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AP�LiCAT'10 FOR CONSTRUCYI N PERIVIIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEA�I-ING SYSTEM: J GAS .J ELECTRIC J <br /> 259-6810 <br /> DEMOLITION ' COMBiNATION BUILDING ��fv1ECHANICAL PLUMBfNG �IGN <br /> OWNER ldAlLAppRE55 CRV IP PHONE <br /> �' ���—I��A�7 _ 5 i ��`� T r-��� � � `��v 1 33_°1- ny�-..� <br /> yiElJANT MiuL"nppRE55 CITV Z�P PHONE <br /> � S��^� � <br /> FRGNITECT OF DE51.uca __ — <br /> ......_.............. �ii. na PMOHE <br /> GE ERALCON RACTOR l.+.FILnDDBE55 ,� rtY � ZIP PMpNE SiATE ICEI15Ea <br /> � cA l r_,� �.R���K � - �- � �,�y�b.�-y���> ��r�,�,—�/,�,�r,��2 <br /> fAELHANICALCO4TRACTOF IdqIL>DDRE55 ITV ZIP PH 'Jo iq EL�-4 ICENS'ce <br /> ��n•,f <br /> PLUMBINGWNTRACTOR MAILADOFESS QTY 2iP PNONE SiATELICENS[a <br /> CGNTFACt PRICE OF W�K — <br /> DESCFI6E WOPK AND SOUARE FOOTRGE INVOLVEO GOM1TACT�PERSsN AND�IyryE N' ,� <br /> ������ � L�r ,Cr C` �7 '���-- ��9 � <br /> !!�-[�:� '�i!'��L1 f�' A' ��� / - <br /> I HEREBY CERTIFY THAT I HAVE 9EAD AND EXAM'NED THIS <br /> aaoaoseo usE oF emioir�c APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PRUVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALDESCRIPTIONOf PFOPERTV�SNGWNBELOWOqATfALHTWOCOPIES) WORK WlLL BE COMPLETED WITH WHETHER SPEGIFIED HEREIN OR <br /> ior s�ocK pF NOT. THE GRANTING OF A PEPMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT M AUTHOR12ED BV THE <br /> OWNER OF THIS PROPERTY TO PER� . THE WORK FOR WHICIi <br /> Paace�Tnxi.o.Nurneea HPPLICATION� MA AND I'- MPLY WITH THE STATE <br /> �/ '� ^� � � . CONTFAC SLAW N 296200 WAC. <br /> CONSTRUCTIONLOANLENDER.ADORE S,TREPHONEKU1.16ER C� � � <br /> \ /� <br /> G <br /> PROJECTADDRESS .Z � \ r� 5�,�"�,,,.- � — �,�� _ <br /> J L� �: uivE�us:wssuco�s�r�o <br /> PLUMBING MECIIANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE t�0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—AMNDLG UNITS—H.P. <br /> _ BATHTUB _.!_ FORCED AIR SVSTEMS—B.T.U. M E.A. �— <br /> _ LAVATORY(WASH BASIN) UNIT HE�TERS—B.T.U. M � <br /> __ SHOWEH CLOTHESDRYERS —�— <br /> KITCHEN SINK&DISP VENTILATION FAN � <br /> DISHWASHFR —T RANGE HOOD —T— <br /> LAUNDRYTIiAY WATER HEATER <br /> CLOTHES WASHER WOODSTOVE ; <br /> URINAL METAL FIREPLACE(WOOD BURNING) —� <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HE�T PUMP �— <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FP.N <br /> SINK(SERVICE—BAR.ETC.) <br /> _i—_ <br /> � <br /> — <br /> SUB TOTAL S SUB TOTAL 5 D <br /> PERMIT S PERMIT S �1 � <br /> TOTAL FEE $ TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FPONi5E1BACK P�ARSET�ACK SI�ESETB�CK PLANGMECKNUM11p[H FE[ R[CEIPiNO <br /> L/�� <br /> usezor+e �oinaea vncnNisite FEES VALUt�TION FEE <br /> '—: YES '! NO aui�owG <br /> irPEOFCONSL ��o_oFSioR�ES acueWcr r;onpmvH_u.urns <br /> �A��' �LUM9ING <br /> —�—._ <br /> 52EOFALOG. FlRESPRINNLERSREO'D PASEM.'Ni h�[CHANICAL �y� <br /> f '.. YES :-� NO --/17�_ <br /> OCCUPANCVLOAD FlPEALqRMqEOD HEIGHTLIMITAT�OH ADDITIONALPLANCHECK <br /> — _ OTHER <br /> REASON __i _ <br /> STATE BUILDINC SURCI�ARGE <br /> I <br /> INTpKEB/ PL�NS�PPROVED�V� CITY OF EVERETT PU6�IC WORKS <br /> �s�f.AL SALES <br /> onre ?i:i '. O�E IS J105 TOTAL <br /> � <br />