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. __ _ . �. . .-�_ <br /> APPLICATIQ�' FOR CONSTRUCT�IN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: �CAS ❑ELECTRIC i, <br /> 259•8810 <br /> ❑ DEMOLITION ❑ COMBINATION i 1 BUILDING j�MECHANICAL ❑PLUMBING ❑ SIGN <br /> OWNE//R / MAILApDRE55 CITV ZIP PHONE <br /> //.-�-✓ (.��-OtiNi�ciz ,<'_ ln �/� //'.✓vnC ��L :^��70? ,�55-//5? <br /> TENANT MAIL r1DOflE55 CITY ZIP PHONE <br /> /1J CJ..`J �_ <br /> ARCMITECTORDESIGNER MAILADDRESS CITY ZIP PHONE <br /> GENERALCONTRACTOR MRILADDRESS CRY IIP PNONE SiATELICENSEY <br /> ���o � �_ <br /> M�EC+HANICALCONTRACTOF MAILADOflE55 CITV 21P FNONE LJ 9— STATELICENSE� <br /> `� O�f-i�'C. E-T�_ G JS�.SFk'�.iC L. :_' ?Z Fi /%"'JF'[L S� f✓i�E ;r' S'�$_?o/ 4/.S 7 C f'/�'r'G!,>S c PG L 7 <br /> PLUMBINGCONTRACTOR MAILADORESS CITY 21P PFOVE STATELICENSEI <br /> CONTIt�CT PFICE OF WORK <br /> c����, o a <br /> DESCRIBE WORK AND SOURRE FOOTAGE INVOLVEO CCNTACT PEFSON AND PNONE NO. <br /> ` n' �� ��$ $' - C9�g 7 <br /> � -�f'S �i<',✓acE'_� EF�,S��i'�E�vi <br /> I HEREBY CERTIFY THAT I HAVE READ AND CXAMINED ThIIS <br /> PROPOSEDUSEOFBIIILDING APPLICATION AND KNOW"iHE SAME TO BE TRUE AilD CORRECT.ALL <br /> PROVISIONS OF IAWS AND ORDINANCES GOVERNII�G THIS TYPE OF <br /> LEGpLDESCRIPTIONOFPROPERTV�SHOWNBELOWORATTACHTWOGOPIE51 WORK WILL BE COMPLETED WITH WHETHER SPEC��°IED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRL SUME TO GIVE <br /> �or BIJCK— OF AUTHORITV TO VIOLATE OR CANCEL THE PROVi�IONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE 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 /> PAFCEI TAX I.O.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENOER,ADDRESS.TELEPNONE NUMBEP <br /> c` <br /> L—�/ ��x___. �O - /c4�� Yy <br /> PROJECT ADDRESS sicHemr+c _ V are <br /> ��G/ 9 /l�i�,✓v,E '"f-�C_, n z e �n G- <br /> cnr ousrvcss i ieer�se eo <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. ; I <br /> BATHTUB - ; FORCED AIR SYSTEMS—B.T,U S�M E.A. <br /> ---�— <br /> LhVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLOTHES DRYERS �— <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER <br /> � RANGEHOOD —T <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOCD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BA.:KFLOW PREVENTERS � GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS ExHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; <br /> � <br /> � <br /> � � <br /> � <br /> SUB TOTAL S � SUB TOTAL 5 <br /> PERMIT 5 PERMIT 5 ' � <br /> TOTAL FEE 5 ; TOTAL FEE 5 '� <br /> FOR OFFICE USE ONLY: <br /> PRONT SETBACN RERR SETBACK SIPE SETBACK PLAN CMECK NUMBER FEE RECEIPT N0. <br /> �� 7� <br /> usezoNe �ornaen VACANTSIiE FEES VALUATION FEE <br /> ,J YES l' NO BUILDWG i <br /> 7YPEOFCONST NOAFSTORIES occoraypr nonvp�suuv,muis i � <br /> cFou� PLUMBING <br /> 512EOFBLOG. FIRESPRINKLERSREO'0 BASEMENT MECHANICAL � <br /> i i YES L� NO <br /> � <br /> OCGUPANCY LOAD FIqE ALARM REOD NEIGHT UMITATION ADDITIONAL PLAN CHECK <br /> OTHER � <br /> P[ASON --� <br /> SiATE BUILDING SUFCHA(iGE i <br /> i_ <br /> INTANE BV PLANS APPROV[OOY CITY OF EVERE7T PUBLIC WORKS <br /> LOCAL SALES <br /> on,e TAX CODE IS 3105 TO7AL � <br />