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pppLICATIC�`1 FOR CONSTRUCT")N PERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> HEATING SYSTEM GAS ']ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259-8810 �IMECHANICAL I PLUMBING ; i SIGN <br /> ' '. DEMOUTION f! COMBINATION ! BUILDING <br /> OWNER MAILAOURE55 � � <br /> LITY ZiP PMONE <br /> /yIARr/ne/Ilcr�r n__ c.,�-.��-Tr yaaoi ��9-�i30 <br /> FJI� eaS/,� /�/p�TD/� /7YC G ZIP PNONE <br /> IENANT MAILFDDRBSS ��t� <br /> AFCMITEGTORDESIGNER MPIL�D�RE55 <br /> CITY ZIP PNONE <br /> CITV ZIP PHONE STATE LICENSE� <br /> GENERALGONiFACTOR h1AILAD�RESS ,�rL�. <br /> MECMANICALCONTRAC70R IdAILAD�RE55 n <br /> CITY ZIP PHONE STATELICENSE � <br /> c. ti,/ER6Y /9��� 6�/nv Hvr' u) .lri✓�✓c✓co� 98c3G 'I7o- /S 1oLFrvSc.ESoGL .Tl�f <br /> PLUMBING GONTRACTOR MAIL ADOPE55 <br /> GTY Z�P <br /> CONTflACT PFICE Of WO K Q � <br /> 6 O CONT4LTPERSONANDPMONENO. <br /> OESCFIBE WORN AND UARG FOOTAGE INVOLVED <br /> /�_ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSEOFBUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> 'r,r� PROVISIONS OF lAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � �� WOHK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAIDESCR�PTIONOFPROPERTVISHOWN�ELOWOFPTTACHTWOCOPIES� NOT. THE GAANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE <br /> PEFFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> P�RCEI TA%I D.NUMBEP CONTRACTORS LAW 18.27 RCW AND 256.200 WAC. <br /> s' - QOj - 00 - OOd /) <br /> CONSTRULiION 104N LENOER,��DFE55.TELEPHONE NUM�EH //��'�� �y/,�/y� <br /> x i� o �E <br /> sicr,�,u�e �J.77/s/ -. <br /> PROJECT ADDRES cnreuswtssuc�rvsi �+o <br /> o�S�S oR� MECHANICAI <br /> PLUMBING fEE N0. TVPE OF EOUIPMENT FEE <br /> NO. TYPE OF FI%TURE OR ITEM ; <br /> WATER CLOSET(TOILET) � A/G—A�HNDLG UNITS—H.P. ._�— <br /> � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> BATHTUB � UNIT HEATERS—B.T.U. M ' <br /> LAVATORY(WASH BASIN) , CLOTHES DRYERS � <br /> SHOWER VENTILATION FAN <br /> KITCHEN SINK 8 DISP --- � RANGE HOOD � <br /> DISHWASHER yJATER HEATER � <br /> LAUNDRY TRAY � WOOD STOVE <br /> CLOTHES WASHER , METAL FIREPLACE(WOOD BURNING) <br /> URINAL � FIREPLACE INSERT ' <br /> DFiINKING FOUNTAIN , HEAT PUMP <br /> FLOOR DRAIN � GAS PIPING ; <br /> BACKFLOW PREVENTERS EXHAUSTFAN � <br /> ROOF DRAINS—RAINLEADERS � ' <br /> SINK(SERVICE—BAR,ETC.) � <br /> � <br /> � <br /> � — � <br /> SUB TOTAL $ � <br /> SUBTOTAL S pERMIT 5 �o <br /> TOTALI FEE 5 ' TOTAL FEE 5 7Lj' <br /> l0 5 7 <br /> FOR OFFICE USE ONLY: aecEivr No <br /> FEAR SETO�CN SI�E SETBACK <br /> PLAN CMELK NUhIBER PEE <br /> FRONTSETB�GK <br /> V�CANT$ITE FEES <br /> VALUATION FEE <br /> USEZONE ��TAAEA L_ YE'S I ! NO � <br /> OUILDING <br /> i <br /> 1YPE OF LONSi. NOAF STORIES ottur�6tr uo o�C.v[u�'��uxns <br /> c4oua PLUMBING <br /> SIZEOF�LOG. FIRESPRINKLERSPEO'0 B45EMENT MECHANICAL 1 <br /> �:� VES ��-� N� ; <br /> HEIGHTLIMITATION ADDITIONAL PL�N CH6CK <br /> OCCUPANCV LOAO FIRE ALARM REOU � <br /> OTHEF ' <br /> REnsort S7ATE BUILDING SURCHARGE � <br /> INTPHE�V PLANSAPPROVED�Y CITY OF EVEflETT Pl1BLIG WORKS � <br /> LOCAL SALES <br /> onTE <br /> TAX CODEIS 3105 TOTAL <br />