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�.V, ,_. <br /> APPLi4.�►710N Ft'?R CANSTRJCTION <br /> PERMI'. , <br /> Ihe Everg�een '� <br /> � n u F CITYOF everel� , <br /> [�y evere�t e <br /> �G BUILDING DEF�ARTMENT <br /> y y�! � 25s-8870 TO BE COMPLETED IN INK— PLEASE PRINT <br /> yC� OWNER MnILA00RE55 CIiY Z�P PHONE <br /> FC T a �EANNg gpt�St 240 HEAZS-g12 ROAD EVEaEiT 98203 252-8319 <br /> 0 TENANT MAILADDRE55 CILY ZIP PMONE <br /> � <br /> 'if M hpC <br /> Hrp�y <br /> PRGMILECTOROSIGNER MAILAOORE55 CItY ZIP PHONE <br /> L�l� <br /> O H � GENERAI.GONTqRLTOR MAILAOOPE55 CRY ZIP PNONE LIGENSEs <br /> � �� MELMANICAIGONTNAGTOR MAILApORE55 CITY 21P PNONE LICENSE� � <br /> �` � RII,IABLE SEiEEP NIEPALIDBA <br /> z i..i pp�(�] nmmtwc 3810 196th St. � N8 LYNNWOOD 96036 670-1256 AROOIL*141LE <br /> 9 y PLUMBING��fTtlt A I�` MAILA�ORE55 CIiY ZIP WIONE �ICENSE• <br /> t-1 <br /> Ny <br /> C� CLASSOFWORH <br /> 0 H <br /> (7�(p ❑ NEW ❑ AUDITION C}t ALTEPATION ❑ REPAIR ❑ DEMO�ITION ❑ WOODSTOVE/FRPL INSEFT ❑ BWLDING RELOCATION <br /> TENANT IMPROVEMENT OR INTEPIOR REMO�EL UNLY GONTACi PERSON AND PMONE NO <br /> � CONTflACiPPILEOFWORM $Z�'�ZL���� <br /> H0N DESLRIOEWORKANUSOUAREi00iAGEMVOLVEO <br /> � . .._.- INSPALL GAS FURNACE AND HO'1' NIIITER TANK <br /> PPOPOSE�USE OF BU'LDING I HEREBV CERTIFY THAT 1 HAVE RF.A�AND E%AMINED 7MI5 APPLICATION AND <br /> � SFR RFSIDII`7CE KNOW?HESAMETOBETRUEANDCOFRECT.ALLPROVISIONSOFLAWSAND <br /> LEGAL OESCPIPtION DF PROPEPiY ISMOW N BELOW OF AIIACH FCUR COPIE51 OFDINANCES GOVERNING THIS T'PE OP WORK W ILL BE COM PLETED WITH <br /> WHETHERSPECIFIEDHF.REIN OR NOT.THEGRANTINGOFAPERMITDOES NOT <br /> PRESUME TO GIVF AUTHORITY TO�'IOLATE OR CANCEL THE PROVISIONS OF <br /> �or e�ocrc ov _ ANYOTHERSTATEORLOCALLF`NREGULATINGCONSiRUCTIONORTHEPER- <br /> FORMANCE OF CONSTRUCTION,THAT I AM AUTHOHIZED BV THE OWNER OF <br /> 7HI5 PROPERTV TO PERFORM THE K'ORK FOR WHICM APPLICATION IS MADE <br /> — AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AN� <br /> 2962001NAC. <br /> SIGNRLUREOFCONiRApOROPFUiHOfi12E0AGENi OAiE <br /> X / <br /> PPOJECTPDDRESS ID ZJ_9a <br /> PPPLIC NiSCIiYtlU"NESSLILENSENOAMO�lI51NE55NAME <br /> 290 HEATF�R ROAD - <br /> f�1 PLUN.BING MFCHANICAL <br /> NO. TYPE OF FI%NflE OR ITEM FEE N6. TYPE OF EOUIPMENT FEE <br /> ' ' WATEP,CLOSET(TOILET) F/C—A/HN�LG UNITS—H.P. <br /> � BATHTUB � FORCEDAIRSVSTEh1S—BT.U9S E1A 3O. O <br /> '�' LAVATORY6'�'ASHBASIN) UNITHEATERS-6T.U. M _ <br /> SHOWER CLOTHESDRYERS _ , <br /> 1 ' KITCHEN SINK 8 DISP. VENTILl+TION FAN <br /> � <br /> DISHWASHER FNNGE HOOD <br /> 1 LAUNO7YTRAV � WATERHEFTER 6. O <br /> f CLOTHES WASHEF WOOD STOVE — <br /> URINAL METAL FIREPLACEB CHIMNEV <br /> DRINKING FOUNTAIN FIREPIACE INSERT <br /> � FLOOR DRAIN HEAT PUMP <br /> �i _ BACKFLOWPREVE.JiERS o� GASPIPING _ <br /> � ROOF DRAINS�-RAINLEADERS EXHAUST FAN <br /> �1 — <br /> SINK�SERVICE—BAR,ETC.� <br /> '� <br /> ' 1 SUBTOTAL 5 SUB70TAL 5 „$� 36. 0 <br /> '�I PERMIT 5 PERMIT 5 �S. O <br /> -. . TOTAL FEE 5 TOTAL FEE 5 (�.� S�. O <br /> fPONi5ET9FCR REARSEiBALN SIpEEETBACN PLANCNFCI(NU�IBEP � FEE AECF.IPfNO. <br /> I <br /> u5E20�+E LOiANEA vncauisire FEES VALUATION PEE <br /> ❑YES C NO <br /> BUILOIN� <br /> TYPEOFLONST. OCCUPANCYGPOOP NO.OFDWEIi_VGUNITS — -- <br /> nuOwnB�eieaun� PWMBING <br /> SIZEOFBLDG. NOAFSTORIES 05MT OGGLOAD � <br /> n v MECHANICAL 6� <br /> ❑u — <br /> H[iGHrurnrtnnorv OTHER <br /> rinESvan+KiensaEaumEo ❑ves nHo STATEBUI�DINGSURCHARGE I�' <br /> STATEENERGVSURCHARGE __ _ _ I <br /> PPPLILAt�ONFLCOY PUNSPPGR.BY <br /> PUBLIC WORKS <br /> TOTAL � J " <br />