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� } <br /> . APPLICATIG� FOR CONSTRUC7 .ON PERMIT �� '� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS i]ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> y�o �+ �(nFuni inoN COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> t�� OW :R MAILADDH �CITY � 21P PMONE n���/ <br /> c <br /> � ��r �,�� us� � � a rx 0;9 C✓�'�°� %�%OG ,;�'_5��. i <br /> .Q y y tENANT MAR ADDRESS QTY IIP VHONE <br /> 9 �� <br /> y�� AfiGMITECTOR0E51GNER MRILADDR[SS CITV ZIP PHONE <br /> K n <br /> �� � /� \ <br /> NE LC iRACiO MAIL ORESS / CITY ZIP PIIONE STAiEUCENSE• <br /> 'tl y H ��� � � 0`1Ff��se I�r�da� l�i��� 1 <br /> � �� MEf.NANiCAL CONT AGTO MAIL RDDRESS CITV ZiP NNONE ST�TE LILENSE s <br /> Q � d PLUMBINGCONiRAGTOR MAIIADDRESS LITY ZIP PHONE S TATELI G E N S E I <br /> �� 8 <br /> p� O cussorv:om. <br /> I NEW '. ADDITIO�! ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERI � EUILDING RELOCATION <br /> GontnC*re�sor+nr+o/^/_Or+E o, �I/'L <br /> � HH �CONTRACTPRIC[OF\YOHN , � „(Ga�(/jGl �,�jy-!/y'/r <br /> gy�„� pE5CRi9E\YORNANDSOUAREFOOTRGEINVOIVED <br /> n d�+ � <br /> [At� PROPOS[DUSEOFBUILOING I HEREBY CERTIFY THAT I HAVE RF.AD AND EXAMINED THIS <br /> �s7 APPLICATION AND KNOW THE SAME TO BE TRUE AND COFiREC?.ALL <br /> O y �e�n�oescairiio OFPROPEFTYISMOWNBELOWONATT4CHFOUPCOPIES) PROVISIONS OF LAW3 AND ORDINANCES GOVERNING THIS TYPE OF <br /> ��e�ocK �y�{ J� WORK WILL �E COMPLFTED WI?H WHETHER SPECIFIED HEREIN OR <br /> iot oF C ei S;%rnd ✓��Y�I NOT. THE GR�tJTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> �q � R 3� � �o OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORh1ANCE OF CONSTRUCiION.THAT I AM AUTHORIZEU BY THE <br /> OWNEfl OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COAIPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> X � �t � ..r� .37�'ii <br /> 'i>tl1�E f<iF <br /> FRQI[CTAO�PE55 ' <br /> 3H�,. veat f�"�e< <,r.A�t,ti«��,�,�,�F., _ ��I <br /> PLUMBING MECHANICAL I <br /> 1�� '� NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE . <br /> C ■. WATER CLOSET(TOILET) A�C—A/HNDLG UNITS—H.P. _ <br /> ��i BATHTl�6 FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> j LAVATORV(WASN BASIN) i UNIT HFATERS—B.T.U. M � , <br /> SHOWER CLOTHES DRYERS ' <br /> ��� VENTILATION FAN i I <br /> KITCHEN SINK 8 DISP <br /> I �' DISHWASNER FANGE HOOD I <br /> LAUNDRV TRAV WATER HEATER <br /> CLOTHES WASHEfl WOOD STOVE <br /> � I L=� URINAL METAL FiREPLACE&CHIMNEY T ' <br /> DRINKING FOUNTAIN FIREPLACE RJSERT __� i <br /> �. FLOOR DRAIN HEAT PUMP ' i <br /> BACKFLOW PREVENTERS i GAS PIPING � � <br /> i '_1�� ROOF DRAINS—FAINLEADERS ExHAUST FAN �I, <br /> � SINK(SERVICE—BAR,ET0.) <br /> I <br /> i � ��� , _—� <br /> SUBTOTAL S SUBTOTAL 5 <br /> ' PERMIT 5 PERMIT S <br /> TOTALFEE S TOTALFEE S —T <br /> �1�, FOR OFFICE USE ONLY: �� <br /> - FRDNTSETBRCN REARSETDACK 51�[SETOACN PIANCII��� -� �' �6E fiEC[IPTNO. <br /> � " <br /> USE20NE toTnnen VFCANTSITE FEES VALUATION FEE <br /> ! <br /> BUILDING <br /> iVPEOfLOMS.ALLOWA6tE iYPEOPCON57.ACipAI aturexcr xoaow[wxGuxirs <br /> r.aouo � PLUMBING <br /> SREOFBLUG. NO.OFSTORIES BASEMENi MECHANICAL � <br /> OCCUPANCV LOAD FIRE SPPNNLERS PE00 MEIGNT UMITATION ADDITIONAL PLAN CHECN � <br /> � <br /> SPRINHLER � <br /> � <br /> Fi[ASON FOR SPRINNLERS <br /> S1ATE BUILOING SURCHARGE <br /> INTAKE DY PLFNS APPROV[D OV CITY OF EVERETT PUBLIC WORKS <br /> LOCALSALES <br /> TAX COOEIS 3105 TOTAL <br />