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l ., ; APPLICATIC 1 FnR CONSTRIJCT' �t�0 PERM�'�' �� <br />' TO BE COMPLETED IN BLACK INK—PLEASE PRINT _�irerr <br /> , �'- j..:i I. <br /> � , <br /> I •- ���„;',:s G�pt. I HEATING SYSTEM: !GAS .J ELECTRIC J _ � <br /> BUILDING DEPARTMENT -- <br /> 259-8810 <br /> DEMOLITION i COPABINATION BUILDING I � MECHANICAL xPLUMBING SIGN <br /> I OWl�Eq MMLADDFE55 CIiY ZIP PI!pHE <br /> AAL�y NOmES 53/L TurL2/•tA,.� /}�lE E� � /Q6 �E/FT7(E. 48/Od'� _��8•3�/� <br />� TENANT 1AqILA00RE55 CITY ZIP PMONE <br /> I APCHI7EGTOROESIGNER IdAIL�DOFE55 CIiY ZIP PHONE <br /> I GENERALG^NiRACTOR A141LFDDRE55 GiV ZIP PHON_ STATEI.ICR1fC:: <br />` IdECH4NIC�LLONiRACTOR M�ILFD�RESS CITV ZIP PHONE STATELICEtfz!�:: <br /> PL111.1BINGGONTq�GTOq ldAILA�ORESS CITV ZIP PHO`![ STqTELICF1itl .. <br /> pne.F� .�e��,�cr A,,.....a ,,s, sar Po Bex saa�y KF.�rrweE ala. 48oax vsa•assc PnesF,�P�t, vc�i�- -- <br />' CONTR4CT PRICE OF WORK <br /> r DESCRI�E WORN AND SOl1APE FOOTAGE INVOLVE� CONTACT PERSON ANO PHONE NO. - <br /> I <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TI115 <br /> PROPpSE�USE OF BWLDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.Al L <br /> PROVISIONS OF LAWS AND ORDIN�NCES GOVERNING THIS TYPE O� <br /> LEGALDESGRIPTIONOFPROPERTV�SHOWNBELOWOfi�TfAGHTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HER[IN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br /> ior o�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAdV REGUTATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED �Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR IVHICH <br /> APPLICATION IS MADE AND I COMPLY NlITFI TH� Sl,'�lF <br /> ❑aace�rnx i.o.Nun+oEn CONTRACTORS LAW 1827 RCW AND 296200 Wl�C <br /> CONSTRUCTIOG LOAN LEN�ER.ADDRESS,TELEFHONE NUh18ER <br /> �rD •�/iy/r-- - <br /> PROJECTADORESS ��< `,J�j� c7>.2 "���` <br /> Ca.�lo 5�0 PeACE EJe2err Cdr. • 5�8 a,.�,vs�mcssi�cir.;�i,� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF PIXTURE OR ITEM FEE NO. TYPE OF EOt11PMENT FEE <br /> �� WATER CLOSET(TOILET) A-C—NHNDLG UNITS—H.P. <br /> �j BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> ,S LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> / SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER �� RANGEHOOD <br /> LAUNDRYTRAY ; WATER HEATER <br /> CLOTHES WASHER 7 � WOOD STOVE � <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS--RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � <br /> SUB TOTAL S qg ; SUB TOTAL S _ <br /> PERMIT S •ip � PERMIT S <br /> TOTAL FEE S / q' ; TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK qEAR SET�lCK SIDE SET�ACK PLAN CN K NU�dOER PGE �F.CEIPT HO <br /> ��C � <br /> usEzoNe �ornaEn vncnNtsire FEES VAWATWN FEE <br /> . . YES � N� BUILDWG � <br /> 1VPEOFWNSi. NO.OFSTORIES or,cuoaccv r;on�l:'.t�.;�..�.�..is <br /> ''°0� PLUMBING <br /> SIZEOFBLOG. FIRESPRINKLF:RSREOD BASEldENT MECHANICAL ' <br /> � ��. YES � ' NO � <br /> ryr,GUPANCV LOAD FIflE�L�RM REO'D NEIGHi LIMITATION ADDITIONAL PLAN CHECK <br /> UTHER ' <br /> ��,:�rtr;nn <br /> --T <br /> S7ATE BUILDING SURCHAFGE <br /> ���:'��� i:� PL�NS�PPROVEDBV CITYOFEVERETT pU�LICWOFKS <br /> LOCAL SALES <br /> ,,,�� TAX COOE IS 3105 rorn� � <br /> -- — - - -- : -,�z.,-,.„. _ <br /> _ - , , : <br /> .___. ._: _ , : _� _., n�-c,f' <br />