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. APPLICATI� �1 FOR CONSTRUCT�N PERMIT � <br /> - . TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � <br /> N�� <br /> BUILDING DEPARTMENT HEATING SYSTEM: '�GAS �ELECTRIC ❑ —� <br /> 259-8810 <br /> f J DEMOLITION f 1 COMBINATION � 1 BUILDING i�(MECHANICAL I"1 PLUMBING Cl SIGN <br /> xOWNER MFILADDRESS CITY IP PNONE <br /> D_�/ /�J��so� ti3a cro sr E✓�e�r-_�y�zl� 3 zss- sPl <br /> TENRNT MAILADDRE55 CITV ZIP PMONE <br /> AFCHITECiORDESIGNER MAILADDRESS �ITY ZIP PNONE <br /> GENERRLCONiRACTOR MAILADDFE55 CITV 21P PHONE STATELICENSEI <br /> �,MECHANICAL CONTflACTOR MpIL ADDRESS CITV ZIP PHONE r ScTATE LICENSE s <br /> � � � V J <br /> PLUMBINGCONTRACTOR MAILAODRESS CITY ZIP PMONE STATELICENSE� <br /> l CONTRACT PRICE OF WORN — <br /> J►— ws <br /> � o� a,v o�n <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED CONTACT PERSON AND PHONE NO. <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �, PROPOSEO USE OF BUI ING APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IJ L!� �l.Y !O PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCflIPTIONOFPFOPERTV�SHOWNBELOWOflATTACHTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLAI'E OR CANCEL THE PROVtSIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERF('RMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERI'V TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMP4Y WITH THE STATE <br /> �PARCEI TA%1 D.NUMBER CONTRACTORS LAW 182 RCW AND 296200�C. <br /> 3�24v4 -9 -D8o- c�OL <br /> CONSTRUGTION LOAN LENDER.A�ORESS.TELEPHONE NJ,.iBER ! <br /> 3-I-94 <br /> *PROJECT ADDRESS s�cr��.une o�rE � <br /> Sl3U ELri't S EVEf1E7f 482v3 ��„a��,�Ess„�E�sE,� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FD(TURE OR ITEM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER CLOSET(TOILET) � FVC—AIHNOLG UNITS--H.P. , <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E,A. � ' <br /> LAVATORY(WASH BASIN) � � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLOTHES ORYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD , <br /> LAUNDRY 1'RAY ; / WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL � MET.AL FIREPLACE(WOOD BURNING) <br /> DRINKING fOUNTAIN � FIREPLACE INSERT ' <br /> � <br /> FLOOR DRAIN � HEAT PUMF � <br /> BACKFLOW PREVENTERS ; 3 GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SWK(SERVICE—BAR.ETC.) ; � � <br /> � ; <br /> � <br /> � <br /> � , <br /> SUB TOTAL $ ; SUB TOTAL $ � o 0 <br /> PERMIT $ � PERMIT $ �'j�O� <br /> TOTAL FEE $ ; TOTAL FEE $ i o0 <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACN SI�ESETBACK PLANCNECKNUMBCR FEE PECEIPTNO. <br /> uSEzowe LOTnREn vacnrvrg;;p FEES VALUATION FEG <br /> C: '(ES f7 NO BUILDING �— <br /> IVPEOFCONSi. NOAFSTORIES WLuosHtv NoamVP.uNGUNrtS � <br /> cnouo PLUMBING <br /> SIZEOFBLDG. FIRESPRINNLEFSREO'0 OASEMENT MECHANICAL I <br /> ❑ YES ❑ NO � <br /> OCCUPANCV LOAD FIRE�LARM REO'D HEIGHT LIMITATION ADDITIONAL PLAN CHECK i <br /> OTHER � <br /> REASON —T <br /> STATE OUILDING SURCHARGE ' <br /> INTFKE BY PLANS�PPROVED BY CITY OF EVERETT PUBLIC WORKS ' <br /> LOCALSALES <br /> DATE TAl(CODE IS 3105 TOTAL � � <br />