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APPLICATI� �� FOR CONSTRUCI _�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � ' HEATING SYSTEM: U GAS ❑ELECTRIC 0 <br /> �UILDING DEPARTMENT ` <br /> 259-8810 <br /> Cl OEMOLITION ❑ COMBINATION ❑ BUILDIN(3 jrJ,MECHANICAL ❑ PLUMBING Cl SIGN <br /> OWNEfl MAIL/�DUPESS CITY 21P PNONE <br /> 7 � <br /> ._i i� 1Ci-� � 43l) �Hc.�S�,.r. �, u�i.�:,� > �1�C��1.� �C,O�. �L �:� u4 <br /> TEN�NT M�N.ADDRE99 CITY 21P PNONE <br /> �aLl1� <br /> ARC/HI/i�EGTORDESIONEP MMLAJDRESS CITr Z�P OHONE <br /> 1 V1�]�C„`+n t , <br /> GENEPILCONTMCTOR MAILAO�PESS CITY Z6' Pl10NE . ST�TELIGENSEI <br /> M GNIWICKCONTAACT R,,� l M110.AODRESS CIiV ZIP PHONE STATELICENSEI <br /> \��v� -�n /�., �, � w '3454 I`'�Av - Sc a1-a S�v���i:- V�a "1���4' "Ccc. C2L �kc,Sb Y��:�un�•3'13IJ_ <br /> PLUMBINOCONTMCTOR /MM.ADOi1E5S CIN ZIP PFIONE ST�TEIIGENSE� <br /> GUSS OF V�ORN <br /> ,NEW ❑ ADDITION ❑ AL7ERATION 1 I REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT I J BUILDIN�RELOCATION <br /> ., / <br /> CONUCT PEfl50N AND P110NE NO. <br /> CONTPACT PRICE OF WON( �J ��'1� �1� � c-�.- <br /> DESCRIBE W0111(/�NO SIXIARE fOOTA6E INVOLVED <br /> /�onS���vw..arL�t��c1••. �� `r�x�C) ,x:.� Q•'l '�UC. (—Z. � �C,S C� <br /> rnoroseouseorauwora � 1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THI3 <br /> � � � ��i�(T �- .��. r. ,,� '�"�F1ud� - � APP�ICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LE6ALOE6GNIP710NOFPROPf.I17V�6HOWNBELOW OR�T7AGNFWRCOVIES� PRO`.ISIONS OF LAWS AND ORDINANCE;GOVERNIN6 7HIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED NEREIN OR <br /> � e�ocK oF NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW RE6UUTING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE ' <br /> OWNER OF THIS PROPERTY TO PERFORM THF_ WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW D 296200 WAC. <br /> X � ���" ,z <br /> tq1UTUPE �j•^ �� <br /> PflQIEGTAODflESS J� I O��% EKF ��3E / <br /> I�J �1 �GYtTI-C>'�"�� 1-�.�/E E��F����: !i�- c�nwsnassi�cEr+scrro <br /> pLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � WATER CLOSET(TOILET) � AIC—A/HNDLG UNITS—H.P. � <br /> BATHTUB ' � FORCED AIR SYSTEMS—B.LU. M E.A. ' � <br /> LAVATORY(WFSH BASIN) � UNIT NEATERS—B.LU. M � <br /> SHC'NER ' CLOTHES DRYERS ! <br /> KITCHEN SINK 6 DISP ; VENTILATION FAN __� <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRY TRAY � WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAL � �' - METAL FIREPLACE 6 CHIMNEY <br /> DRINKINO FOUNTAIN i . FIREPLACE INSERT � <br /> FLOOR DRAIN �� �-� � HEAT PUMP ' <br /> BACKFLOW PREVENTERS - ;�;� �::1 GAS PIPING <br /> ROOF ORAINS—flAINLEADERS :� �� E%HAUST FAN <br /> SINK(SERVICE—BAR,ETCJ ; % �'' ,�� ' ' -fd ' �' �� <br /> � <br /> � <br /> � ; <br /> i <br /> i <br /> SUB TOTAL S ' SUB TOTAL S '��c% <br /> PERMIT S � PERMIT S 2� <br /> TOTAL FEE S ' TOTAL FEE S � � � <br /> FOR OFFICE USE ONLY: � `�� ��� �� <br /> FHONTSEiBAGN AEARSETBACK SIDESETB�CK , PLANCII�N�1}I�BEB / FEE�� �S� RECE�NO���/ <br /> -� �� i/ <br /> O � � � <br /> USE ZONE � LOT ANEA VACANT 61TE FEES VALUATION FEE <br /> BUILDIN6 ' <br /> ttPEOiCON15.AllOWABIE TYPEOfCONSI.�CIUAI aiq'u�' Mo.aPM«�OU��6 � <br /> PLUMBINO <br /> / i <br /> �•FBlD6. NO.oFSTORIES BlSEMGNi MECHANICAL � � <br /> � <br /> OGCUPANCY LOAD fIPE SPRNNLEflS REO'D HEIGIIT LIMITATION ADDITIONAL PLAN CHECK � <br /> ' ,� <br /> SPRINKLER � > I <br /> flEA50N F0t15PRWNLE115 � <br /> STATE BUILDING SUflCHRRGE <br /> INIANEOY PL NS MNOVEOBY CITY OF EVERETT PUBLIC WORKS � <br /> LOCALSALES 7 <br /> TA%CODE IS 3105 Torn� /�0 6 ;<S�' <br /> . � , � �r�//�=� <br />