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APPLICA'p'IC" 1 FOR CON�TRUGT �N PERM1�' ��� � <br /> TO BE COMPLETED IN DLACK INK—PLEASE PRINT <br /> BUILDING DEPAf�TMENT �HEATING SYSTEM: .�GAS J ELECTRIC .J I <br /> 253-8810 <br /> DEMOLITION I COMBINATION i ! BUILDING MECHANICAL i PLUMBING i SIGN <br /> 'VUlER��, I UAILADDR[55 CItY Zm PI/ONE — <br /> \ <br /> iEtlA4T MAILADORFSS CITY ZIP PHONE <br /> nRCHRECTORDE5IGNER MFILqD�RE55 qTV ZIP PHONE I <br /> GENERA�COtJTpACTOR IdAILA�OFESS CITV 21P PNOtlE STATEUCENSFu Ili <br /> fwr I <br /> IAECNFIlICALCOI CiOR IAARqDOFESti �ITY 21P Pf10NE STATELICEkSEn I <br /> �y4 �a��-F'= �� O.�cx'�'o�o ► �fu.C.. 9i9�1�i- �L63o $n6sF�tilS3c�{ <br /> PLUTA�INGGOtliRnCTOR 61�II AO�RESS GTY ZIP PHONE STATELIGENSEa <br /> CONTR�GT PRICE O�ORN��J^� � <br /> [JESCRIBE WOPK AND SOUAR[FOQI4GE INVOLVEO CONTA T SOC �NO N01� ���_ <br /> �►t�,a t�aa_oait�1 a 1ti � _ t(.3 e <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED ThiIS <br /> PPOPOSED USE OF BUILOING APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> PROVISANS OF LAWS HND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGdL�ESCRIPTIONOFPROPERTVISHOWN�ELOWORATfACHTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREW OI; <br /> �or--�Z— BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMF TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TIi[ <br /> OWNER OF THIS PflOPERTY TO PERFORM THE WOR'C FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> rnace�rnx i.o.wuMeea CONTRACTORS LAW 18.27 RCW ANG 296200 WAC. <br /> COIJS�RUQION LOAN LEN�EF.�DDRESS.TELEPHONE NUMBER <br /> PROJECT DR�E� „`.L =,�,,, ���— � � 3 <br /> '*u',��,�/ ncie <br /> ��� CiiV 0'Jb 4f SS i ICfFlSL 1.0 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A'C—AIHNDLG UNITS—H.P. ; <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVA'iORY(WASH BASIN) � UNIT HEATER��—B.T.U. M ; <br /> SHOWER � CLOTHES DR�:'�:RS <br /> KITCHEPJ SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER � RANGE HOOD T— <br /> IAUNDFiY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE ; <br /> URINAL ; MCTAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> __ BACKFLOW PREVENTERS ; ,3 GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ; <br /> SINK(SERVICE—BAR,ETC.) ; <br /> � ; <br /> � <br /> � <br /> SUB TOTA: S SUB TOTAL $ <br /> PERMIT $ PERMIT S <br /> TOTAL FEE S ; TOTAL FEE 3 <br /> FOR OFFICE USE ONLY: <br /> FRONiSETU�GH REARSEiBACK SIDESETBAGK I PL��JCHECRNUAIBER FEE RECEIPTNO. <br /> 2�5� i <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> ❑ YES ❑ NO BUILDING ', <br /> iYPEOFCONSi. NOOFSTORIES GctUanntY rmorGnFuinGmnx I <br /> caaua pLUMBING , <br /> SREOFOL�G. FIRESPRINKLERSREO'D 9ASEMENT MECHANICAL i <br /> G VES ❑ NO <br /> OCCUPANCYIOAD FIflEALARMPEO'D HEIGHiLIMITATION ADDITIONALPLANCHECK � <br /> OTHER � <br /> REASON — <br /> STATE BUILDING SURCHARGE <br /> INiAKEDY PLANSAPPROVEUOY CITY OF EVEflETT PUBLIC WORKS ' <br /> �ocn�sa�Es <br /> oq,E TAX COOE IS 3105 TOTAL <br />