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�_. <br /> ���..._.. ^ lY�:. <br /> r pppLICATIt,�I FOR CONSTF�UC7 �ON PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � <br /> r HEATING SYSTEM• LI GAS �]ELECTRIC ❑ ---� I <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION I�BUILDING MECHANICAL PLUMBING SIGN <br /> NNLA��RE55 *-/ ��TY Z�P PtlONE <br /> o,,,�:�1R � ,. _ , . � �. 3y �- 2 i 6 0 <br /> H� I b �P ✓�C �O L {-��i: i�4:� .1 .: ��� CITV i.l:'1 21P � i. PHONE <br /> j..: <br /> � .Etl4NY MRILA�DRE55 v <br /> � h Y � iFLy.� �'sL- ��(� .�il' �^ � ��� 1� D i � �� <br /> b � ;�� ,,,: r,:.� ��.r. f ��• 1':� ►., � �, <br /> y titplltECTORDE5IGNER M1IAlLA0DRE55 <br /> CITY ZIP PIIONE <br /> � � ��n, Z�p PHONE STATE LICENSE• <br /> y � FCnE ALGONiR TOR MAILA�DFESS <br /> M M �U � � �1 ��C/�.�.�- <br /> y CIiY ZiP PIIONE STATEUCENSEY <br /> N M[� �dECHI.NICAIGONTRRCTOH MAILADDRESS <br /> � Q [{� CITV ZIP PMONE STATE LILEN�[I <br /> F7 C7 PLUMBINGGONTRACTOR M�ILA�OPESS <br /> O M - <br /> N tnC <br /> G1 • GLASSOFWORK . <br /> ~ y � �. NEW '. ' ADDITION . f"SRATION �'REPAIR ��. DEMOLITION WOODSTOVE�FRPLINSEFT BUILDINGRELO <br /> � �/ �� CONTACT PERSON AND PHONE NO. <br /> H }C�. <br /> y WNTRACT PF�JE Of 1VORK <br /> M <br /> l7 N DESGRIffEWOPKANDSOUAREF00�A�EINVOWED <br /> � � � � ., i/: � <br /> H PFOPOSEDUSEOFBUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � y APPLICATION AND KNON!THE SAME TO BE TRUE AND CORFiECT.�LL <br /> �"�'J/`��; — PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �e�nioescnianallo RiY�SNOWNBEIOWORATTAGIFOURCOPIE�� WORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> h� �� 1 � oF I ��S '� 1� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT I t OLOCK _�_ <br /> 1 � �-� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> � I � � �t� �� �� L � r^I PERFORAIANCEOOF OONSTRUCTION.LTH TG AM AU HORIZOED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COA4PLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> �,l ',�� �� � ,� � � � <br /> - <br /> Xc.niwa- nait� <br /> PR0.1ECTd00RE55 , � <br /> � �.. ...:\ � +��� / ��L � ��� . �1 � , .1� _ U1v905M(59l�CFNSENp <br /> L <br /> C�' PLUMBING MECHANICAL <br /> FEE NO. TYPE OF E�UIPMENT FEE <br /> NO. TVPE OF FIXTURE OR ITEN q�C—A�HNDLG UNITS—H.P. <br /> � � �,� WATER CLOSET(TOILET) ; <br /> BATHTUB FGRCED AIR SYSTEMS—B.T.U. M E.A. <br /> '�� _ LAVATORY IWASH BASiMI _ UNIT HEATERS—B.T.U. M <br /> CLOTHES ORYERS <br /> i <br /> � ��' SHOWER <br /> � ' KITCHEN SINK 8 DISP VENTILATION FAN <br /> � DISHWASHER RANGE HO00 <br /> WATER HEATER <br /> LAUNDRYTRAV ' <br /> I �� CLOTHES WASHER � WOOD STOVE <br /> METAL FIREPLACE&CHIMNEY <br /> URINAL — i <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> HEAT PUMP <br /> r�! FLOOR DRAIN ' <br /> 1 � B�CKFLOW PREVENTERS ; GAS PIPING ' <br /> ROOF DRAINS—RAINLEADERS EXHAUST fAN ' <br /> i <br /> SINK(SERVICE—BAR.ETC.) <br /> +, ' ' i <br /> '_��' ' i <br /> � <br /> � SUBTOTAL 5 pERMOTAL � <br /> '�' TOTALIFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: ReceiPTNo. <br /> PLANGHECKNUMEI R FG[ <br /> FRONiS[iOAGK REARSETUNCK SIDESETBACK ��`��� <br /> USE ZONE LOT RREA VACANT SITE <br /> FEES VALUATION FEE <br /> BUILDING <br /> I�PEOFCONISALL01YAftE iYPEOiLaN4.AG711A1 a�p���� �oa�t������'•��5 pLUMBING � <br /> �— <br /> SIZEOFOIOG. NO.OFSTORIES DASEMENT MECHANICAL <br /> i <br /> ' A�DITIONAL PLAN CHECK � <br /> OCCUPRNCYLOAD FlRESPPNNLEHSREOD NEIGNTLIM1IIT�iION � <br /> i <br /> SPRINNLER �_ <br /> REASON FOR SPRINNLERS <br /> STATE BUILDING SURCHARGE <br /> INTANEOY PLANSAPr10VE��Y CITY OF EVERETT PU�LIC WORK$ <br /> LOCALSALES S �� <br /> TAX CODE IS 3105 TOT^� <br />