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APPL.ICATI� FOR CONSTRUC7'�`�N PERMIT ��� <br /> '(O BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: �GAS ❑ELECTRIC ❑__ <br /> BUILDING D�PARTMENl' <br /> �59-8810 <br /> ❑ DEMOLITION 1=1 COMBINATION I�BUILDING i I MECHANICAL ! I PLUMBING I I SIGN <br /> OYINER MFILAD�FE55 GITY 21P PH�NE <br /> '�AuY I-4mnES 3��/a cAsrc,n,�F rpv� F Setltl�r w� 9b'iot 3LP- j�� o <br /> TENANT MAILADDNESS GITV ZIP PMONE <br /> AqCNITECTOF0E51GNEFl MAILADOPE55 CIiY 21P PHONE <br /> GENEHRICWlTRACTOfi MAILAUORESS CIiY 21P PHONE SIATELICENSEI <br /> S/I�NE AS ow ��/z DWctylfj �zO L7 <br /> MECHANICRLGONTPAGTOfi MAIIA��flESS GTY ZIP PHONE STAiEUCENSEY <br /> PLUMBING CONTRACTOR MAIL ADDfiE55 CITY 21P PNONE STA'E UCENSE M <br /> ClAS50F WORK <br /> ❑ ADDI�ION L I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVFJFRPL INSERT I I BUILDING PC-LOCATION � <br /> NEW ___ <br /> GONTACT PIERSON AND PHONE NO. <br /> CONTflhCTPflICEOF\'vORK —�Qn � Gr�ivss 3�-3 7� o <br /> OESCH�BE WORK AhJ SW AHE FOOTAGE INVOLVED C Y� <br /> N�liJ_� /�/ <br /> Pii0PO5EDl�SEOFBUIl014Gr i HEREBY CER7IFY THA7 I HAVE READ AND FXAMINED THIS <br /> 5/N�/f 7 Qsn/�y �.� 5 ICI2vi C b' APPLICATION AND KNOW THE SAME TO BE 7RUE AND CORRECT.ALL <br /> Le3AlDE5CRIP710NOFPROPERTY�SNOWNEEIOWOAATTACHFWFCOPIES) PROVISIONSOFLAWSANDQRDiNANCESGOVERNINGTHISTYP[OF <br /> WCRK WILL BF.COMPLETED WITH WHETHER SPECIfIED HEREIN OR <br />�; �ot_S_S_ e�ocK oF S/�V P/2 17UJ NOT. TH[ GRANTING OF A PERMIT DOES NOT PRESiIME TO GIVE <br /> ` AUTHORITY TO VIOLATE OR CPNCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTY TO PtRFORM THE WORK FOR WHICH <br /> _ - APPLICAT:ON IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> T r�? �t/�l/'�22� � —z/-9y' <br /> X / <br /> PROJECTADDFESS sicH ee oeie <br /> •3 8 � � .`��-O yy� E � �• cirreusir+Essuca�ser+o � <br /> PLUMBING MECHANICAL <br /> NO. 'fYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPiNENT FEE <br /> WATER CLOSET(TOILET) A/C—luHD1�LG UNITS—H.P. � <br /> BATHTUE� ; � FORCED AIR S�STEMS—B.T.U. M E.A. ' _ <br /> LAVATORY(WASH BASIN) � UNIi HEATERS—B.T.U. M � _ <br /> SI10'NER � CLOTHES CFlYEAS _ __ <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN __ ___ <br /> � OISHWASHER � FiANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE i � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY _ <br /> DRINKINv FOUNTAIN I FIREPLACE INSERT � �� <br /> FLOOR DRAIN � HcAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPItJG <br /> ROOF DRAItJS—RAINLEADEFS � EXHAUST FAN <br /> SINK(SERVICE--BAR,ETC.) � � <br /> �. , <br /> � --� <br /> _ � <br /> � SUBTOTAL $ <br /> SUB TOTAL $ � � — <br /> PERMIT $ � PERMIT S � <br /> TOTAL FEE $ ' TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: . — <br /> FPONTSETBACN REARSETBA�K SI�ES`O�GK PL�NZVECI$NUM�EA FEE __� FELEIPDS � <br /> ..�^ J �'y 7 7 � <br /> rr <br /> USEZONc LOTPREA VRCANTFITE FEES VALUATION FEE _ <br /> - 1 � � , `t� ��5��� L�� <br /> I 9 � � BUILD:4G <br /> TYPEOS:ONiS.ALLOWABLE iYPEO(CONS7.ACNAL IX[pa�r Noori[wrvtUxus � <br /> Y � PLUMBING � <br /> , <br /> ��3��p�F � NO.OFSTORIES BASEMENT MEChIANICAL _ �_ <br /> 5 Z ��p � <br /> F A�DITIONAL PLAN CHECK � <br /> OCCUPANGY LOAD FIRE SPRNKLERS REOD HEIGNT LIMITATION — <br /> r � <br /> i1 No �-- (�, C <br /> REASON FOfi SPfiINHLERS i )� <br /> STATE BUILDING SURCHARGE v <br /> INTAKEBY PIANSAPPiiOVEOBY CITY OF EVERETT PUBLIC WOFlKS %J./ i � // <br /> �J�d LOCALSALES n r� <br /> G 3 � iAX COOE I°i 3105 rora� y'"�j ;�7�' <br />