CITV 21P PHONE STATEUCENSEr <br /> / <br /> TRACT PFICE OF WOR <br /> 3��,0`� _ _ <br /> DCSGA�pE WORN ANDSOVAPE F�T GE WVOLVED C9H1nC1 P[R5011 nND�'110N[NO <br /> ��S�rr�(l�n�' C?d5 ���lz�c't l�-�7�trl�a , _ <br /> ,___ �—�-�. .. _ - <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> P� OFBl11lDING � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG�L�E>CRIPTIONOFPqOP[RIv151!OWNDE�OWOR4iT�CNTWOWPIE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEAEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> lOT—�� BIOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �� PERFOfiM11ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br /> -=- - APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAr�EL.TA1 IO NUAIBER <br /> / � �, 3-�/���.%n �nL�l CONTRACTORS LA\N 18.27 RCW AND 296.200 WAC. <br /> J �7Y I <br /> CONSTRUCTIONLOANLEN�ER.A�DFZSS.iELEPHONE YUMBER / �� <br /> i 7 <br /> PROJECT ADDRESS � . w* ie -oere /"-�- <br /> �� ' � r�n "t�' ° ��%3 <br /> cav ous��.ess uccrae r+o <br /> PLUMBING � MECHANICAL <br /> NG. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET�TOILET) A'C—A�HNDLG UNITS—H.P. <br /> 6ATHTUB ' � FORCED AIR SYSTEMS—B.T.U. h1 E.A. <br /> LAVATORY�WASHBASIN) ' UNITHEATE:iS—B.T.U. M <br /> SHOWER CLOTHES DRYERS —� <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> IAUNDFYTqAY � WATEF HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL A4ETAL FIREPLACE(WOOD BURNING) <br /> �RINKING FOUNTAIN FIAEPLACE INSEFT <br /> I'LOOR DRAIN HEAT PUfdP � <br /> 6ACKFLOVJ PREVENTERS GAS PIPING <br /> FlOOF DRAINS—RAINLEADERS E%HAUST FAN <br /> `INK(SEFVICE—BAR,ETC.) <br /> � <br /> � <br /> —T <br /> SUB TOTAL 5 ; SUB TOTAL S �� <br /> PERMIT 5 PERMIT 5 �S � � <br /> TOTALFEE S TOTALFEE 5 - <br /> FOR OFFICE USE ONLY: <br /> FRONTSETEI4CN REARSETOACN SIDESETOACN P�ANCHEC'K/NUMBER F@c RECEIPiNO <br /> 4��� <br /> U"aEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> ❑ YES ❑ NO BUILDING <br /> fYFEO�CON:I NO.OFSTORIES o[Nawtr r.po��nnu,utrts <br /> �aOJP PLUh181NG <br /> S�Z�Of�LCO flRESPRINKLERSREOD DASEM1IENi MECHANIC�i. <br /> 1 YES NO <br /> OCCUPANC�LOAD FIREALAR61PE0� HEIGNTl1611TAT10N ADDITIONALPLANCHECK � <br /> _ OTHER � <br /> REASON <br /> i <br /> STATE BUILDING SURCHARGE <br /> ���T�KE Bv P�ANSAPPROVEDOY CITY OF EVERETT PUBUC WORN$ <br /> LOCALSALES �— <br /> un,r TAX CODE IS 3105 rorn� � <br />