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.� _ . ,R� <br /> APPLICATI��, FOR C��IS'�'R�Jtt;T �IV PE�A!!IT 'I <br /> TO BE COMPLETED I� BLACK INK—PLEASE PRINT `����3� I <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS ❑ ELECTRIC U _. — <br /> 259-8810 <br /> DEMQLITION COMBINATION BUILDING XMECHANICAL PLUMBING SiGN <br /> GWNER b1AILA0DRE55 CITV ZIP PHONE <br /> 7�qL�y J,�n.�ps �, <br /> TENANT 61/+ILAD�RE55 CITY ZIP PHONE <br /> ARCMIT[CTOHDESIGNER MAILAU�RESS GTV ZIP PHOYE <br /> GENERALCONTRACfOF MAILAODRE55 CITY ZIP PHONE STATELICENSEN <br /> ��«y h��,� S <br /> M HAN/)ICALCO�.TRfCTO^� n MAILjODq� X / �Iul fJ�`"�'� / �'�`� / J / � '/"V�O OLLGEO 1 <br /> S r - /1 n <br /> J �'�- <br /> ��%� r v F.c � cti <br /> PLUMBING CONTRACTOR IdAIL ADORESS CITY Z� PNONE STATE LICENSE x <br /> � CLASSOFWOPK <br /> n' NEW ' - ADDITION �I ALTERPTION �� REPAIR DEMOLITION � WOODSTOVEiFRPL INSERT � � BUILDING RELOCATION <br /> GONTACT PER50�'AND PH;M[HO. <br /> � .� ��T 7y �-/�3� <br /> WNiRAGTPRICEOFWORK ���� C-pr � <br /> DESCRIBE WORK ANO SOLIARE FOOTAGE INVOIb'ED <br /> J 1�1LC Gom�alp,� 1l�� S c'�"1 <br /> PROPOS�DUSEOFfiUILDING i HEflEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> A?PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> LEGACDESCFIPTION OP PROPEftTV(SHOWN]cLC1W CRATTACH FOUR CGPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � 1 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> tor�J eioca oF _ _ NOT. THE GRANTING OF A PERMIT DOES NOT FRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROV'SIONS OF ANY <br /> � � ' OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION C9 THE <br /> — PERPORMANCE OF CONSTRUCTION.THAT I AM AUTHURIZED B�THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR �/HICH <br /> APPLICATION IS MADE AND I COMPL`.' WITH THE STATE <br /> CONTRACT RS LAW 18.27 RCW AND 296.20C WAC. <br /> 7 � -�� p� . `- �� <br /> 2 !� o X �� 7 /�/g � <br /> I °HOJEGTA�DRE55 ���":��uR[ �� <br /> I Cil�OUSirvL55'JCENSE t�0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMEP'� FEE <br /> WATER CLOSET(TOILET) FVC—AiHNDLG UNITS—H.P. <br /> - � BATHTUB FOHCED AIR SYSTEMS—B.T.L� .3t. � <br /> � LAVATOFY(WASFI BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOWER ' CIOTH�?S DRYERS ' <br /> KITCHEN SINK d DISP I VENTILATION FAN I <br /> � DISHWASHER / RANGF HGOD __ � <br /> � LAUNDRY TRAY ; WATER HEA'fER � <br /> CLOTHES WASHEF WOOD STOVE _�, <br /> � URINAL ' METAL FIREPLA:E 8 CHIMNEY ' <br /> DRINKING FOUNTAIN FIREPLACE INSEF:T __� <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; Z GAS PIPING � _ <br /> , <br /> ROOF DRAINS—RAINLEADERS i EXHAUS�i FAN � <br /> SINK(SERVICE-6AR,ETC.) � ' <br /> � ' <br /> — � <br /> � <br /> � ' <br /> � <br /> SUB TOTAL 5 ' SUB TOTAL $ ; <br /> PERMIT S PEFMIT $ � <br /> TOTAL FEE 5 TOTAL FEE� $ ' <br /> FOR OFFICE USE ONLY: <br /> FROtlTSETBACK PEARSET9ACK Si0E5E.-BACK PLANCHECKNUldBER FEE PECEIPTNO. <br /> use zoNe �oT naen VACPNT SITE FEES VALUATION FEE_�_ <br /> BUILDING <br /> TY"EOFCOHTS.PLLOWABLE n'PEOFCONSTALTOAL a[ur�Ncv NaafoWEWrvGod�s <br /> GFOUP PLUMBING <br /> 1 <br /> , SIZEOFPLDG. NO.OFSTORIEF BASEMENT MECHANICAL � <br /> i <br /> Of,Gl1PANCY LOA� FIRE SPRNKlERS REOD HEIGHT LIMITATION <br /> ADOITIONAL PLAN CHECK i <br /> i <br /> � SPRINKLER <br /> REASON FOh SPFINKLERS . <br /> STATE BUILDING SURCHARGE � � <br /> INTAKEBV PLANSAPPROVEOBV CITYOFEVERETT PU�LICWORKS I <br /> LOCAL SALES � <br /> TAX COUE IS 3105 TOTAL ' <br />