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APPLICATIC 1 FOR CONSTRUCT'"lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: J GAS ']ELECTRIC U <br /> 259-8810 <br /> DEMOLITION � COMBINATION � I BUILDING I MECHANICAL I I PLUMBING I SIGN <br /> owNEn r.mi�nooness � arv zia rr�oN �s`c7_3 S S/ <br /> CC,��iy� °1���v�ntia.7�" oz-2 a � -e.�,err.P,�i` a,��'. �-Ce�•� 98s �� � <br /> 1EN4NI IANL�D�R[SS CIiY ZIP PuONE <br /> �RG/IRECTOf10E51GNER MAILFODRESS GIiY 71P PMONE <br /> r� <br /> GENEMnIC�ON,TR�ACIOf�n ^ MAILAOOPE55 G7Y 'IP P'dONE STATELICENSEe ♦ <br /> � � ,w( �����H� <br /> IdECNANIC�LGONTRACIOR AtAll�00RE55 CITV ZIP P��ONE STATELIGENSEe <br /> �� <br /> PWM1IBINGCONTRACTOR MMLApORES$ CITY ZIP PI/ONE STATELICENSEe <br /> !'�- <br /> CONTR�CT PPICE OF WORK �D 0, n c I <br /> '� �y, °�e,w�,� -2 � 9- 3 s s / <br /> DESCiiI�E WURK�ND SOUAPE FOOTAGE INVOLVED GONTqCT PERSON�ND PMONE N0. I <br /> ��(/f p� � / OYi �l.P.GJ ��� <br /> 3 ��I: T �� S . FT I HEREBV CERTIFI' THAT I HAVE READ AND EXAMINED THIS <br /> Papov Tsq eouseoFeuaoiNc� I R AAo APPLICATION AND KNOW THE SAME TO BE 7RUE AND CORRECT.ALL <br /> .pnp2Qj��fQ y�� ����t-. PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> iecn�oescF.il�fIONOFPR EnrvisNow �ELOWOfl�TTACMTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. ThIE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> l0T- BLOGN oF AUTHORITY TO JIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTH[R STATE OR LOCAL LAW pEGULATING CONSTHUCTION OR THE <br /> PERFOR�7ANCE 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'fAX I D.NlIMBEF CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> � <br /> CONSTaUCTIONLO�NLENDER.ADUflESS.TElEPMO NURIDER <br /> -- � 3 /� �u. x �� �U�e.�'�- �,�a�93/ <br /> pRf�IECTADDRESS s�cH.ronc w�� � <br /> cnv ousiNcss uu wr rvo <br />� PWMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EDUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—A�HNOLG UNITS—H.P. <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.LU. M _� <br /> SHOWER ' CLOTHES DRYERS ' ' ,I <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; - � '�� <br /> DISHWASHER RAN�E HOOD <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE <br /> URINAI ; METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOF DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.� ; <br /> � � <br /> � <br /> � <br /> SUB TOTAL 5 ' SUB TOTAL S <br /> PEAMIT S PERMIT S � <br /> TOTALFEE S ' TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBRLK PEARSETBACK SIOESETB4CK PLANCHEC NUM9EL1 FEE �ECEIPiNO <br /> a�a�� <br /> usezorvE iornaen VAC�NTSRE FEES VALUATION FEE <br /> ,� YES :–I NO BUILDING �7 ; � <br /> IYPEOFCON57. NOOFSTORtES DCturaqrr r,00rpnFuir:cc!;��5 � <br /> caour pLUM81NG � <br /> SIZE OF�LDQ FIPE SPR:NKLEFS REO'D BASEMENT � <br /> MECHANICAL <br /> �-1 YES ,: NO <br /> OCCUPANCYL040 FIREALARIAFEOD NEIGNTLIId1TAilON ADDITIONALPLANCHECK i <br /> OTHER ' <br /> REASON <br /> STATE BUII.DING SURCH�RGE �� � jiJ <br /> IIITANE DY PLANSAPPROVED BY CITY OF EVERETT PUBLIC WORKS <br /> LOCALSALES <br /> OATE TAX CODE IS 3105 rora� � r ;,�` � <br />