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APPLICATIC''1 FOR CONSTRUCT""�1�'d PERMIT � <br />TO BE COMPLETEL� IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT L HEATING SYSTEM: '� GAS J ELECTRIC ,.J I <br />259-8810 <br />DEMOLITION COMBINA"SON �' BUILDING -�MECHANICAL /pLUMBING SIGN <br />OWNER M1IAILAODRE55 CITV ZIP PHON[ <br />��i�'Ew f�vSi�iti� . �v� 9'�iov -l9/ P/.S�. E����,�.ls ,��vzc. 7 � r-3 �v� <br />TENANT h/AI�ADDPE55 CITv IIP PI:DNE <br />ARCHRECTOqOESIGNER MAR�DORE55 CITv ZI^ PHONE <br />GENERALCONTRACTOR AIAILADDRE55 <br />S�3���-G <br />MECNFNICALCONTFqCTOR M1/AIL��ORE55 <br />Nw,_ P��;�« >>��� <br />CONTRACT PRICE,QF 1YORK / <br />1(1��.� �"l. <br />DE <br />CITV I;P <br />CITY ZIP <br />t A1 Iii2!'—l—K �.Q�i^� P �f IA U <br />PMONE <br />9f0/ � <br />SiATE LIGEIJSE • <br />�,�c /v 8n. � <br />STATE LICENSE r <br />SCRIBEWORKANDSOUAREPWTAGEmvu�vm / ' CONTACTPERSONANDFHONEtJO. <br />J ✓ I '`' � <br />HOfl�c l Z� S�r �iMr) nae.• �t��� N' �OU/v l 7�/-�j 9D� <br />L� — - <br />�,9 t N�N �� � i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />raoaoseo use UIL�ING APPLICATIQN AND KNOW THE SAME TO BE TRUE AND CORRE:.T. ALL <br />h� �'L PROVISIONS OF LAWS AND ORDINANCES �OVERNING THIS TYPE OF <br />LEGALOESCFIPiIONOFPROPEpTV�SHOWNBELOWOR/A�TTAGNTWOCOPIE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�oT# 4 e�ocK � oF S` �7-�Z- NOT. THE GR�NTING Of A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOIATE �R CANCE, TNE PROVISIUNS OF ANY <br />OTHEN STATE OR LOCAL LA.'� RFGULATING CONSTRUCTION OF TI1E <br />PERFOR�IANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR VlHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />PARGEL TAX ID. NUMBFR NTRACTO S LAW 18.27 RCW AND 296.200 WAC. <br />CONSiRUCTION LOaN L[NDER. AD�RESS. TE� FV•✓J1.c AUMBf�R ���� <br />� i iN aI /1��f i 1 un.'�-cv't d� - 1- 9=1 <br />PROJECT ADDRESS s�cn<i .nr ���c <br />� ci��nusn�Essuccr�si r,o — - — <br />PLUMBING MECFiANICAL <br />N0. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br />3 WAi ER CLOSET (TOIIET) � A'C-A�HNDLG UNITS-H.P. <br />Z BATHTUB / ; � FORCED AIR SYSTEMS-B.T.U. M E.A. -� <br />LAVATORY (WASH BASIN) // UNIT HEATERS-B.T.U. M <br />1 SHOWER � � CLOTHES DRYERS - —� <br />KITCHEN SINK 8 DISP VENTILATION FAN <br />1 DISHWASHER . --r RANGE HOOD - T— <br />LAUNDRY TRAY � WATER HEATER - <br />� CLOTHES WASHER i WOOD STOVE <br />URINAL � METAL FIREPLACE (WOOD BURNING <br />DRINKING FOUNTAIN � � FIREPIACE INSER"i . <br />FLUOR DRAIN <br />BACKFI.OW PREVENTERS <br />RUOF DRAINS-RAINLEADERS <br />SINK (SERVICE-BAR. ETC.1 <br />SUB TOTAL S <br />PERMIT $ <br />TOTALFEE � <br />FOR OFFICE USE ONLY: <br />FRONiSEB�CK � PEAR SEIOAGN � <br />�J <br />❑SEZONE LOTAHFA <br />rYFE'�oNSr !a� Rz� <br />— Z <br />S2EOF[3LDG_ , RRESPRINNLERSREO'� <br />OCGUPnNCVLO <br />�� /�� <br />IN'�NEPY PLANSAPPROVEDBY <br />-.� �' <br />�nrn G /�� /9 <br />EXHAUSTFAN <br />PLAN <br />vncnNt siTe FEES <br />. ��. YES �-� NO OUILDING <br />oct��avn r,00�ov.nin�;,i�•,rts — <br />cunur <br />{�.'3 I PWN�BING <br />BASEMENT � MEGHANICAL <br />-'' YES :✓NO <br />HEIGMTLIMITAi10% ADDITIONALPLANCNECK <br />OTHER ��O�J <br />STATE BUILDING SUFCHARGE <br />CITY OF EVEflETT pU�LIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL $ <br />PERiAIT $ <br />TOTAL FEE S <br />��d� � �� ✓_ <br />' I ai •-� <br />� <br />T <br />i� <br />Cd / <br />�— <br />� <br />�/ i <br />D' <br />—�--- <br />_(" <br />'0 i Gb <br />�O <br />; %;,') <br />/ � �il <br />