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_ �. <br /> --- � <br /> ��:� <br />, A�'IPLIC/��1�1 FOR CONSTRUCT+�1N! pERMeT � r� <br /> TO BE COMPLETED IN BLACK ;NK—PLEASE PRINT �' <br /> �HEATING SYSTEM: � GAS ❑ELECTRIC J _� 4 �1 <br /> BUILDING DEPARTMEPJT r � <br /> 1,.. i <br /> zss-sa�n i ; <br /> DEMOLITION ' i CCMBINATIO"1 BUILDWG L 1 MECHANICAL �I PLUMBING ❑ SIGN <br /> 01'JI1ER AIAILAODRE55 CiTv ZIP PHONE � �' �� <br /> .S'«,�/�� G� �n�t irc� 3y'-" ���E �:w sT �-� 95'�91. ���) GS-�- s`ss7� <br /> TENAtJT �AAILAD�RE55 GTV ZIP PHONE <br /> SG,,, e- '� <br /> AFCHITECTORDESIGNE9 MAILADDRE55 �j��yl• GITV ZIP PHONE �� <br /> � „r,��s s��,.� /.,2N� N� 15-��-,13T S�+f}1e 98%5�S �.�^,6� 3G'.>2 -���a � <br /> bENEfil.Lf.�1NT ACTOF IdAIL0.DDRE55 CITY ZIP PHONE STATEUCENSE � <br /> _S�l;d,��� c�„�t i�a� 3y'—° A�E �y s.-�,.,ad/ 98a9� ��oY)G'S�-Sby(�S�tib�� -o��� � ,, <br /> CITV 21P PHONE STATE LICENSE a �I � <br /> 'AECNANiCALCONTRACTOR 'dAILADDRESS ,�y <br /> — f'� <br /> PLUMBINGCONTFACTOR MPILAOORESS <br /> CITY 21P PHONE STATELICENSEN <br /> F�`ti <br /> CONTRACT PfiICE OF WORK /J 'j�� <br /> __ J .�....,. � (��� g41 <br /> DE CRI�E WO��K AtID SOUAPE FOOTAGE INVOLVED CONTACT PEFSON AI�' PHONE N . �� <br /> /I(a✓�'- �. a�' Ur, f .S o �.20� �sa- s �_. <br /> ,. <br /> yG� 5 FT ���t /�Iaor � <br /> qss` sQ �r �.,� F�r i <br /> �—�� _ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ��Y., <br /> a'.oPosro us OF BUILDING APPLICATION AND KNOW THE SAME TO BE TfiUE AND CORRECT. ALL t�.- <br /> /� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF k <br /> � r� /�F9i t G <br /> �Ecn�o s�" aiaTioNOFP OPERTV�SMOYlNBELOWORHTTAGHTWOGOPIE51 WORK WILL 6E COMPLETED WITH WHETHER SPECIFIED HEREIN OR ' , <br /> NOT. THE GRAMTING OF A PERMIT DOES NOT PRESUME TO GIVE �,.;r <br /> �oT 7 e�orx ��U oF ` � � �9 AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ��.�/ 3 '� ������ ��U�/�� , OTHER STATE OR LOCAL LAW REGULATING CONS�RUCTION OR THE � <br /> �P�( !t_cc� pERFORM11ANCE OF CONSTRUCTION.TNAT I AM AUTHORR_ED BY THE <br /> -E. <br /> T�v �� �' OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICH i <br /> /J AppLICATION IS MADE AND I COMPLY W�TH THE STATE <br /> anac �rna i u Nu�+ee� CONTRACTORS LAW 7827 R�ND 296.200 WAC. ��,. <br /> q5=cx7o-c�7—oa —oy ��' <br /> cx c <br /> COYSTPl1CTI0NL0ANLENDER.ALDRESS.TELEPNONENl1lABER /J� �j �_ / � A'�-j , <br /> // � <br /> Fi'a 7ri�i` /3 �C 3�� SC✓ Ea•/P�t/1b/�4/y SS/N'07j siorvn�un[ onrz f�' <br /> i � . <br /> P�RrO�JECT ADDRE-7SS — —� ' <br /> Ggi] G�/ �^ $J� 5G✓ L�l�^/f7`�G�f�i 5' .�c:lj citvn��s�r:r:ssuccnsEr+o S . <br /> Q- MECHANICAL . <br /> PLUMBING ' TYPE OF EOUIPMENT FEE <br /> N0. TYPE OF FI%TURE OR ITEM F_F.E N0. _ , k` <br /> WhTE9 CLOSET(TOILET) I �`��� A�C—NHNDLG UNITS—H.P. ' . � <br /> BATHTUB / � � FORCED AIR SYSTEPAS—B.T.U. M E.A. ' . �� <br /> LAVATORY(WASH BASIN) � '� UNIT HEATERS—B.T.U. M ' <br /> ; �— <br /> SHOWER ' CLOTHES DRYERS ' _ <br /> KITCHEN SINK& DISP / 7 I VENTILATION FAN � � <br /> DISHWASHER / f � RANGE HOOD ' - - �' <br /> _ � WATER HEATER � <br /> LAUNDRY7RAY ' ; <br /> CLOTHES WASHER 7 � WOOD STOVE 4 <br /> � METAL FIREPLACE(WOOD BURNWG) ' _ ` <br /> URINAL ' ' <br /> DRIM<WG FOUNTAIN I FIREPLACE INSERT � ' <br /> FLOOR DRAIN � HEAT PUMP _. � - <br /> BACKFLOW PREVENTERS ; GAS PIPING i - <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) � ; <br /> , —� <br /> x � <br /> � —� <br /> SUBTOTAL C ' SUBTOTAL S I <br /> PERMIT S <br /> PERMIT 5 - - � <br /> TOTAL FEE S � J � TOTAL FEE 5 - <br /> FOR OFFICF USE ONLY: AeceiPrNo <br /> REARSETBACH, SIOESETO�N / PLANGMECNNUTA9ER fEE ,/ <br /> FRONT SETOACF./ /l/l�ti ��'f 7 f OS � <br /> T y �/ � <br /> LOTAREA� VACANTSIT FEES VALUATION FEE <br /> USEZONE � <br /> —' YES . �� NO BUILDIN3 U �C.O ^ <br /> � _ — <br /> TYPEOFLONST. NOAFSTORIES ottuvnncr i�00iowFwxGUMrtS i — II <br /> 2 °��3 PLUMBING ' <br /> �- � � � <br /> SIZE�O�L�GS� FIRESPRINKf.ER5RE0'D BASEMENT � MECHANICAL __ � � � <br /> t :_ YES itYNp � �� <br /> '4'�� �� C?�L HEicHT uMi7AnoN. /+ODITIONAL PLAN CHECK � <br /> OCC�LOAD FIPE ALARAI REOD � 7 / i <br /> � O7HER �� ' <br /> T <br /> REaSON STATE BUILDING SURCHAR�E <br /> INTAKF 9Y PLAYSAPPROYED BY CITY OF EVERETT PUB'IC WORRS � � <br /> � � LOCAL SALES �OD ' �0 <br /> oqTE ' ��j yc�, TAX COfIE IS 3105 T�T^� _ _ '� <br /> , �: _- ::. . <br /> - - ----�k <br />