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APPLICATIOI. FOR CONSTRUCTI, N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: GAS ClELECTRIC O <br />259-8810 <br />I I DEMOLITION 11 COMBINATION BUILDING II MECHANICAL CI PLUMBING ❑ SIGN <br />OWNER MAAAOORE55 CITY IIP PHONE <br />E✓oAcTr doubA/G ,BiJTA/oes �' /4 z'a e,¢ P✓ nsrr W4 57P 706 o2p Ae4'LZZ <br />TENANT MAAADDRESS CRY ZIP PHONE <br />ARCHITECT CR DESIGNER MAA-ADDRESS CRY ID' PHONE <br />PLVMBWGCCNTMCi(K YAAAOIX1E59 CRY LP PHONE STATE LICENSEE <br />,-I .. YNIUt <br />rl w n enmmnu V(�AtTFRATION LI'�REPAIR I 1 DEMOLITION f_ I WOODSTOVE/FRPL INSERT I_I BUILDING RELOCATI(N <br />CoCq(fACiPERSp1AN <br />CONTRACTPRICEOF'KORN Co <br />00 <br />NONE NO. A <br />�� SSC ,9A1 A&WlXel- <br />OESCNIBEY KANOSOUAREFOOT ELYV0. D <br />a5�- sl4l <br />FTMPOSEDUSEOFBUACING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DUES NOT PRFSUME 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 I AM AUTHORIZED BY THE <br />OWNER OFJ49"PAPPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICA ON IS AD AND 1 COMPLY WITH THE STATE <br />CONTR TORS LA 18.27 WAND 296.200 WAC. <br />x Gam- �1 <br />LEGAL DE50RIPTIONOF PROPERTY ISHONN SELOWOR ATTACH FCUROOPIESI <br />LOT BLOCK a <br />PROTECT AOpf1E89 /yl a 3 - as- J <br />NDwivM wl <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-NHNDLG UNITS-H.P. <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />) <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR, ETC.) <br />T <br />SUBTOTAL 5 <br />SUBTOTAL $ <br />PERMIT 5 <br />PERMIT $ <br />TOTALFEE 8 <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />VACANT SITE <br />— I RECEIPTND. <br />7o �7 <br />BUILDING <br />V ,... <br />Mi CF CUNIB. AILWA&E <br />TIARSPRNnEn <br />AIA0PLUMBING <br />SITE OP BLDG <br />*M= <br />MECHANICAL <br />ADDITIONAL PUN CHECK <br />OCCUPANCY LWD NREITMKN <br />SPRINKLER <br />REASONFCBSPRINKLERS <br />STATE BUILDING SURCHARGE <br />y7I <br />INTAKE BY <br />PLWSAPPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />q hZ, JMI <br />LOCAL SALES <br />I TAX CODE IS 3105 <br />TOTAL <br />