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� APPLICATIO" FOR CONSTRUCT�"�N PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br />259-8810 Fi�E sE'K�t�KI.�R- <br />❑ DEMOLITION I-1 COMBINATION I I BUILDING I�MECHANICAL I'l PLUMBING I 1 SIGN <br />OWNER ' M4ILADDRE55 CIIY Zlp PHONE <br />TENANT MAILADORE55 CI�Y ZIP pIpNE <br />KRTHG-��NE ClX)2T 51 l8 S. 2ND ,�vE EVE,eER" <br />ARCHIIECTOqDESK'iNER MRI�ADORE55 GTY 21P PHONE <br />OENERA�CONiP�CTOR M111L�DORE55 CIIY ZIP PIIONC STATELIGENSE/ <br />FdIR1-Iru.1T i.K'1-IK I►K'. 21902 3Rl'U iiVEW. Pif21[� �A)!J �2^.�p �c%-743� <br />�`IUMBIN�CONiflACTOfl MAILADOqE55 <br />�C S OF WORK <br />NEW ❑ ADDITION f I ALTERATION <br />ccvrnncrra�ceoFwo� �2-O�� <br />ZIP PI/ONE <br />.. �.-._ �__._._.....��6)27 <br />CIiY 21P 1'HONE <br />I I REPAIR I I DEMOLITION I-I WOODSTOVEIFRPLINSERT I I BUILDINGRELOCATION <br />,:onrncr rensa+u+o r��or+e No. <br />IRAC`t' M�6 �21��i2"71-55�8 <br />Ab�I.T t�CR�IIJCz CA'2E <br />LEGAL DESCIiIPT10N OF POOPERTY �SIIOIVN BEIOW OR ATTACII FOIIB GOPIES) <br />LOT PLOCN pF <br />PROJECTPODPESS <br />2Nb <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SUBTOTAL S <br />PERMIT $ <br />FOR OFFICE USE ONLY: <br />FRONTSE7BACN PEAA: <br />USEZONE <br />11'1'EUf �CONIS1.�IIOWPBLE <br />i�/ <br />SIZE OF BLO(7. <br />�(�I <br />ocCUPANCYLOAO <br />C� <br />� IHSON FON SPPINNIERS <br />�ornnen <br />-�Y-��/ <br />NO. OF STORIES <br />2 <br />FIRE SPPNNLERS PEOD <br />4��• <br />PLANSAPPROVEDBY <br />FEE <br />V4CAN1 SIIE <br />acurnr�a xoao-+rtui�uxns <br />caaP I <br />BASEMENi <br />,lJb <br />HEIGNT LIMITATION <br />�- d�- ��� <br />CITY OF EVEHETT <br />LOCAL SALES <br />TAX COOE IS 3105 <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK \VILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHEfi STAiE OR LOCAL LAW R[GULl�TING COIJ:iTRUCTION OR THE <br />PERFOFiMANCE OF CONSTRUCTION. TH�T I AM AUTHORIZED BY THE <br />OWNER OF TII�S PAOPERTV TO PERFORM TH[ WORK FOR WNICN <br />APPLICATION IS MADE ANO 1 COMPLY WITH TIiC- STAT[ <br />CONTRACTORS SgYJ 18.27 RCW AND 296.200 WAC. <br />MECHANICAL <br />N0. TYPE OF <br />VENiIL�TION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE <br />PLAN CIIEGN NUANEII <br />y����o <br />FEES <br />B111L�ING <br />PLUMOING <br />MEGHANICAI <br />AUDITIONAL PLAN CH[CN <br />SP(iINKLE(i <br />STA7E UUILDING SURCHAfI� <br />PUBUC N'ORKS <br />TOTAL <br />��L� <br />❑ECEIPT NO. <br />C� ����%`i�� <br />VALUATION FEE <br />a <br />