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APPL.ICATIC`1 FOR CONSTRUCT`"`)N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: � GAS ;J ELECTRIC U_ <br />BUILDING DEPARl�`.AENT <br />259-8810 <br />DEMOLITION COMBINATION IBUILDlNG IMECHANICAL ��PLUMBlNG I_i SIGN <br />OWNER MNIA�DRE55 LiIY ]iP PHONE <br />nd a.nrc �. .S`f/a So Is��e. ^ ereLT/ yPza 3 �, S'�... 37/ I <br />tENnNi MAILAU�PE�S CiiY ZiP • PHONE <br />4RCHIiECTCR�ESI[NER I.IFR40�RES5 CIIY ZIP PHONE <br />�K�Pessro h(�e,slyn ��.29 JAxkson sr tuPveri .3S�S= 320� . <br />GENERA CCNiRACTOR <br />G��d �c � <br />MECN4NICALGOYTPACTOR <br />PIUMBING <br />GONTPACT PPICE OF WORN <br />M4R ApDRESS <br />MAIL <br />dTY IiP �� � �HONE <br />i r.�v� LSVPrPT �"A, 9a�aoa <br />qTy ip PHONE <br />CITY ZIP PHONE <br />i d �n c l CON�C�^Sf]dANDP7NUEdN/ C <br />1 / �� rl ! <br />PROPOSED USE OF BUIL�ING <br />SlnqfP �s�M� r Resid n c� <br />lEGr1L ESCRIPiI NO`PHOP i`���SNO�W,NBELOWORATTACHTWOCOPIE51 <br />LOT ' OLOGI: �— OF � �w�--� � � <br />--5 �c-o�^+1t�1t�"�' <br />r- f3o <br />i s+o 0 9 0 6/'�— <br />NDER ADORESS. TELEPIIONE NU�1tlE . <br />332 s w E�PrtTj;O�'J <br />OF <br />LAVATORV�WAS� <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRYTRAY <br />,� IqI t UGbNJt • <br />�,. Geod <br />STAiE LICENSE � <br />SiATE UCENSE � <br />I HEREBY CERTIFY THAT I HAVE REAU AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINAIJCES GO`/ERNING THIS TYPE UF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEFFJRAtANI`c OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEfiTY TO PERFOFM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />NO. <br />FORCED AIR SYSTEMS--ti. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />DRINKING FOUNTAIN� � FIREPLACE IN: <br />FLOOR DRAIN HEAT PUMP <br />6ACKFLOVJ PREVENTERS ; �._� GAS PIPING <br />..--.-�:.—�o on�uicnnooc i I/I I ExHAUSTFAN <br />FOR OFFICE USE ONLY: <br />FPONTSETBA�K � AE�RSEiBA( <br />26' <br />11SEZONE ��TAR��� <br />�_Z, i2oo <br />iVPE Oi CJ!1S1 NO. OF STOR <br />FIRE SPRINKLERS PEO'D <br />N� <br />FlR[ 4LAHM PEOD <br />NV <br />pY PLANSAPPR VIqdV <br />c7 <br />DATE ,.. /... / � <br />5 <br />5 <br />S <br />SIDE SETBACK PLAN C � �M�A <br />. . .� <br />5 v-io :��.wH a <br />VACANTSITE FEES � <br />� � V�S � N� [IUILDING <br />occuo�t�v rvoaowuuxcunns -- <br />"a'3 , PLUMBING <br />BnSEMEN* � � MECHANICPL <br />' . YES 'L�F10 <br />��EiGMt LiAlrtnnoN AD�I110NAL PLAN CHECK <br />_ �� O1HER ����� <br />STATE BUILDING SURCHARGE <br />CITY OF EV:RETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />� <br />_ SUBTOTAL S /� <br />PERMIT 5 <br />TOTALFEE S <br />FEE RECEIPTNO <br />� . �S � 03 <br />VAlU:1TI0N FEE �_ <br />8378 � >lUZ <br />/% /J,I <br />� <br />--�n�'- — <br />_—_ /O///�) <br />� i'1 <br />� l� f �7 <br />