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APPL6��AY1�'y� FOR COM�TRUCT��aN �ERM@T � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BilILDI�JG DEPARTMENT � HEATING SYST"cM: � J GAS J ELECTRIC J _ _ � <br /> 259-8810 <br /> DEMOLITION ; COMBINATION I ' BUILDING J t�1ECHANICAL Cl PLUMBING SIGN <br /> OWNEa M�IL40�AE55 CITV ZIP PMONE <br /> ���_�/,�(��q�x�S �//� �-/Cn�L�� 9J��3�'3 �5G �c% 73 7 <br /> 1LIrAN' IdAILADDRE55 CITY 21P PNONE <br /> �FCHITECTORDESIGNER �AFILADDRESS GTY ZIP PNONE <br /> GENERAL CONTRACTOB GIFIL AOCRE55 CITY ZIP PHONE STATE LIGENSE a <br /> �J k _L <br /> MECHANICALCCIliRPJTOR IdldLAO[IRESS CITV ZIP PMONE STATELICENSEM <br /> PLU1dBINGCONTRhCTOF MAILFDDFESS CITV ZIP PHONE STATELICENSEk <br /> WNTRACT PRIGE OP WORK <br /> 7f0(� <br /> OESCRIBEWORKAN�30UAq'cFOOTAG'cINVOLVED �^ � CONTFGTPERSONANDPHONENO <br /> I� <br /> ��nA� Sa�uG_ <br /> i HEREBY CEF��IFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BWL�ING APPLICATION AND KNOW THE SAME TO BE TRUE AND COP.RECT.ALL I <br /> S/-2 PROVISIONS OF LAWS AND ORDINAfJCES GOVERNING THIS TYP[OF � <br /> LEGAL�ESGRIPTIONOFPRO°ERTY(SHOWNBELOWOFATTACNT\'lOCOPI[S� WORK WILL BE COMPLETED WITH WHFTHER SPECIFIED HEREIN OR � <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 31VE <br /> �oT e�ocK oc — AUTHORITY TO VIOLATE OR CANCEL THE PP,OVISIONS OF ANY �, <br /> OTHER STATE OR LOCAL LAOI' fiEGULATIIJG CONSTRUCTION OR THE � <br /> PEHFORMANCE OF CGNSTHUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANU I COMPLY WITH THE STATE <br /> PARCELi�%ID.NUM�ER CONTFlACTORS LAW 18.27 RCW AND?36200 WAC. <br /> CONSTPUCTION LOAN LENOER ADDRESS.TELEPHONE NIIMBER <br /> �E/�/a �/.l<C����� �� 9- 9 -9� <br /> PROJECT ADDRESS p �L �-�-- '"''10i'E °"" <br /> � e�'//6 ��O �� JG cnvuwr��.ssuco,scr,o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OP EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A�HNDLG UNITS—H.P. <br /> BATHTUB FORCED HIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATEHS—B.T.U. M � <br /> SHOWER CLOTHESCRYERS <br /> KITCHEN SINK&DISP � VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER ' <br /> CLCTHES WASHER WOOD STOVE � <br /> URINAL ' METAI 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 /> i <br /> JUB TOTAL $ SUB TOTAL S <br /> PERMIT 5 PERMIT 3 � <br /> TOTAL FEE S TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> F;iUNiSETBACK REAFSETBAGK SIOESETBAGK PLANCHEC NU1.10[R F[E RECEIPTNO. <br /> 55/� <br /> usezorve �oTaaen vncnNrsiTe FEES VALUATION FEE <br /> � YES � NO BUILUING — <br /> iYPE0FW115T. NO.OFSTORIES Otni'.:C� no6C'Niu�i,SCnu i <br /> caou� PLUMBIIdu i <br /> SREOFBLDG. FIRESPRMKLERSREO'D BASEMENT pqECHANICAL 1 <br /> � <br /> :-1 YES ' �. NO � <br /> OCCUPANCY LOAD FIRE ALAfi�A FEC'0 HEIGHT�IMITATION nDDITIONFL PLAV CHECK i <br /> OTHER ' <br /> i <br /> REASON � � <br /> STATE BUIL�ING SUfiCHARGE <br /> INTAKE B1' PLANSAPPROVED � CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES , / � � <br /> on,e � I TAX CODE IS 3105 TOTAL [f r <br /> -, . . +r.y:. ' �^T.y�Y::y.i[ �rt- ���a���M'V��'� �'�� � �l n A�ya �f'4.���'� ���n <br /> . i'- . .yy� � <br /> r'..,�... ... ...: . 5 +'f�✓• ''r.-+.r'. N �"�^'� :.'�.y�i'�_.-1`?�}'t`_., .., <br /> 1 3 '� .J �_ _ . T.tl- " '�C < <br /> r-�::.. '� � - <br /> rn�+..A.� �iw.m� ..t.m��ki�.tL;;� . f'4'�M"� _ <br />� x � <br /> r ,ea. - x �..av.,,�,o,,,�,F,i. <br />