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APPLICATIG�: FOR CONSTRUCT JN PERMIT � <br /> �j\ TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br /> � <br /> BUILDING DEPARTMENT _ HEATING SYSTEM: J GAS LECTRIC CI <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING /SIGN <br /> OWNER � MFILADOR[5.. GTV ZIP pNONE <br /> �1C I�Gr�al�� l o O t�l PT� D� �_r�1� G 8���� <br /> TENANi MAIIAp�R[55 CIiV ZIP PMONE <br /> Y10 n1�'�J <br /> ARGNITE�TORDESIGNLH l,IA�IL}AD�F[55 1 / CITY ZIP PHONE <br /> GENEPAL�ACTO�qI� I'�,ql`jAI.I')SSfJE I IfnT� JI� GI�LrK�Q�ZIP �r��`� PH�NE��—�IMTA��FJaTI-II�I���� <br /> MECMRNICALCONTRACTOR MAILADDRESS CITV ZIP PHONE STATELICENSEa <br /> PLUM�INGWNTFACTOR MNIADORESS CITV ZIP PHONE SiATELICENJLe <br /> CLASS OF R'ORK -- <br /> x NFW ADDITION ALTERATION REPAIR DEMOLITION . WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTAGT PERSON ANO PMONE NO. <br /> GONTRACT PRICE OF WORN <br /> OESCRIBE WORK AND SOUARE FOOTFGE INVOLVED <br /> PROPOSEDUSEOFBUILDING i HEREBY CERTIFY TI1AT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> LEGAL DESCR�PTION OF PROPERTV�SHOWN BEL0IVOR ATfACM FOORCOPIES� PROVISIONS OF LAWS AND ORDI�ANCES GOVERNING THIS TVPC- OF <br /> WORK WILI BE COMPLETED WITH WHETHER SPECIFIED NEREIN OR <br /> ior BLOCK oF _ _ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUML �O GiV[ <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATC OR LOCAL LAW REGULATING CONSTRUCTION OR TI IE <br /> PERFORMANCE O�CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PcRFORM THE WORK FOR WHICH <br /> �, � � � APPUCATION IS A1ADE AND I COMPLY WITH THE STATE <br /> ��i��L�ctf: CONTRACTORS LAW 78.27 RCW�ND 296200 WAC. <br /> • — _ - , , <br /> PROJECT4DORESS (� 11�,� Pyj�� ✓Iq(1S� �.�ct� Xr:ntunt ' n�r� � � �-" <br /> .�Z DnJeThru - 4ltcxe.� I E'n�r{t�r,CcSi �= ?W� I e�i� . <br /> � C� G Ci v�?uGY.(SG�I' P FNG <br /> PLUMBING M A <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—A�HNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASW) UNIT HEATERS—B.T.U. M <br /> SHOWER � GLOTHESDRYERS —�— <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHN��`�{ER RANGE HOOD —T <br /> _ LAUNL � TRAY ; WATER HEATER <br /> _ CLOTHESWASHER � WOODSTOVE � <br /> URINAL � METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) � <br /> � <br /> � - <br /> �— <br /> SUL TOTAL 5 SUB TOTAL 5 <br /> PERMIT $ PERMIT S <br /> TOTAL FEE 5 TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> PRONiSETBACK REARSET�ACK SIOES[i�ACK PLANCHECKNUAI€3[ FE[ RECFIVTNO. <br /> 3 <br /> r �4�-.E� ( c'� FI• �l��.'`I <br /> USLZONE n LOTAREA vncnNTsiTe FEES VALUATION FEE <br /> _ `� � � �' � / BUILDING _���� en _9�; <br /> IIPEOFCONiSALLOWABIE iYPE fCONSI.ACiUAL oaurq,Cv uo �CA'FwxGWn�S <br /> cAouo pLUMBING <br /> i <br /> SIZ[OFBL�G. NO.OFSi'HIES BASEMENT MECHANICAL �— <br /> � <br /> OCCUPANCY�OAU I FIRESPRNKLERSREO'D HEIGHTLIMITFTION ADDITIONALPLANCHECK �;�) <br /> SPRINKLER i <br /> RLn50N FOR SPRINKLEPS � <br /> --T <br /> STATE BUILDING SUFCHARGE � �-7� <br /> ItIIAN[pY P�ANSAPPROVED�Y CITYOFEVERETT PUBIICWORKS � <br /> LOCAL SALES <br /> �JM �� ��G�z� TAX CODE IS 3105 TOTAL ��i �y� <br />