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APPLICATIC��I FOR CONSTRIJC'T""lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: �J GAS ❑ ELECTRIC .J <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I ! DEMOLITION L; COMBINATION � BUILDING I 1 MECHANICAL X� PLUMBING ❑ SIGN <br /> GWNE MAILA��RESS CITV ZIP P��ONE <br /> �P� �ross ZS30 �a.,�mJ ����� �� �� � <br /> TENANT IdAILA00RE$S CITV ZIP PHONC <br /> pFCNRECTORDE5IGNER IdAILA0�RE55 GIT`I ZIP PNONE <br /> G NZ � <br /> GENERALCONTF�CTOR MAILA�Df� E55 �7D1-o-ch V�rM1 W7� Z�P PHONE STATELICENSE <br /> I�r�LPv�, �us�•� //d�c.�> Edv�e-tI �/�Z�3 3y� i37b' DeC� .- G,i��T/J <br /> MECHANICALCONTRFCTOF IdAILA[1DRE55 CITY ZIP PNONE SiATELICENSEa <br /> PLUMBINGGUNTRACTOR M�IL40DRE55 CITY ZIP P40NE STATELICENSEa <br /> CONTPAGT PRIGE OF tYORK . <br /> �/{000 l <br /> DESCRIBE WORN AND SOU�A OOTAGE IN OLVED CONiACT PERSON FND PHONE ND ,7 <br /> �)> > P.nn,u _ ��lo �, �' tu i�lvn �;a / 3v7-/37 <br /> e f l �oo -+ - <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> aaoroseo use oF euaoiNc APPUCATION AND KNOW THF SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE CF <br /> LEG�LDESGPIPTIONOFPPO�'ERTY�SNOWNBELOWOFATTAGHTWOGOPIES� WORK WILL BE COMPLETED VJIThI WHETHER SPECIFIFD HEREIN OR <br /> �ot a���Z o�ocK �� oF ���FO� [�ai</7� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOL,4TE OR CANCEL THE PROVISIONS OF AN`! <br /> uO, � /� /7 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCIION OR THE <br /> �%�Z iC p iv�✓S o�" Snd� pERFORM1IANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOH WHICH <br /> p,,,,�SI� —. qpPLICATION IS MADE AND I COMPLY WITr1 THE STATE <br /> P4RCEL TA%I.D.HUMBER OODLG CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> - ��� � <br /> CONSTRUCTIONLOAN�EN�ER.AODFESS.TELEPNONEI:UMPER � � /� <br /> �.�1 � � /L�'� 7— /lu�^j L� <br /> SIGNniOPE GAIE <br /> PROJECTADDRESS - . <br /> �` LO C�iv905iN[SSULENSF.NO <br /> PLUM8ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> - � WATER CLOSET(TOILET) � A/C—AiHNDLG UNITS—H.P. ' <br /> Z BATHTUB FORGED AIR SYSTEMS—B.T.U. M E.A. ' <br /> �Z LAVATORY(WASH BASIN) � UNIT NEATERS—B.T.U. M � <br /> 'y SHOWER CLOTtiES DRYERS ' <br /> Z, KITCHEN SINK 8 DISP ', VENTILATION FAN �_ <br /> 'f DISHWASHER � Z. RANGE HOOD _ <br /> � LAUIJDRY TRAY Z WATER HEATEF �~— <br /> ( CLOTHES WASHER WOOD STOVE ' <br /> ��RI�JAL ; MC-TAL PIREPLACE(WOOD BURNING) <br /> DRINKING fOUNTAIN � FIREPLACE INSERT <br /> FLOOR DP.AIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> SIhK(SERVICE—BAR, ETC.) <br /> _ — <br /> � <br /> — SUB TOTAI 5 SUB TOTAL $ <br /> PERMIT $ PERMIT S <br /> TOTAL FEE 5 TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: ��E�Eiarrvo <br /> PRONT SET�AGK REAR SETB�GK SIDE SET�Cri' PLAN CHEQ1.ylIhlBEji FEE <br /> 7� ' ztS ' ' � "� <br /> , <br /> USEZONE LOTAREA VAGANTSITE FEES <br /> VALUATION FEE <br /> p ,_� ��� YES ��. NO 6UILDING �roO � <br /> - f--�— <br /> fYPE[1FCONSi. NO.OFSTORIES ectvvxaCv roo�c'dFio4,ur;n5 <br /> 2 'qp1 PLUMBIN� C� <br /> SIZEOFBLD�J FIRESPRINNLERSFE00 BASEtdENT MECHANICAL ��� � ��� <br /> �J `, YES . �. NO I <br /> I �G ADDIPONAL PLAfI CHECK ' _ <br /> FIRE ALABM PEO'0 NEIGHT LIlAITATICN � <br /> OCCUPANCYLO D _ _ � <br /> � � �/J C.1S OTHER <br /> i <br /> r�ensoN i- �!-r7 <br /> STATE BUIIDWG SUFCHARGE <br /> INTAH[F1Y PL4N5 APPROVEO BY CITY OF EVERETT PU6LIC WORKS <br />