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. APPLICATI�i FOR CONSTRUC7�N PERMIT � <br /> ' TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> ��ap HEATING SYSTEM: U GAS ❑ELECTRIC �_.L/o�+� �II <br /> H BUILDING DEPARTMENT <br /> _. 259-8810 I <br /> s�� � DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING ' SIGN �' <br /> t� <br /> u ONMER MAILRODRESS CIiV ZIP PHONE ���L ZS7'L•(��V <br /> � C��v�sT��e �� NenL Izi�{- �iaTl, J�z S,E. Lal(� STe�e�.s , 7PZi�r aa�1-�s�sb <br /> �f]� TEN�NT MAIL RDDRESS CITV ZIP PHONE <br /> {-1 ICCSSU �` ol2C� .S.4rrl� <br /> �W� �RCHITEC ORDESIGNER MAILADDPESS GITY ZiP PHONE <br /> � GENERRLCONTNRCiOR MAILRDORE55 CiTY 21P PHONE STRTELILENSEs <br /> ON <br /> �� MECH�NICALCONTPACTOR MAIIADORE55 CITY Z�P PMONE STqTEIICENSE• <br /> Q� <br /> �y PLUMBINGCONTRPCTOR MAILRDDRESS LITY 21P PNONE STATELICCNS[• <br /> ~ CLASSOFWORN <br /> �� ��. �, NEW � -. ADDITION � ALTERATION REPAIR DEMOLITION WOODSTOVE;FRPLINSERT �BUILDINGRELOCATION � <br /> � CONt�GT P[RSON AND PNONE NO. <br /> CONTR�CT PqIGE OF WORK Sn rn Z. CC S C) w�� °L� <br /> y OESCRIBEWORK�Np50URREFOpiAGEINVOIVED � <br /> � <br /> —. . . �ELOCnTG CS�reSso �-A.CT — 80 5 .FT. i <br /> PROPOSEDUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND ERAMWED THIS � <br /> APPUCATION AND KNOW THE SAME TO BE TRUE AND CORi7ECL ALL <br /> IEGRLDESCR�PTIONOFPROPERTY�SN014N0[1O1Y0R�TTAGHFOUR�OPIES� PROVISIONSOFLAWSANDORDINANCESGO`lERNINGTHISTYPEOF <br /> tor aiocK Z y�00 oF I-I�w�1C /� �a. WORK WILL BE COMPLETED WITH\VHETHER SPECIFIED HEREIN OR I� <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRES�IME TO GIVE I <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV ' <br /> OTHER STATE OR LOC�AL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUiHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO pERFORM THE WORK FOR WHICH 'i <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE �� <br /> CONTRACTORSLAW18.27RCW AND296200 WAC. <br /> Z�o� x CC,._�—�C, �t�,..� �sl � 1 y L <br /> PPQIEGT�DDRE55 <�:naoui per[ <br /> /� OZ3lo09 <br /> ��� ✓, �a�/}-t) ���.�- b�-�,�L. . �onnusoirss�rcKs�mu ' . <br /> 1 ' PLUMBING MECHANICAL <br /> � N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—ArHNDLG UNITS—H.P. � <br /> '�' BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. � <br /> 1_' LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> 1 DISHWASHER RANGE HOOD , <br /> ' IAUNDRYTRAY WATERHEATER �i <br /> CLOTHES WASHER WOOD STOVE <br /> '� , URINAL METAL FIHEPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN FIREPLACE INSERT I <br /> 1� FLOOR DRAIN HEAT PUMP <br /> �' BACKFLOW PREVENTERS GAS PIPING <br /> '_' ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> 1 <br /> '� — <br /> 1 ' ' <br /> SUBTOTAL 5 SUBTOTAL S <br /> � � PERMIT 5 PERMIT S <br /> �- �� TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> FqONTSETBACN RERFSETOACN SIpESETBRCK PLANGNECKI�UMBE'P/ FEE � PCCEIPTNO. <br /> p� �r v � .3P��'Y� <br /> USEZONE �oTaaen WCANi51IE FEES VALUATION FEE <br /> _T_ <br /> C+ 7 U BUILDING <br /> IYVEOfCONiS.AIIOWRBtE tYPEO(LONSI.RLNAI attcwocr boG�c�cmke�,���s — <br /> \ , L°ar .— PLUh1BING <br /> \l -� <br /> SIiEOFBIDG. NOAFS oPtEs EMENT MECHANICAL <br /> OCCUPANCVLOA� FiRESPqNKLERSFEOD NPGHtUfARATION ADDIiIONALPLANCMECK <br /> � 2 / <br /> � J7 SPRINKLER <br /> REA WN FOR SPRINKLERS — <br /> STATE BUILDING SURCHARGE <br /> INTAK[BY PUNS APPROVE BY CITY OF EVERE7T PUBLIC WORKS <br /> „/ j� LOCAL SALES <br /> �`/ "/,�s 9 TAX COUE IS 3105 TOTAL <br />