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APPLICATIC 1 FOR CONSTRUC7�!9N PERMIT � <br /> 'i O BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEA7ING SYSTEM �QGAS J ELECTRIC J___ � <br /> 259-8A10 <br /> DEMOLITION I I COMBINATION xBUILDING ! ' MECHANICAL i I PLUMBING SIGN <br /> RVNFII M�ILADDiiE55 CITY ZIP PHONE �I 3 <br /> �l ', � (� S'C1SN 1� r� � .���,�_�c.0 � ,i�,n,, � �nla 7�03��-��1� <br /> �_s�i���-,�� <br /> rrunNi MML�ODRESS GI'V 1 21P PMONE <br /> ARGMIiECTORDE5IGNER � fA41L4DDPiS CITY ZIP P ON[ <br /> �rr�s�i"hTn��s ��yi8���;rn�� ������_`%�820 ! �c�� asa -iaco Tn�a�ss�5n <br /> G[NERALCONTR�C R IdfILA0URE55 CITV 21P PMOME $TATELIGENS�—� <br /> � r - �' ���c� �tl i�1P� o��aC'E {?c4�pn���—c-37 7�13�y(�:(� I�►�fAK1�le"771�5 <br /> ldEGHFNICALGOtliq�GTOfi l.fAILAODii[59 CITV I(P PHONE SiATEUCENSEn <br /> PLUMB'NGCONiRACTOR MNL��DR[SS CITV ZIP PHONE STAiEL1:3N5ER <br /> CONiRP T 'RICE OF WORK <br /> XDES;RIB�A Jp SQt A;[F(kJT�Lc irvP I V�_�o — CONTACT P[RSON ANO PNONE NO. . <br /> ..� . � �'1"r+,+;��l Ts,T� <br /> `.�,r����u:� U ' S � _ <br /> 1� ��� i HEREBY CERTIFY THAT ! HAVE READ AND EXAMI�[D THIS <br /> �x pa aoseo use eF ew�oiNc APPLICATION AND KNOW THE SAME TO 6E TRUE AND CORREC i:ALL <br /> " ��Qh�ul��re�; ���(Q PROVISIONS OF LA4'JS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �J�ecn�o cRianoNOF�v�sriowNee�owoanrrnc�irwocormsl WURK WILL BE CGMFIETED WITH WHETHER SPECIFIED HEREIN OR <br /> J� tr //����1,�}} �� �� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUNIF TO GIVE <br /> lOT—�— BLOGK OF �`1 lt{/c. {� AUI�HORITY TO VIOLATE OR CANCEL THE PROVIS�CN:i Or ANY <br /> ���n',��� �V V��_, SeU aD TV� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIOh OR THE <br /> r-- PERFORA1ANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> �! 5E Wm OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR N/HICH <br /> � 7�� ) - -- - APPLICATION IS MADE AND I COMPLY WITH 'I�HE STATE <br /> �/aa�ce�rnx i,o.mua+AEr+ ' CONTR CTO S LAW 18.27 RCW AND 296200 WAC. <br /> �� � ���- pop-DO(o,- 000��._i � . �, <br /> ,_ - __ _ , <br /> CJNSTRUCTION�-A��ENUNR.ADORF;SS.TEIEPHONENUMRER I�']� ��, ��.�1� '�7`���� i ` <br /> �.. g �,5'�'-'�0 �IA.'Iu��J[��j�� c. ' ,.� � �ti � Z. 2f v <br /> _ � <br /> PROJ�D�SS� sicr�nt�iHE �i oni[ <br /> O LiIY bU5iNL55liC[N50 NO <br /> LUMBING NICAL <br /> NO. TYPE OF FIXTURE OF��EM FEE , NO. TVPE 6F E�UIPMENT fEE <br /> �"�— WATER CLOSET(TOILET) -- "� A/C—AIHNDLG UNITS—H.P. � <br /> ^--�-- <br /> 3 BATHTUB FORCEJ AIR SYSTEMS—B.T U. M E.A. � <br /> LAVATORY(WASFI BASIN) � UNIT HGiTERS—B:i.U. M � _ <br /> Q SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK& DISP � VENTILATION FAN ' <br /> DISHWASHER % RANGE HOOD ?— <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> — � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL METAL FIREPLACE(WOOD BURNING) ; <br /> DF.INKING FOUN7AIN FIFEPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVEN7ERS GAS PIPING � <br /> ROOF DRAINS—�AINLEADERS T EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> r <br /> C' S d ' <br /> -- , <br /> SUB TUT�L S SUB TC'TAL $ ' � <br /> PERMIT S �EFMIT 5 <br /> TOTAL FEE S ' TOTAL FEE S ---� <br /> FOR OFFICE USE ONLY: ��� � <br /> FRONTSETB�GK REARSET�AGK SIOES[iB� H PI�NCHECKN@AI3ER FEE fiECEIPTN <br /> 21� � �" � �� � � � ��� <br /> usezoNe �oTnNi� / vncwr:ite FEES VALUATION FEE <br /> � S l_YES . NO BUILUING ��G3 � ' — <br /> tY?EOfWHSiI NO.CFSiORIES aeu.ae,�r uaarp;;Eiiwuuns i <br /> —� — �'0:"3 PLUMBING �, <br /> SIZEOF6LD, F:RESPRINKLERSREtrD PASEMENT � �� MECIIANICAL � <br /> 2 O� ��O }.LO _ ;-�� YES ,.�/NO — <br /> OCCUPAN Y LO�D FIiiE ALARM REO'� I HrIGMt iIMITATIGN> ADDITIONAL PLAN CHECK <br /> / <br /> _��A- _ �J I OTH[R _1C� � <br /> RE�SON ! `�/) <br /> STATE OWLDING SURCHARGE (.� <br /> ICR�KE BV PLAIlS FPP �OVW BV C;TY OF EUERETT PUBLIC WORKS �(../ � <br /> � �� LOCAL SALES <br /> I ppTp 3���9 TAX CODE IS 3105 �rora� � <br />