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� . <br /> APPLICATIC � 1 FOR CONS7°RUCT�)N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> /� 47�93 <br /> BUILDING DEPARTMENT f HEATING SYSTEM: J GAS J ELECTRIC ❑ <br /> 259-8810 <br /> DEMOLITION COMRINATION BUILDING MECHANICAL �(PLUMBING SIGN <br /> OWNER IdA:L F�ORESS GiY ZIP PMONE <br />` C�IG.1��i�Sfo.�,� PKof� ��CS y2c�� I-�r�v7' 1�✓.x S& 33 1 -2��� <br /> TENANT MAtLF�DRE55 CITV 21P PHONE <br /> AFCHITECTOROESIGNEfl lAAIIADOPE55 CITY ZIP PHONE <br /> GENERALGONTRACTOR IdqILA�[1RE55 CITV ZIP PHONE STATE�ICENSEp <br />� MECHFNICALGONTRACTOR IAA�LADDRE55 CITV LP PHONE STATELICENSEp <br /> I' PLUMBINGGONTRFCTOR IdAILPppqES$ CITV � TIP PHONE STATEIICE�ISEa <br /> �C�„c�,� PG�� Po, �z9 ��'I���is�-s��3- 982�0 ��53-"Ll�o PILCf�P.�is9�1P <br /> CLFSS OF WORK / -� <br /> �NEW �. ADDITION ALTERATION � REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONT PEH/SON AI�D PHONE N0. a / <br /> CONTRACTPRICEOFWORN �/ �� SO/l� �S7 — �/ (�iU <br /> DESCRIBE WORN AND SOUARE F�OTAGE INVOLVE� <br /> PROPOSEDUSEOFBUIl01NG / � i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> i C3'.-c.i Q��i�,,f APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAI�ESCRIaiION OF PFOPcRTV�SHOWN�ELOW OR ATIACH FpUR COPIES) PHOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE �F <br /> WORK WILL BE :OMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AP1Y <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERfORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TI1E WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOFS LAW 1827 RCW AND 296200 WAC. <br /> � � S� � - n ^ , .— <br />( PROJECTADDPE55 S�c�+rusE i ��t G <br /> � <br /> Cnv6�9NE55 iCR�s'LN <br /> PLUMBING MECHANICA <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. 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 /> � LAVATORY(WASH BASIN) I UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRYTRAY ' WATERHEATER <br /> CLOTHES WASHER WOOD STOVE ; <br /> URINAL ; METAL FIREPLACE&CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ' <br /> FLOOR DRAIN HEAT PUMP , <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> I ROOF DRAINS—RAINLEADERS EXHAUST FAN � ; <br />�f SINK(SERVICE—BAF,ETC.) � <br /> � <br /> � <br />� � T <br /> I SUB TOTAL S i SUB TOTAL S <br />� PERMIT � PERMIT 5 � <br />' TOTAL FEE 5 TOTAL FEE S <br />! FOR OFFICE USE ONLY: <br />! FRONTSETBACK REARSETBACK SIDESETBACK PLANCH C7(NN�BER � FEE RECEIPTNO. <br /> i � <br />� USE ZONE LOT AREA VACANT SITE � F ES VALUATION FEE <br /> BLIILOING � <br /> iYPEOFCOHi5.ALL0YlABLE iYPEOFLONSTAC �AL o[cUvaKCY Aoo:o'�tiiuc.6uwr5 <br /> l ceoua pLl1MBING � <br /> i <br /> I SIZEOFOLDG. NO.OFSTORIES BASEAIENT MECHANICAL _~ <br />� i <br /> OCGUPA^'^.V LOAO FIR°SPflN:<LERS REO'D MEIGHT LIMITATION ADDITIONAL PLAN CHECK � <br /> SPRINKLER i ' <br /> I REASON FOR SPRINNlERS — � <br /> � <br /> STATE BUILDING Sl1RCHARGE i I <br /> i INTAKEBY PLANSAPPBOVEOBY CITYOFEVERETT PUBLICWORKS � I <br /> LOCAL SALES ' i <br /> I TAX CODE IS 3105 TO7AL ' I <br /> � <br />