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APPLICATII .+1 FOR CONSTRUGZ �DN PERMIT ���� <br /> Tp BE COMPLETED IN fiLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS ❑ELECTRIC ❑_._ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I i DEMOLITIUN I COMBINATI7N I BUILDING MECHANICAL I ',PLUMBING i SlGN <br /> p�y/crt.F r MAILAO�RE55 / Cltt �J 21P PHONE�J <br /> l,(� aY�� L=�/OrF7� �.�Oo l ��Q�zn �.✓ 'l�O��O/ _�'� -.1Go0 <br /> TENANT MAILAD�flESS CITY ZIP PHONE <br /> �p HIiECT Of10E5�G R MAIL DDRESS CI7Y ZIP PMONE <br /> ���;� ��l'��a/� ioo �� ,�,��c2.s�� � �.�iii a�i - y%� — <br /> GENEFALCONTPALTOR MAILPODRESS CRV 21P PHONE STATELICENSEa <br /> rr�c.o C—�Uc�. Cr�s-r 4�0� C_���c. r,ce;p,.�N :.rx.. c�-���3531� <br /> MECHANIC4LC0�1TA/�TOR MnILADDRESS CITY 21P PHONE STATEUCENSE♦ <br /> .. ,�l..Lln,`�;nr» 'v✓�A `7`�ZZ�v <br /> PLUMBING C TRACTOR MAIL AODRE55 CITY ZIP rMONE STATE LILENSB n <br /> CLASS OF WORK <br /> I i NEW I_1 ADDITION � ALTERATION i �. REPAIR I '�, DEMOLITION '�. ! WOODSTOVEIFRPL INSERT . '. 4UILDING RELOCATION <br /> CONTRACTPPILEOFWORH CONTACT��SONANDP���S n��� _ qq�� <br /> l/ <br /> /jY � 0 0 <br /> DESLRIBE WORK AND SOl1ARE FOOTAGE INVOLVE� <br /> PROPOS SEOFBl11L01NG I HEP.EDY C�FTIFY THNT I HA\'E READ AND FXAMINED THIS <br /> n L � �, ? APPLICATION AND KNOW THE SA1.1E TO BE TRUE AND CORPECT.ALL <br /> �ecn�oescniar$NOf FROPERfV�SHOWN BE OW OR ATE9, H FJUF:OPIES) PROVISIONS OF LAWS AND OFiDINAN;ES GOVERIJING THIS TVPE OF <br /> WORK VJILL BE COMPLETED WITH WHETHER SPECIFIED NEPEIN QR <br /> �or siocK oF NOT. THE GRANTII�G OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORI-iY TO VIOLATF OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STA�E OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I Ald AUTHORIZED BY THE <br /> 0`NNER Of THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> AP?LICATION IS MADE AND I CO'�4PLV WITH THE STATE <br /> CCINTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> AG,"r�'z ccyvfi�%L G� �UiU�' x �,r.a aa ;��-, I?lgltiz <br /> PR0.IEL�DU ESS � . / • � ��� � � siGr+ntuaE - oniE <br /> 9 / p / <br /> 1n13 �tf�-�- A act, /� � ,L � d� ��.�a���Ess������E�o <br /> PLUMBING � MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EWUIPMENT FEE <br /> WATER CLOSET(TOI�ET) � A/C—AiHNDLG UNITS—H.P. <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> IAVAIORY(WASH BASIN) UNIT HEATERS—B.T.U. M _�_ <br /> SHOWER CLOTHES DRYERS __' <br /> KITCHEN SINK�DISP � VENTILATION FAN . <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY ' ' WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE __�_ <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' _ <br /> DPINKING FOUNTAIN FIREPLACE INSERT ____� <br /> FLOOR DRAIN HcAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING _ � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN _ <br /> ��M1K(SERVICE—BAR,ETC.) � <br /> i <br /> � -- T <br /> 1 <br /> SUB TOTAL $ ' SUB TOiAI $ <br /> �'ERMIT $ PERMIT S i <br /> TOTAL FEE $ ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FiONTSEiBACH fiEARSET�4CK SIOESETDRCH PIANCMECKNUMBER� <br /> FEE REGEIPTNO <br /> -�j 7G� <br /> usezoNe �oinaen VACANTSITE FEES VALUATION FEE <br /> {�, � <br /> BUILDING ��!7✓L �� <br /> TVPEOFC@I15ALlOWABIE TYPEOFWNSLACiUAI occoc;.vcr r.00�v.vFwnGuxirs i <br /> �� 'TY� 1 �" ° � �Y PIUMBING <br /> 11./V K/ <br /> SRE OF BLDG. N0.OF STORIES B�SEMENT�0 MECHANICAL _ <br /> Z� �� � ADDITIONAL PLAN CHECK �r � <br /> OCCUPANCYLOAD FIRESPRNKLERSFEQ'D MEIGHTLIMITATION <br /> � <br /> � /G�O SPRINNLER <br /> REASON FOR SPRINNLEPS � <br /> STATE BUILDING SURCHARGE _`_ <br /> INTAHE BY PLANS PPPROVED BY CITY OF EVERETT PUBLIC WORKS � <br /> LOCAL SALES / Cp�SD <br /> �1 h z J <br /> TAX CO�E IS 31U5 TOTAL ) ' <br />