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APPLICATI�1 FOR CONSTRUC�D�I PERIiAiA1T <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br /> RUILDING DEPARTME ATING SYSTEM: U GAS ❑ELECTAIC ❑ <br /> 259-8810 ��Lr���Jj� �(,�j � <br /> I 1 DEMOLITION l� COM INATI BUILDING xMECHANICAL � I PLUMBING ' SIGN <br /> OI.OII�LY4 Rcal �s�teDDflE55�dJ �tM N�. T��7lry�J"�✓V .iC2' 14' IO�V�ONE �.�a� � 337 <br /> 0 <br /> TENRNT MAILAODRE55 �ITY ZIP PIIONE <br /> I�oUa ��lor�e��,ae I(��U 5�C CVCY��E. W12�1 l,U�u C eve�L�- <br /> AF..HITECTORDESIGNER �� vmAaAuuHt�� CITY ZN PHONE <br /> GENERALCONTRFCTOR MAILAD�FESS CiTY ZIP PHONE S7FTELICENSEp <br /> �1n�G� SUStP4+�5 �oat <�•W• Klt`clutzE �,�1a� S�nG loV �a�tLt �1�13�f �(N� �%45Y �QUf�iI��R�R <br /> MECMANLICJA�LCnOn�'nnCGTG��'n_r_, "wiL"nuu'ne55 t,� �., � GITY Z_ IP � pHpN�� STATELICENSEb��� <br /> ��'G'eJL `S�vY§�4i�'�S ��'- '�..lLa✓rtCCCt'.�1-�.1S1�8w KY��� ! y%�o: YRrN�%�Y� <br /> PLUMBINGCONTRFCTO MAILA�OPESS CITY ZIP PHONE STATELICENSLa <br /> T��nt Tv�orovemen� <br /> CLA55 OF WOPK — <br /> i i NEW i I qDDITION XALTERATION . . REPAIR , ��. DEMOLITION . ; WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> "� CONTP.CT PERSON AND I'MONE NO. <br /> CONTRACTPRICEOFWORN � yq J�oo g�1� �\�SLI `�(� ��y. �3'��� <br /> OESCRIBE N'ORK AND SOUARE FOOTAGE INVOLVED —� <br /> PROPOSE�USEOFBUILDING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �'l e,Q APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL , <br /> LEGALDESCRIPTIONOFPROPERN�SHOWNBELOWOFARACHFOURCOPIES) PROVISIONSUFLAWSANDORDINANCESGOVERNINGTHISNPEOF <br /> WURK WILL BE COMPLETED WITH WHETHER SPECIfIED HEREIN OR <br /> �or BLOCK oF NGT. THE GRANTI�'G OF A PERMIT DOES NOT PRESi1ME TO GIVE <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF'fHE <br /> PERFORMANCE OF CONSTHUCTIOPJ.THA��I AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTFACTORS LAW 7827 RCW AND 296200 WAC. <br /> x U�/`-r �I.eXN�1� J •� ��! <br /> PROJECT ADORE55 SiGrvnruae onrE <br /> �c� s�G• Ewr�tc VY1al� 1.iJ C3�3ioa <br /> CRV 0 W�NE55 uLENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. YYPL OF EQUIPMENT FEE <br /> � WATER CLOSET(TOILET) � A,'C—fVHNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIF7 SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASW) � UNIT HEA7ERS—B.T.U. M '— <br /> SHOWER � CLOTHESDRYERS <br /> KITCHEN SINK 8 DISP ; VENTILATION FqN <br /> DISHWASHER � RANGE HOOD ; <br /> LAUNDRY TRAY ' WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN ; FIREPLACE iNSERT ; <br /> FLOOR DRAIN � HFAT PUMP T- <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ; <br /> SINK(SERVICE—BAR,ETC.) � — <br /> � � <br /> ' � � <br /> � <br /> � <br /> T <br /> SUBTOTAL $ SUBTOTAL $ <br /> PERMIT S � PERMIT S �_ <br /> TOTAL FEE $ � TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK PEAFSETBACK SIDESETPACN PLANCHLCKNlIM9ER FEE AECEIPTNO. <br /> USEZONE LpTAREA VACANTSITE FEES VALUA'f�ON FEE <br /> T <br /> BUILDING ; <br /> T1PEOfCONiS.ALLOWABLE TYPEOFCONSi.ACTOAL otNaANcr r;oa4owEluu6W�n5 <br /> cxauc � PLUMBING � <br /> i <br /> SREOFBLDG. NO.OFSTOf11E5 BASEMENT MECHANICAL � <br /> i <br /> i <br /> OCCUPANCVLOAD FIRESPRNKLEflSREO'D HEIGHTLIMITATION <br /> ADDITIONAL PLAN CHECK � <br /> SPHINKLER i <br /> FEASON FOR SPRINKLERS �_ <br /> STATE BUILDING SURCHARGE i <br /> INTFNEBY P{,ANSAPPROVEDOY CITYOFEVERETT PUBLICWORKS i <br /> LOCAL SALES --� <br /> TAX CODE IS 3105 TOTAL ; <br />