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o� <br /> APPLICATIOi� FO1; CONSTRUCYII .�! PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS CJ ELFCTRIC U <br /> 259-8810 <br /> DEMOUTION COMBINATION BUILDING MECHANICAI_ PLUMBING SIGN <br /> c1'�s�r �,Nes I•ik_ 3Z`fUt—�va-/�K c �tS /�'/c� 3"ZE�'--377C� ' <br /> TENANT MAILADDRESS CRV ?IP PHUNE <br /> �,,,r�r <br /> AqCHIiEC70flDESIGNER h1AILAD�PESS CITY ZIP PPONE <br /> f�-��SEa ��22 -��� S75W LyNN�..��� 9&�s� 7�t 3-/7�D <br /> GENERALCONTRACTOR MAILA�DRESS CITV ZIP PHONE STATEUCSNSEN <br /> IAECNANICALCONTRACTOR MAILFDORESS CITY ZIP PHONE STFTELICENSEp <br /> P�UMBINGGONTRACTOR h1AILA0�RFS5 CITV ZIP PHONE STATELICENSEa I <br /> ' CLA"�OFWOflK <br /> �EW ��. i ADDITION � ALTERATION REPAIR DEMOLITION VJOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTACT PERSO4 AND PHONE N0. 2 p 2 <br /> GONTRACT PPICE OF WOFK � �.x`jf�/j�T L,JZ[/ � J��Q <br /> OESCRI9E WOFK ANO S�UARE FOOTAGE INVOWED <br /> PROPOSE�USEOFBUILDING i H�REBY CERTIFY THAT I HAVE READ AND EXAMINED 7HI5 <br /> AFPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> �.LGAL�ESCflIPTIONOPPROPERTY�SHOWNBELOWORARFCHFOUfiGOPIES� �ROVISIONSOFLAWSANDORDINANCESGOVEPNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITN WHETHER SPECIFIED HEREIN OR <br /> �or B.00K oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV[ <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AN'I <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BY THE <br /> ON'NER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLI�ATION IS MADE AND I COMPLY WITH THE Si1TE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> �,'�� s/z��z <br /> PROJECT AD�RESS scr n'�nt �nrE <br /> l — /� Li cu.ousr.t-ss�.e,ccseno <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUHE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TJILET) A�C—A/HNDLG UNITS—H.P. <br /> - BATHTl1B ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SIUK 8 DISP ; VENTILATION FAN <br /> DISHWASHFR � RANGE HOOD �— <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN � FIREPIACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVE lTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR, ETC.) <br /> � <br /> � <br /> SUB TOTAL 5 SUB TOTAL S <br /> PERMIT $ � PERMIT $ <br /> TOTAL FEE $ TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBAGK SIOE SETB�CN PLnN CNECK NUMBER FEE RECEIPT N0. <br /> � �v � 3m9�,�. <br /> usezorue �orae[n VACANTSITE FEES VALUATION FEE <br /> – � ��_v � � � BUILDING 5 VU � ' UO <br /> TYPEOFCONiS.AILOWABLE TYPEOFGONSi.ACiUAL acture�,cr NoavowEu'NGwurs — <br /> cnou� � pLUMBING <br /> -/ -iV .3 <br /> SIZEOFBIOG. NOAFSTORIE BASEMENT MECHANICAL , � <br /> / C- <br /> OCCU A' /NCVLOAD FIRE SPRNK��S REOD HEIGHT LIM� ION ADDITIONAL PLAN CHECK � � . .� <br /> /� A/A SPRINKLER ' <br /> FEFSON ORSPRINKLERS - <br /> STATE BUILOING SURCHARGE �SU <br /> INiAK[BV PLANSAPPROVEDBY CITY OF EVERETT PUBLIC WORKS � <br /> J� LOCAL SALES <br /> �,�� TAX CODE IS 3105 TOTAL <br /> - r ,. _ _ •� <br /> � ., `°'"` ahhM �� ' y� .. rx.'". :, "'W� ' x,. }�� <br /> K�. �'_k-''�w�,.��' '�� �: ,� ��' '�" . y� 4 .. � . <br /> � <br /> =� w..,+^' e.s ..._. . . . x. c h,� . <br /> .. ,. .,. . ._. , <br /> e .. <br /> . . , .. ,� ...:_ . . . . ._ <br /> Ms . <br /> .� ; ,�,. _ . . ' su� ' _ <br /> , .. ..+r' .uk_ -,....+ <br /> -0 . .}�I�� <br /> � � . M ��3L�.,�'�} 5{ <br /> .:. : (. r. „ . <br /> u�� <br /> .. <br /> :. . ... i � .��.. . •�. r:. . ._ <.�.:. .�� ' ' <br /> � � <br /> . _ . . .._ . . -T'� � �" <br /> _ _ �' <br /> _ � ._ --_ -_ _. . �._.G., -. ..<. c:_: ..- <br /> ....._._ .. __ _.-;+.,..�.� �'.'. ' ._.»� Yt-�'x': <br />