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- - APPLICATIOf�'�R CONSTRUCTIL�Ii PERMIT �VefPt; <br /> u��Evergieen TO BE COMPLETED IN INK—PLEP.SE �RINT � <br /> CITY OF <br /> eve rett HEATING SYSTEM: �GAS ❑ELECTRIC [I � <br /> BUILDING DEPAFlTMENT <br /> 259-8810 <br /> -1 DEMOLITION I_ �OMBINATION X BUILDING I MECHAIVICAL �PLUMBING SIGN <br /> OWNER MAILA�,^.BESS CITV ZIP PHONE :�,;:..1 <br /> S/�,c%AL a�✓EC.�i'4,lE�, 2l�C. //!9 /'1¢-b'GA��E DY2. �I/�2£71" y82d3 353-�'�6� <br /> TENANT MFIL ACDRES� CITY ZIP PHONE ����7 <br /> �� <br /> ARCNITEGTOfl0E51aNEH MAILAODRESS Qiv 21P PHONE <br /> �E'SlGN LiNt.s Zo/o .7Sf`' �Ja� 9���.? 353 -os3r ��F� <br /> GENEFALCONTFALTOR MAILADDRESS CITY ZIP PHONE UCCNSE„ '��';� <br /> ��fE ['.+n/STfI1.cc77v.v' SfF�� A�TI•foitfCG[[D'O(._ ,'� <br /> MFCHANICALCONTRACTOR MAILAODRESS GITV ZIP PHONE LICENSE4 <br /> S,-� <br /> PLLIMBINGCONTRACTOR MNLA�DRE55 CITV 21P PNONE UCENSEM <br /> CLASS OF WORN <br /> NEW �. �'� ADDITION . � ALTERATION �. - REPAIR ' -'�. DEMOLITION �- I WOODSTOVE/FRPL INSERT �1-�1 OUILDING REiOCATION <br /> � CONTqGT PERSON AND PHONE NO q <br /> COt1TRRCTPRICEOFWORN �QSiODO na(cP E. T !�� Js.�,rrs�O <br /> C�C�I�OORK�O SQ�qR�OOT^,IN�D " �/�� I , <br /> 2 �� /,(�/rrA/I CAcaO �GKG:t <br /> , vv T <br /> PROPOSE�USEOFBU/tLO'ING ^ I HEREBY CERT!FY THAT I HAVE READ AND EXAMINED THIS <br /> SIN 9� Ya'�!I-� �td�CG. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDES IPTIONOFPROPEiiY�SHUWNOELOWORATTACHFOUFCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLE7'ED WITH WHETHER SPECIFIED HEREIN OR <br /> �oi e�ocK oF NOT. THE GRANTING OF� A PERIv11T DOES NOT PRESUME TO GIVE <br /> ^ ��' �� �J �J ^ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ��„�„{! OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> '- —� PERFORMAiJCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> . OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> - APPI.ICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 256.200 WAC. <br /> SIGNATUREGFC^ilTRqCTOFOFAUTHONIZEDAGENT OATE <br /> � // � � �r <br /> PFOJECTAD�PESS - _ <br /> ) n�/ PLICAN�,IICE C i10.AND BUSINE55 NAME <br /> �7 G <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM PEE NO. TYPIS OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) D � - A/�NHNGLG UNITS-H.P. <br /> BATHTUB /p ; fORCEDAIR.i`.�STEMS-E3.T.U. M E.A. <br /> LAVATORY(WASH BASIN)� �- UNIT HEATERS-B.LU. M ; . <br /> SHOWER � � CLOTtiES DflYERS T- <br /> KITCHEN SINK d DISP ;- VEN7ILATION FAN ; <br /> J DISH'.VASHER . � RANGE HOOU �— ., :�::j <br /> LAUNDRYTRAY / WATERHEATER ��.TJ <br /> / CLOTHESWASHEA ��� WOODSTOVG � ���``<� <br /> _ URINAL META�FIREPLACE 8 CHIMNEY ;'-'�� <br /> DRINKING FOUNTAIN FIREPLACE INSERT �_ ,`_��1 <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFl_OW pREVENTERS GAS PIPING ; � .!;i <br /> ROOF.DRAINS-RAINLEADERS � EXHAUST FAN � ��:�`��� <br /> SINK!SERVICE-BAR,ETC.) ; .{,.,w u-w-�- 1 oua,j'� .":;I� <br /> — i i <br /> i i � <br /> i , <br /> SUB TOTAI 5 ' f; ` SUB TOTAL 3 �p ; a� <br /> PERMIT $ i PERMIT $ <br /> TOTALF[E 5 �f4�;� TOTALFEE $ F�10 � �— <br /> FOR GfFICE USE ONLY: 60. <br /> FFONTSETBFC,� �AqSE�; SI�ESE�BRGN / P�LA,N�KN�MBEAO� 4F3/3, �3p REGEl�rO. � <br /> S / n/� � <br /> CxCIC <br /> usezo�+e �ornaea p VACANTSIiE FEES VALUATIO FEE <br /> ��CJ BUILDING ���JQO �S�' O o <br /> iYPEOFCONiS.ALIOWABIE 1VPEOFL@lST.AGiUAL OtCwnxcv u0 Orow.Euix6uer5 <br /> cAouv � PLUMBING Cf�';Da <br /> -�-- - -3 <br /> SI,'.EOFPL�G NO.OFSTORIES BASEMENT MECHANICAI i <br /> 2es� sF+ 2 No _ o eo <br /> zo 5�`Gn 2 � <br /> OCCl1PANCYLOFD FlRESPRNHLERSREOD MEIGHTLIMITATIOi ADDITIONALPLANCHECK (�'� i 8O <br /> N Q ND OTHEfl <br /> MEASON I'OF SPRINNiERS <br /> STATEBUILDINGSURCHARGE [f ; sd <br /> INTAKE BV PIANSAPPPOVED BV CITY OF EVERETf PUALIC WORKS ' <br /> � f LOCAL SALES �v , ac <br /> �X � TAX CODE IS 3105 70TAL �S-D �3a <br />