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�1PPLICATIC��7 FOR CON�TRUCT'�lN PERMIT �N�" <br /> TO BE COMPLL'TED IN BLACK INK—PLEASE PRINT <br /> HEATIMG SYSTEM: rl GAS ❑ELECI NIC .J <br /> EUILDING DEPART�AENT — — <br /> 2�59�-88�10 <br /> �DEMOUTION `J COM�INATION BUILDING ! MECHANICAL -! PLUMBING -'. SIGN <br /> OWtIEF lAFILA�DFESS CITY LP F40NE �S � <br /> e Q N�. � ?�T/� � �0.-7-`, cu��? 3 3 z-� Shc�.� :� E �•�eh�� 98Z�1 �5 oa`� <br /> TENANT MAILAD�PESS CItY ZIP PHONE <br /> AFCNREGTOPDESIGMER MAILA�OFESS CITY ZiP PMONE <br /> GENERALCO iRACTOF MAILA�OPE55 CITY ZIP PHONE SiFT�C-LiGcNSEn <br /> '/� � �e��/ti-g7���, 9 �:=?3 <br /> M� f'C �// EK�auct� ,i� li�, � �3s�a Jok1P� f� �,. 32oa <br /> MFCHFNICALGONiRACTOR IdA�LA00RE55 � CITY ZIP PMONE STATELICENSEa <br /> P�UM IN,CONTRRCTOR IAAILl+OORESS CITY ZIP PNONE STFTEUCENSEa <br /> �� y O�Oroc7 <br /> CONiR�E OF WOFK � <br /> H �. I���5�,� a S � -5's� <br /> DESGRIBE WORN AND SOU RE POOTAGE IHVOLVED � � �, _ CONTACT PERSON AND PHONE NO. <br /> h•2 F-t G pPc-1 �i�-.�S 3onc� — — <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAiv11NED TFiIS <br /> PROepgEC tl5E OF 9UILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.f�Ll_ <br /> PROVISIONS OF L�1WS AND ORDINANCES GOVERNING THIS TYPE OF <br /> teca�oeswivnoNOFeeoaearvis,+o:+r+ee�owonnrrncNnvocoaies� lVORK WiLL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN pR <br /> NOT. THE GRFNTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOGK oF -- — AUTHORITV TO ViOLATE OR CANCEL THF PROVISIONS OF ANV <br /> GTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> __ PERFORMANCE OF CONSTRUCTION.THAT!Aht AUTHOFIZeD 6Y 1Hid <br /> OWNER OF THIS PROPERTY 10 PERFORM THE WORK FOR WHICFi <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ❑nFxei rn��;i o.r+urneee CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> /Cy,,.��,.F��iflUCT10NL ANIEN�ER.�CDRE55.TELEPNONENUM�ER � ) �L� <br /> / d0�:2 � o �IG ��C�G�.L�D�, Y l[C�t[/V�ti'(/L� ne,'� <br /> PROJEC DRESS smH mne _ <br /> n*v uuswEss ucen-c ra <br /> PLUMSIN.^a MECHAN!CAL <br /> NO. �� TVPE OF FIXTURE OR ITEM FEE N0. TYPE OF C•�UIPMENT FEE <br /> �I N1AfER CLOSET(TOILET) � A�C-NHNDLG UNITS-fI.P. i <br /> BATHTUB ; FORCED AIR SY3TEI.JS-B.T.U. M E.A. i_ <br /> LAVATORY(WASHBASIN) UNITHEATERS-B.TU. M � <br /> SHOWEA I CLOTHES DRYEPS _ ' <br /> KI'CHEN SINK 8 DISP � VENTILATION FAN �_ <br /> DISHWASHER flANGE HOOD _ <br /> LHUNDRYTRAY WATER HEATER <br /> CLO�HE�'NASHER � WOODSTOVE <br /> URINAL ' MrTAL FIREPIACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIflEPI.ACL�NSEf1T __�__ <br /> FLOOR DRAIN HFAT PUMP <br /> BACKFLOW PHEVENTERS ; uAS PIPING <br /> R90F DRAINS-RAINLEADERS _ �—�— EXHAUST FAN <br /> SINK(SERVICE-BAR,ETC.) � � - <br /> �— <br /> --- —j , <br /> —T <br /> SU�TOTAL S SUBTOTAL S __ <br /> PERMIT y PERMIT _5 �_ <br /> -- -OTALFEE S ' _ TOTALFEE S _ <br /> FQFt OFFICE USE ONLY: <br /> FECEIPI FD <br /> fR�tltiETBACK REPRSET9ACK SIDESL�6ACK PLAY[HECI<NUh1�ER FEE <br /> usezorve LOTAR'cA vticanr:;�te FF 5�� VALUATION __ ��E=� <br /> �I "ES ❑ NG � <br /> E7UILDING <br /> 1VPEOFGC:lSi. M1O.OFSTORIES P:Gd•nxtv NOO�OW[�Lrt:6u'ut5 --'—' <br /> 4P0°° VWMBING _ <br /> S12EOFOLOG. °IRESPRINKlER5FE0'D BASEMENT MECHANICAL <br /> �.�. YES i= NO — <br /> OCCUPANCYLOAU FIRE4LAFMRW�� HEIGNiIIMIT�TION <br /> ADUITIONAL PlAN CHECK <br /> . i <br /> OTHEF <br /> —�_ <br /> REASON <br /> i <br /> STATE BLI1LDItJG SURCHARGE <br /> NTAKEBY PLlNSAPPROVEDBV CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES � <br /> pq,� TAX COUE IS 31�5 TOTA� � <br />