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APPLICATIC �J FOR CONSTRU�C7^JN PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �r� <br /> BUILDING DEPAflTMENT HEATING SYSTEM: ❑GAS ��ELECTRIC ❑ <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER IdAILADDRE55 GTY ZIP PHONE <br /> /�/J.v��� � - ,l���/Z ,?6Gl �I1CKSriJ /-ve�cl{ �'iv.7G3 34 '7 /oZli� <br /> TENFNi MAILqODRE55 CIiV ZIP PNONE <br /> ARCHITECTOPDESIGNER lAAILADOFESS CRY ZIP PHONE <br /> (7 U t n%'c� <br /> GENERALCONTRACTOF ldAILAODFESS CITV ZIP PHONE STATELICENSE> <br /> O�%vNl=1� <br /> MECHANICALCONTRFCTOR MAILADDRE55 CITV ZIP PHONE ST�TELICENSEa <br /> � w�Jl�1� <br /> PIUMBINGCONTR�CiOR MAILAODRE55 CITV ZIP PHONE STATELICENS[> <br /> CU�N�I'2 <br /> CLASS OF WORH <br /> NEW :v ADDITION . ALTERATION . REPAIR . DEMOLITION WOOGSTOVE/FRPL INSERT BUILDING RELOCATION <br /> L� � GI ZGD �G CONTACT PERSON AND PHONE N0. <br /> / / <br /> CONTRACT PflICE OF Y/OFK �j G �D� <br /> DESCRIBE WORK FND SOUARE FOOTAGE NVOLVED <br /> PODLir�.J /,3 /;U s5 rl-, <br /> PROPOSEDUSEOFBUIL�ING^ I HEREBV CERTIFV THAT I NAVE READ AND EXAMINED THIS <br /> n,_(/J^CLt=i✓4 APPLICATION AWD KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL�ESCRIPTIONOFPROPERTV ISHOWNBELOYlORATT�CHFOURCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or,�1 3-�, 3¢ e�ocK 7�;9 11-OooF LNF N✓? T ZU C NOT. THE GRANTING OF A PERMIT DOES NOT PRE511ME TO GIVE <br /> , AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORM1IANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CO,.IPLY WITH THE STATE <br /> CONI"9ACTORS LAW 1827 RCW AND 296.200 WAC. <br /> PRU!ECTAODRE55 � sC::�+ �u��o-. � �. ��� Y/�/ /� <br /> /� ontr <br /> 2 �� �l.iC�, � urv m��ir:[s9 ucen�.E uo <br /> PLUMBING M[CHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A�C—A�HNDLG UNITS—H.P. <br /> BATHTUB / ; FORCED AIR SYSTEMS-9.T.U. M E.A. <br /> LAVATORY(WASH BASIN) i UNIT HEATERS—B.T.U. M <br /> ( SHOWER � � CLOTHES DRYERS <br /> I KITCHEN SINK& DISP r; VENTILATION FAN <br /> / DISHWASHER — RANGE HOOD <br /> LAUNDRYTRAY � WqTEfl HEATER <br /> � CLOTHES WASHER /'� WOOD STOVE <br /> URINAL METAL FIREPLACE&CHIMNEY � <br /> DRINKING FOUNTAIIJ FIREPLACE INSERT <br /> FLOOR DRAIN � HE.�T PUMP �— <br /> BACKFLOW FREVENTERS GAS PIPING <br /> ROOF DRAINS—RAWLEADERS � EXHAUST FAN I <br /> SINK(SEFVICE—BAR,ETC.) � <br /> l/1 �9 <br /> / <br /> �— <br /> SUB T07AL S / SUB TOTAL S <br /> PERMIT $ PERMIT S i <br /> TOTALFEE $ TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> FRONiSETBACK REARSET�ACK SNESET9ACN PLANCH[C'NUTABER FEE qECEIPTNO. <br /> � � � 7 30 ,5 �7 �9- <br /> usezor+e LOTAPEA vncnNrsite FEES VALUATION FEE <br /> i _� � <br /> �� BUILDING �y � a JU �/j��J� <br /> iYPE F C�N75.AI�I,O/WABLE ivPE OF CONSi.AC1lIAL Occucnvc ho or OwEwnewu�s <br /> V — I�J V " /�✓ Gp�1 PWMBING ' <br /> i <br /> SIZE OF BLOG. NOAF STORIES BASEMENT � <br /> I�I � ��'Y t, n �O MECHANICAL i <br /> V) 0 i <br /> OCCUPANClLOAO FIRESP NNLERSFEO'D NEIGHTLIMIiATION ADDITIONALPUINCHECK �- <br /> n�o Z i — <br /> SPRINKLER � <br /> REASOh FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE i JG <br /> INTAH@ BY PLANS PROVEO BY CITY OF EVER[TT PUBLIC WORKS `T <br /> LOCALSALES <br /> v TAX CODE IS 3105 rorn� -n��; .— <br /> � <br /> . ; � <br /> r <br /> , <br />