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APPLICATIC� FOR CCUNSTRUCT'�N PERMIT � <br /> TO BE COMPLETED IN BI.ACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS ❑ELECTRIC O —1 <br /> 259-8810 <br /> DEMOLITION �( COMBINATION BUILDING I MECHANICAL PLUMBING SIGN <br /> OWNER MAILFpORESS CITY ZIP PHONE <br /> /�'I� N,., �k9.��6 l� Ave sf_ Evere�' 9g�a8' -353 —�f-�6 7 <br /> TENANT MAILADDPESS CITV 21P PHONE <br /> _�'— <br /> ARCHITECTOfl�ESIGNER MNLpDDPE55 CITY ZIP PNONE <br /> GENERFL GONiRACTOR MA�L A�DRESS CITV 21P PHONE STAiE LICENSE I � <br /> � w�re�` 1� L u oL — <br /> h1ECHANICALtONTRAGTOP MFIL AD�RESS CITY 21P PNONE ST4TE UCENSE a <br /> Ta � LT - — <br /> PWMBINGGCNTRA^,TO^n MIAlA00RE55 CI1Y ZIP PNONE STATELIGENSE• <br /> � ' ' � <br /> LLASS OF WORN <br /> �{NEW � ADDITION . ALTERATION � REPAIR . DEMOUTION � WOODSTOVEiFRPL INSERT � I BWLDING RELOCATION <br /> ,/ CONT�Ci PERSON AND PHONE NO. <br /> LONTRACTPRICEOFWOFK q�p (.p � �� ���5` 1'3- 'JzL 7 <br /> OESCRIBE 1VORK r1ND SOUARE TAGE NVOLVED <br /> � ew t✓ II <br /> OPOSEDIISEOFBU1L01NG � I HEREBV CERTIFY THAT I HAVE RE.4D AND EXAMINED THIS <br /> S. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �EGAL DESCFI ONOFPROPERiV�SHO N BEIOW OR ATTACI'FDUR GOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT I e�ocK O�J�1 _ oF �~ NOT. TH[ GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> i-"""� � ---���� AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> C f7�2_�� 'SS9 �J f �� C) a OThIER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �____ .y PERFORti1ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> _ y- /.�-�i'� OWNER OF THIS PROPFRTY TO PERFORM THE WORK FOF WHICH <br /> APPLICATION IS MADE AND I COAIPLY WITH THE STATE <br /> �/�D^ ^����/S/';� CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> ry L <br /> z �_�il 7 z/ /7/ 9� <br /> PRQIECTA�ES�D � �) � S�Gn�iunf oniE �— <br /> 2 i�, .n <br /> S.(J�C �.r CIIYBOSINESSIiLCN5EN0 <br /> PIUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) / A'C—NHNDIG UNITS—H.P. <br /> BATHTUF� � FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN! /� i UNIT!iEATERS—B.T.U. M <br /> f SHOWER � CLOTHES DHYERS i <br /> KITCHEN SINK&DISP � VENTILATION FAN <br /> � DISHWASHER � RANGE HOOD i <br /> LAUNDRYTRAY ' WATER HEATER i <br /> � CLOTHES WASHER � WOODSTOVE <br /> URINAL � METAL FIREPLACE 8�HIMNEY ' <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; ) GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ✓ <br /> SINK(SERVICE—BAH,ETC.� _ ; <br /> SUB TOTAL $ ' SUB TOTAL S ^ �_ <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ ' T01AL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACN SIDESETPACK PLANGHE\NUMBER FEE� � � AE�T�1Q /�� <br /> �� � j�j/ � �o�2 �i Y�i y <br /> use/JzonE / �or aAen � VACANT SITE FEES VALUATION FEE <br /> /�. � BUILDING 6 . �� � � <br /> i <br /> 7VPE Of GONfS.ALLOIYAbLE iYPF OF COH57.ACiUAL oCtu�aYCr xo cr W.'FwHGUxnS � <br /> ae PWIABING �jiJi <br /> -n/ ��3 / <br /> SREOFBLO NJAFSTORIES BASEMENT MEGHANICAL � �' <br /> �2�74 �'r k _— � <br /> (�GFi SF C�.q2 I N� qDDITIONALPLANCHECK i7� <br /> OLCUPRNCVLO D FIRESPRNKLERSFEO'0 MEIGHTLIMITATION <br /> N � No 7� ' �£� � �o/�) 0;= <br /> REASONiO^.bPRINNLERS <br /> STATE BUILOING SURCHARGE �`� <br /> INiAKEBY PlANSAPP,R'O.YEUOY CITY OF EVERE7T PUBLIC WORKS �(,/� � <br /> J d LOCAL SALES <br /> 3Ls4`1 <br /> TN(CODE IS 3105 TOTAL � , ; 7 <br />