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APPLICATIC"1 FOR CONSTRUCT'lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> HEATING SYSTEM: ❑GAS ❑ELECTFIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I _l DEMOLITION LI COMBINATION f_l BUILDING I 1 MECHANICAL Ll PLUMBING C 1 SIGN <br /> 01YNER MAILA��RESS CITY ZIP PHONE <br /> 51SKJnl ai�8 Ev�RETT AY� �✓tRbi� 98.��� asa- 3�88 <br /> TENANT MAILPDDRF55 CITV ZIP PNONE <br /> kEn► 3Rt,u��J �D 3�x 1135 SUL�FlNI �JA. 7y�-r».�a� _ <br /> ARCHITECTORDESIGNER MAILADDRE55 GTY ZIP PNONE <br /> GENERALWNTRACTOR MAILADORE55 CITY ZIP PHONE STATEUCENiE• <br /> MECH/.NICAIGONTRACTOR MAILADDRE55 GTV ZIP PHONE STATELICENSE� <br /> PWMI3ING CONTRACTOR MAIL ADDRESS CIN ZIP PNONE ST�TE LICENSE t <br /> CONTRACT PRICE OF WORN <br /> DESCFIBE WORK AND SOUARE FOOTRGE INVOLVED CONTACT PERSON AND PHONE NO. <br /> � '789' /7 7 <br /> L� NANbE TD OFF/ E �3by SQ� Kc�.� �ROtt�N' - 7' <br /> SFIL� EfI '�y� 'S�� I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED TH�S <br /> PROPO/S�ED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �/fJ'y� BD�/_�QEP s��� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> IEGM �CSCRIPTIONOFPROPERTY�SHOWNBELOWORAiTACMTWOGOPIES) ✓A�/( C�III WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ot e�ocK oF AUTHORITY TO VIOLHTE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TA%I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> �9 �- �30•- Da 8- o00 <br /> CONS RUCTION LOAN LENDE0.AODRESS.TELEPHONE NUMBER /�n[ <br /> / w /J�7"7L(c �..Z-..ZQ"53 <br /> PROJECT ADDRESS smr��*uae ^��E . <br /> � I S E ✓ERFTT t ��,���S�NEss�����s<<,o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � /VC—AIHNDLG 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 DRYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRY TRAY WATER HEATEii ' <br /> CLOTHES WASHER WOOD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BUP.NING) <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVEN7ERS GAS PIPING � <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) I � <br /> � ' <br /> � <br /> � ' <br /> SUB TOTAL 5 ; SUB TOTAL 5 <br /> PERMIi 5 � PERMIT S � <br /> TOTAL FEE S TOTAI FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONiSETBPCK REAFSETBACK SI�ESETBACN PLANCHE NUMBE�/ FEE RECEIPTNO. <br /> �J � 2._c� <br /> �.lJ-� <br /> u=_ezor+[ IOTAREA VACANTSITL FEES VALUATION FEE <br /> �- i�' YES i� NO gUILDING vV IJ � <br /> ivPE aF LON57. NO.oF STORiES aavu;cr xn a ow[wncuni�s PLUMBING i <br /> BZP � 2 , <br /> 52EOFBLDG FIRESPRINKIERSREOD BASEME T MECHANICAL <br /> `3{2O �F NO !� YES JC NO � <br /> OCGUPANCY LOAD FIRE ALARM REO'D HEIGHT LIMITAiION ADDITIONAL PLAN CHECK i <br /> '�j I � OTHER <br /> R[ASON <br /> STATE BUILDING SURCHARGE �- <br /> i <br /> INiANE BV PLANSAPPROVLDBV CITY OF EVERE7T PUBLIC WORKS � <br /> JM LOCAL SALES � <br /> DATE i2 2°� �j3 TAX CODE IS 3105 TOTAL <br />