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APPLICATIC 1 FOR CONSTRUCT )N PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUI�DING DF.PAR'fMENT �HEATING SYSTEM: ❑GAS J ELECTRIC �I <br /> 259-8810 <br /> DEMOLITION COh1BINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OY:NFR MAILADDFE55 Gi 21P �' . PHONE <br /> ��4J.L)lJl �l:l,lLl� � L4�:�1 �� �'l.( ��iLL..�J� �t.�CIZE.7� d��� �?)'-�`7- LC�Ic�, <br /> iENART 6;�I�pDOFE55 GTV ( ZIP PHONE <br /> ARCMITECTOR�ESIGNER A1qILA00RL5S CRY ZIP PHONE <br /> NATURAL GGS E',';!?MENT C�.. INC. <br /> GB:[RALCONTRACTOR MAILAOIIf�$u� F, Marine Vie��� ��. CITY 21P PHONE STATEUCENSEP <br /> Everett. Washinaton 9t3201 <br /> 1.tC.C!IANICALGONTRACTOq AINLAUDRE55 2�,2�� GITY 21P PHONE STATEUCENSEn <br /> d/r}T(,�I��1 I C P 1— <br /> PLU�.101NGCONTRACTOR IA�ILAODFE55 CITY 21P PHONE SiATELICENSEe <br /> t o/�t3 <br /> CLASS OF WORK <br /> NEW ADDITION ✓ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPLINSERT . : BUILDINGRELOCATION <br /> C r ��`� CONT�CTPERSON AND PMONE NO. ( }/ <br /> CONTRACT PRIGE OF WORK �C�_% '--� ��)C��� Y j`. LV—� `L,�-� <br /> D[SCRIBE WORK AND SOUAPE FOOTAGE INVOWEO , <br /> ��C1.� �J� 1.�C� -t-� <J ���CCt--C���� �,�`��`h - �.1 �-/��� <br /> vr�ovos USEOFBUI� Nc . ,\ i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � �- -{T1 ���Lv , APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> i.�c�.�oescaianaN oF aaoreATv i WN BEIOW OR ATfAGH FOURCOPIES) PROVISIONS OF LF.'NS AND ORDINANCES GOVERNWG THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH \NHETHER SPECIFIED HEREIN OR <br /> �or BLOCN OF NOT. THE GRANTING OF A PERMIT UOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTIOtJ.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACT/ORS LAW 78.27 RGW AND 296.200 WAC. <br /> X I �l' `/`��..�.�.'_ c`r�— I�,, (.l -� <br /> P��OJECTADDFESS � sic�nmrr oeT[ <br /> � .�� � J �L. �'����1._� � �.��-'L��� cnvnos-nrss��cinsn.o <br /> PLUMBING � MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � AiC—AMNDLG UNITS—H.P. ,� � <br /> BATHTUP FORCEDAIFSYSTEMS—B.T.U.'(rJM E.A. �_ <br /> LAVATORV(WASH AASIN) UNIT HEATERS–�l.T.U. M � <br /> --r— <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEh SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASNER � RANGE HOOD <br /> LAUNDRY TRAY ; � WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> VRINAL METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN ' ��L�" `EIRE-PCAGE�IN&ERT I <br /> —� <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOWPREVENTERS ; ,;j GAS�IPING �� tCCLtC.Cc�t�� ' <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � —� <br /> SINK(SEHVICE—BAR,ETC.) ; <br /> —_ � <br /> SUB TOTAL S ; SUB TOTAL S <br /> PERMIT S PERMIT S �� � <br /> TOTAL FEE 5 TOTAL FEE 5 ' ~ <br /> FOR O�FfCE USE ONLY: <br /> FRONTSETBACK REAfiSET�AGK SIDESETOACN PIANCHECKNUAI�ER FEE RECEIPiNO. <br /> �� ;�� <br /> USEZONE LOTAREA VACANTSI7E FEES VALUATION FEE <br /> BUILDING <br /> IVPEOPCUNiSALIOWABLE lYPEOFLONSLACIIIAL Occuraqtv ADaGwtw:cuv"5 — i <br /> °POOv PLUMBING � <br /> SR[OFBLDG. NO.OFSTORIES BASEMENT h1ECNANICAL <br /> i � <br /> G`CCUPANCYLOAD FIRESPRNKLERSPEO'D HEIGHTLIh11TAilON ADDIT{ONALPLANCHECK � <br /> i <br /> SPRINKLER ' <br /> RE�SON FOR SPRINKLERS —� <br /> STATE BUII�ING SURCHARGE <br /> ir:mnEnv r�nNsnnraoveoav CITYOFEVERETT PUBLICWORKS <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL � <br />