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ppPLIC�T101�FOR �ONSTRUCTI:... N PERMIT � <br /> T(: BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> J &C� I <br /> HEATING SYSTEII' �)GAS ��ELECTRIC 0 <br /> BUILDING DEPARTMENT � <br /> 259-6810 <br /> DEMOIITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> MFIL AO�RE55 Cli\' ZIP PMONE (� �J <br /> OWN[N YL �S�s—�.J 3 1 <br /> �� -u l �4L�s i����n� r'/ F�e��F�l- wr� 4k�r✓-' �/ <br /> C1�, Z�p PHONE <br /> TENAN /� AIFI'_ADDRESS <br /> �4���l PHONE <br /> CITY ZIP J <br /> ARGNIIECTORDESIGNER MAIIADORESS �C � , \ _/ , <br /> �l <br /> �� . 7f-1, I, � CITV ZIP PNONE STATEUCENSEI <br /> GENERALCO ACTO MAILADDRE55 <br /> C�rc'.ti'C' �� —� . <br /> MEGNANiCRLCOHTFRCIT'OR MPILADDRESS <br /> GITV ZIP PHONE SiATELICENSE• <br /> ������i( (r — J �' � �r �_ �( I Z�p PHONE STATELIC[NSF• <br /> PLUMBMGCONiR4CTOR <br /> MAIL ADDR�S.. ��TY <br /> O Lcv,A1 � � _ L � C� I` (!� <br /> cuss oF wor+k - � <br /> I I NEW ;xADDITION � � ALTERATION REPAIR . � DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> I CON7ACT PERSON PND PHONE NO. �p4 G <br /> 2/,(n00. — '��, �� � - ,�11 q�o_�_�Q-� <br /> CONTFACT PRiCE OF WORK n �..I. <br /> DESGR18EWONKANDSOUAREFOOTAGEINVOLVED h ��� r <br /> 1 '[ � � 0��1�� 1'p <br /> Cc'O�I�e..� � y� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSE OF BUIL it+c ' �' qppLICAT10N AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> �5 j7 — C�:�E PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEBRlDESCRIPTIONCFPROPERTV�SMOWNBELOWORATfACMFWRCOPIES� yyORK WILL BE COMPLETED WITH WHFTHER SPECIFIED HEAEIN OR <br /> �oT � fi B�ocK _� aF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � . � � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> R PERFORMANCE OF CONSTRUCTION.TNAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> �A�„` ��Cn�1Iv�7M1411�f1'QJ�°--�"'h�'�-"' APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> I�- � � � �I�� Q r '�a`}"S Aose�,$�� A� ��I�lA`� _]`"�J 7��— <br /> SN. � � rl IJs'� x�,�.��E � o.E <br /> PROJECi RDORE55 �� � <br /> O t �;C.L r.i*•nuswcssi�cFr+sErw <br /> V � MECHANICAL <br /> PLUMBING FEE NO. TYPE OF EOUIPMENT FEE <br /> NO. TVPE OF FI%TURE OR�TEM � <br /> WATER CLOSET ITOILET) � A/C—A/HNDLG UNITS—H.P. <br /> FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> BATHTUB UNITHEATERS—B.TU. M <br /> LAVATORY(WASH BASIN) - , OTHES DRYERS � <br /> SHOWER VE LATION FAN <br /> KITCHEN SINK 8 DISP RANG OOD � <br /> ISHWhSHER WATER HE ER � <br /> L NDRY TRAY y,�ppD STOVE <br /> CLO ES WASHER METAL FIREPLAC CHIMNEY � <br /> URINAL �� FIREPLACE INSERT <br /> DRINKIN OUNTAIN HEAT PUMP �— <br /> FLOOR DRAI GAS PIPING <br /> BACKFLOW PR ENTEflS EXHAUSTFAN <br /> ROOF ORAINS—R IEADERS � <br /> SINK(SERVICE—BAR. TC.) <br /> � <br /> SUB T AL $ SUB TOTAL $ <br /> PERMIT 5 <br /> FERMIT $ _ ' TOTAL FEE 8 <br /> — TOTALfEE S <br /> FOR OFFICE USE ONLY: — aeceiarno <br /> PL/hCHECKNUMBER FEE <br /> REAR SETOACN SIDE SETBACK � ` ' Z= (/�� <br /> FNON!SETBACK / / � 1 � <br /> '�Q Zp' � FEE <br /> VPCANT SITE FEES VALUATION <br /> USE 20NE LOT RREA �O n J �O J <br /> T7_� � QOQ OUILDING � S � � <br /> (1... <br /> P'PE OF CONSI.ACiUAI. OCGJP.1N:v NO OF pWFILINL�N�15 � <br /> iVPE OF CONT�ALLOWABIE ceo�o � p�UMBING � <br /> •3 ; <br /> NO.OFSTORIES BTSEMENT MECHANICAL <br /> SIZE OF BLDG ,`� <br /> G}7$ � ' V ADDITIONAL PLAN CIIFCK <br /> OCCIIPANGVIOR� FIRESPRNNLERSREOD HEIGHTUMITA�N <br /> N/a t�J SPF�NNLER ' <br /> ,� <br /> REnSON FOR SPR1r+KLERS STATE BUILDING SURCHARGE ��"� <br /> i <br /> IN7AKE0Y PLANSPPPROVE00V CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES roTn� � ' � � � <br /> � S��$ TAX COUE IS 3105 <br />