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/�Y � <br /> APPLICATION FOR CQNSTRUCTtON �LRMIT � <br /> TO BE COMPLETED IN BL.ACK INK—PLEASE PRINT <br /> BUi_DING DEPARTMFNT HEATING SYST[M• tiAS ❑ELECTRIC O <br /> 259-8810 <br /> ❑ DEMOLITION O COMBIP�ATION �'BUILDlNG ❑MECHAIJlCAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAl1,ADDRE55 CITY ZIP PHONE <br /> �H�`Y�li;vr.v:( �`mc��.�s ��J��0 �,�'ccLiei��'aacu�22�vc,�2 �' -�3��, <br /> TENRNT � MAIL�DDRE55 CITY 21P PMONE ��`� ��OU� <br /> AR�HiTEGTORDE5IGNER MAILAD�RESS CIiY ZIP PHONE <br /> l J�n/ �_� . <br /> GENERa�CONTRACTOR M\ILADDRL55 CITY ZIP PHONE STPTF.LICENSE/ <br /> �iLYLG c.�S 42J�N�G.r ('OGG�VTl2/Ur+4T <br /> MECHAw�A�ppNTflACTOR MAILADDRE55 pTV ZIP PHONE STATEUCENSEs <br /> PWIA6INGCONTFACT07 MAILAODFESS CITY ZIP PHONE ST�TELICEN591 <br /> CONTRACT PRICE OF K9qK <br /> C i r,qIBE WOR�50 ARE�E INVOWED • �r�y>Q,L�pEpt�u�u �4� --�./`�' �/�� <br /> � Hviu (I�� 'l; T <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE O^FIWI.DING APPUCATION AND KNOW THE SAME TO BE TFUE AND CORRECT.ALL <br /> � � PROVISIONS OF LAWS AND OFDINANCES GOVERNING THIS TY��E OF <br /> LEGAL S���C^^^RI TIONOFPqpPE 7 (SHOWNBELOWORATTACMTWOCOFIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or� BLOCN aF �I'yL! �� NOT. THE GRANTING OF A PEFiM1T DOES NOT PRESUME TO CNE <br /> r'/� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> 7Y7, S � V•� OTHER STATE OR LOCAL LAW RC-GULATING CONSTRUCTION OR THE <br /> �I-. PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> (/� q3 (�-H" �3� OWNER OF THIS PROPERTY TO PEfiFORM THE WORK fOF WHICH <br /> PAPCELTAXID.NUMBEP APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> O�^• :"' � _ D CONTRACTORS LAVJ 1827 RCVJ AND 296200 WAC. <br /> _1 � <br /> COHSL ."TION LOAN LENOER.AODRESS.TELEPHONE NUMBER � � � <br /> PROJE�ADDRE25� ,-r � snrur 4 2� � <br /> ��u� /�� � LT'WSiN:SSL�CEH5E1q <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> ,7j WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. ' <br /> Z BATHTUB � ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; � <br /> I SHOWER r— ' CLOTHES DRYERS � <br /> I KITCHEN SINK 8 C�SP ; / VENTILATION FAN � <br /> I DISHWASHER � RANGE HOOD � I <br /> LAUNDRYTRAY ; WATER HEATER <br /> CLOTHES WASHER � WOODSTOVE ' <br /> URINAL ' 2 METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAW I FIREPLACE INSERT ' . <br /> FLOOR DRAIN � HEAT PUMP � ' <br /> BACKFLOW PREVENTERS ; GAS PIPING -/ C 5 �i r . ' <br /> ROOF DRAINS—RAINLEADERS � EXHAUST rAN , <br /> SINK(SERVICE—BAR,ETCJ � , I <br /> i � <br /> � � <br /> � I <br /> � <br /> i I <br /> ' SUB TOTAL $ ; SUB TOTAL 5 ; <br /> � PERMIT $ � PERMIT $ ; <br /> TOTALFEE $ ' TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONT SE�/ REAfl SE BACK � SIDE SETBACK ' / PIAN CHECK NUMBER FEE RECEIPT NO. <br /> 7 G%� 7 �i�2 � ) /i�%.S� <br /> usezone LOTAqEA VACANTSITE FEES VALUATION FEE <br /> '"v I� ScJ� ❑ YES ❑ NO �— <br /> � <br /> ivPEOFLOH57. NO.OFSTOFIES p�v,wa xo.orowFtuxGUxns BUILDING 'Z�� � ��C�� i �(� <br />� -fy-_� /) axouv � PLUMDING �. c�' /�� <br /> i�- L, <br /> SIZE OF BIOG FIFE SPflINKLERS PEO'D BASEMENT i <br /> 72t3.SSG �M1l+C..� /..I.D ❑ YES NO MECHANICAI ��/O ' Qc�) <br /> i <br /> OCCUPANC�LOAD FIflE ALAPM HEO'D HEIGHTLIMITATION ADDITIONAL PLAN CHECK � <br /> _— � i <br /> REa50N� � !J � OTHER U i O U <br /> STATE BUILDWG SURCHARGE �<,� � <br /> INTAKE 01' PLANS AP POVED BY CITY OF EIIERETT PUBLIC WORKS , � ' <br /> �J�"' �";(? <br /> I� LOCALSALES � <br /> onTe ���� R TAX CODE IS 3105 rora� y .,,— ; ��--, <br /> �c'J i <br />