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pPPLICATIC -1 FOR GONSTRUCT" �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: L1 GAS ❑ELEJTRIC U � <br /> BUILDING OEPARTMENT <br /> 259-8810 <br /> [7 DEMOUTION Ll COMBINATION : l BUILDING n! MECHANICAL I J PLUMBING ❑ SIGN <br /> OWNER <br /> MAILA�DRE55 CITV ZIP PMONE <br /> iL�n�c �1���ev �1iS Flv.. St �vovcC� ��?1/�i n$ .2''-L.,�' _ - <br /> TENANT MALI.1pRE5� CITV <br /> ZIP PHOHE <br /> ARCNITECTJR�ESIGNEfl MRI�pDDiIE;C <br /> CIT\ ZIP PNONE <br /> GENER�LCCYTRAC70R MAILADDPESS <br /> ��TY Zip PHONE STATE LICENSE M <br /> MECNHNICALGONTRqCiOR MAILAUDRE55 <br /> CITY ZIP PHONE STA�E LICENSE M <br /> �F�L�G Nn�t�.. ^ ' S '7`/r10v. 'G-.. _✓�cirvi NZ OS" 3 P7�OZ% 7 Fsrn�rii�seOS3 f)8 <br /> P�UMBINGCONTFACTUB ILAOORESS <br /> CONTp�CT PRICE OF WORH <br /> �"`C B� p C06iACT PERSON�ND PHONE NO. <br /> �J[�IL' EW!'OVtDL�UAR�00TAGEINVJLVED .�� CIIYl.K Gn�'ttC:� �9'�D���� <br /> /•1 � Ps't •4�a — <br /> / / tif �L(/(C� <br /> I HEREBY CERTIFY THAT I HAV[ READ AND EXAMINED THIS <br /> PflOPO5EDl15EOFBU�LDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDESCRIPTIONOFPROPERTV�SHOWNBELOWORAiTACHT\YOCOPIE51 WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT B��K oF �UTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICAT�ON IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA%ID.NUMBER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTPUCTION LOAN LENDER.AODRESS.TELEPHONE NUlABER ��� /J ,f, ty� / / / ,G—/S <br /> t1l> /C �u 1c��a��1 <br /> pAiE <br /> - S�GN>tUFE <br /> PROJECT ADDRESS crtv nusw�ss uccnse rvo <br /> MECHANICAL <br /> PLUMBING TVPE OF E�UIPMENT FEE <br /> N0. TYPE OF FI%TURE Ofl ITEM FEE N0. <br /> �JATER CLOSET(TOILET) � A/C--NHNDLG UNITS—H.P. <br /> � FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> BATHTUB ' <br /> ' UNIT HEATERS—B.T.U. M � <br /> LAVATORY(WASH BASIN) CLOTHES DRYERS � <br /> � <br /> SHOWER . � VENTILATION FAN � <br /> KITCHEN SINK 8 DISP � RANGE HOOD <br /> DISHWASHER � WATER HEATER � <br /> LAUNDRY TRAY WOOD STOVE <br /> CIOTHES WASHER METAL FIREPLACE(WOOD BURNING) ' <br /> URINPL � FIREPLAI:E INSEFT ' <br /> pRiNKING FOUNTAIN ' <br /> � HEAT PUMP � <br /> FLODR DRAIPJ ' <br /> BACKFLOW PREVENTERS <br /> � GAS PIPING <br /> , EXHAUSTFAN � <br /> ROOF DRAINS—RAINLEADcRS � <br /> SINK(SERVICE—BAR,ETC.) � <br /> �� <br /> � � <br /> � , <br /> SUB TOTAL $ _ SUB TOTAL S �O 1' � <br /> PERMIT 3 ' <br /> — PERMIT 5 � — TOTAL FEE S �' � <br /> TOTALFEE S � <br /> FOR OFFICE USE ONLY: aecemrr+o <br /> PLAN CNECK ❑� A FEE <br /> FNONT SEiOPCN REAR SE7BACK SIDE SETBACK �� . <br /> / - i• <br /> /G,�"'r FEE <br /> VACANTSITE FEES VALUATION <br /> USE ZONE l0T AREA _ � <br /> ❑ YES i-! NU BUILDING � – <br /> TVCEOFCONST. NO.OFSTORIES OCGqoup[r Naor�tiEw':G'�ivnS PLUMBING � <br /> i <br /> i � <br /> SIZE OF BLDG. FIRE SPRINKLERS REO'D BASEMENT MECHANICAL � <br /> ❑ YES i 1 NO � <br /> HEIGHT UMITATION AODITIONAL PIAN CHECK — <br /> OCCUPANCV IOAD FIRE ALARM REO D � <br /> � <br /> OTHER � <br /> i <br /> REASON STATE BUILDING GURCHARGE � — <br /> i <br /> i <br /> INT�KE�Y PLANSAPPPOVEDBY CITYOFEVERETT PUBLICWORKS � <br /> LOCALSALES � <br /> DATE <br /> TAX COOE IS 3105 TOTAL <br />