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i <br /> AQta�ICATIC� F'OR COIVSTRUCT'�-)N PERMIT ���� I <br /> TO BE COMPLETEO IN BLACK INK=PLEASE PRINT <br /> � <br /> �HEATING SYSTEM: � GAS ,J ELECTRIC U. __ � I <br /> BUI�DING DEPARTMENT — I <br /> 259-8810 <br /> DEMOUTION COMBINATION BUILDING ECKANICAL PLUMBING SIGN I <br /> � n_ OIYNE MAIL RD�RE55 CIl 'iP PIIONE <br /> E���� g 1/¢iV�—�fG2—`�- �`%t�r��r /�• �=L�z�r n��G3 257_-�S/ I <br /> T ANT �AM�RIL R DRE9 55 �CITY ?IP � PMONE , <br /> 5!'/r�t� <br /> ARCHIiECTGR0E51GNER AINRADDf1E55 CIiY ZiP PMONE <br /> • <br /> GENENALLONiR4CTOR MAILADOFE55 CRY ZiP PMOYE STAiELIGENSEi <br /> C'J�� _ -- I . <br /> M[C ICALCONTRAC 0 AIAIL�fLN 55 PHJNE St�ELICENSE�� ^ M <br /> �y �m� � i�.s�z �./��T����T�P��Z>�-�,�, �� �'� <br /> � "�' h, I�Y 2iP / �NONE STAtE lIC[NS[• <br /> aH PlUA1BINGf.ONTRA iOR 1 ilAODRESS <br /> yv� <br /> y �� L.455JFWORF <br /> T <br /> K y� NEW . ADDITION ALTERATION REPAIR �EMOLITION WOODSTf,VE�FRPL INSERT B I�DING RELOCATION <br /> .C) CONiACT PERSON AND PMOYE NO <br /> � y Q� �.C/ — . , � <br /> CONtRRCTPRICCOFIYCR�N �� � � <br /> � x� DESCFIBE 1YORR R SOb> 'FOO� GE��/�� veo��_� r f/ _ �Q�,���j <br /> Q ����r� L��°�'-�.L'J1F�if'd��Bf� �f�'U � <br /> � Hd ano�oweo�oui� itic� i HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � APPLIGATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> l[GRlDESCNiPT10NOFPROPERTY�SMJIYNBEL0IVORATTACMFOURCOPIES! PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPcOF <br /> 4'~y�(] WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or eiocK oF NOT. THE GRANTING OF A PERldIT DOES NOT PRESUME TO GIVE <br /> � y� 1/ ,�[�� p /'}�� /���� AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS QF ANY <br /> H H �/c—�l�/.1 Gl�`�L v/ -�l/C_)_ �THER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFOfiMANCE OF CONSTRUCTION.THAT I AM AUTHORIZ[D 6V THE <br /> y H OWNER OF THIS PROPERTV TO PERFORM THE WOFK FOR WHICH <br /> n dy APPLICATION IS MADE AND I COtAPLY WITN THE STATE <br /> � �� CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> H O Cn � <br /> X q � s.�'Y <br /> .,�c:e�r�i� � ' �. /� o�i[ <br /> P JJECTRD[1 5 !, ` /�_ �� � <br /> �� � �. � Uivl.u:'.FSSI`WSENI <br /> % <br /> PLUMBING / t�ECHANICAL <br /> (� NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> { v v WATEF CIOSET(TOILET)' ��C-A�HNDLG UNITS-H.P. �[� <br /> BATHTUB ) FOFCED Alfi SYSTEMS- . .0 ��1 E.A. <br /> I�!` ¢ UNITHEATEflS-B.T.U. M �I <br /> LAVATORY(\YASH BA..IN) � <br /> � SHOWE9 _ CLOTHESDRVERS _ _ I <br /> �•r HITCHFN SINK 8 DISP _ VENTILATION FPN __�_ I <br /> I '' OISHV ASHER _ _ RANGE HOOD __ <br /> WATER HEATEF � <br /> LAUNDRfTRAY • <br /> CLOTHES WASHER WOOD STOVE I� <br /> ' +� URINAL METAL FIREPLACE 8 CHIMNEV � <br /> I �i DRINKING FOUNTAIN FIREPLACE INSERT _ , <br /> , FLOOR ORAIN HEAT PUMP ��, , <br /> � �r ' BACKFLOW PREVENTERS GAS PIPING 7 , <br /> ��.i ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINK(SERV�0.-BAR,ETC.) _ <br /> r� - <br /> � SUB TOTAL S ; SUB TOTAL 5 O � <br /> � ' I PERMIT S � PERMIT S /S� _ <br /> � TOTAL FEE S TOTAL FEE 5 1� : <br /> , FOR OFFICE USE ONLY: <br /> FflONTSETBACK REARSETBA:K SIOESETI3ACK �'IANCr�[CK'µ�!.�BER�/' �EE fiECLPiNO <br /> �) /C/U' <br /> USE20NE lOTAREA VFCRNLSITE FEES VALUATION fEE <br /> DUIL�ING <br /> 1�PE01GON15RLOWABtE 1YGEOFCONSinG10Q aevo�h:r rqa2ntuaeveis — <br /> �°aj° � PLUMBING <br /> SIZE OF BIDG� NO OF STORIES BASEMENT MECHANICAL S�� <br /> OGCUP/NGYIOAD FIRESPRNNLERSREOD NEIGNTLIMITATION <br /> FDD1110NAL PLAN CHECK <br /> SPRINHLER <br /> ---i—' <br /> REASON FOR SPRINMlERS <br /> STAT[BUILDING SUfiCHARG@ <br /> winKi or � rin��s�Prnoven nr CITY OF EVFRETT i�uat.iC woaHs <br /> LOCAL SALES <br /> TAl(CODE IS 3105 TOTAL <br /> �-- <br />