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APPLICATIC�1 FOR CONSTRUCT�-7N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />r HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ � <br />BUIIDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION Ll BUILDING [ i MECHANICAL q pLUMBING C! SIGN <br />�/�1�5�' /:MBs�z �psa��s %'r`i %�y-�,z�L•��r�G����zr'- Z%5-��'G PHO��� 5/�5 S <br />rsy� f�fF <br />TENANT MAILAD�FESS CIiY ZIP PHONE <br />S�M�c <br />ARCHITECTOROESIGNER IAAILA�ORE55 CITV 21P PHONE <br />GENERFLCONTFAOTOR MAILADORESS CITy 21P PHONE STATELICENSEk <br />i%Ge%�/� 2 <br />MECHANICALCONTPACTOR MAILADORESS CITY ZIP PMONE STATELICENSEa <br />PLUMBINGCONTRACiOR MAllA0DRE55 CITV ZIP PHONE STATEUCENSEx <br />CONiRACT PRICE OF WOFK <br />OESCRI9E WORK AND SOl1ARE FOOTAGE INVOLVED <br />�or <br />OF BUILOING <br />5� <br />PROPERTV (SNOWN BELOW OR ATfACH TiVO COPIES� <br />BIOCK OF <br />PAFCELTAXI.O.NUM9ER <br />CONSTRUCTIONLOAN�ENDER,AOORESS,TELEPMONENUMBER <br />PROJECT ADDRESS _ J / � <br />3�l2 �. a �Z PG �j'� . <br />� PLUMBING � <br />NO. TYPE OF FI%TURE OR ITEM � I <br />� WATER CLOSET (TOILET) � <br />BATHTUB <br />LAVATORY �WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />i niwnovTonv . � <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />9ACKFLOW PREVENTERS <br />ROOF DRAMS—RAINLEAC <br />SINK (SERVICE—BAR. ETC <br />FOR OFFICE USE ONLY: <br />FRONTSETBACN REAFSETBACK <br />TYPE Of CCNST. <br />SRE O� G. <br />n � � . <br />OCLUPANCVLOAD <br />2 <br />REASON <br />INTANE BV <br />SUB TOTAL <br />PERMIT <br />NO. OF STORIES <br />FIFF. SP��I�NKLERS PEO'D <br />PIRE ALA MOREO'D <br />No <br />PLANS RPPROVEO BV <br />JM <br />onTe d.�/. �A�-. <br />CONTACT PERSON AND PMONE NO. <br />^f� � r/�� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS iYPE Or <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PP.FSUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW AEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC�TQRS LAW J827 RCW AND 296.200 WAC. <br />y,-- <br />si vn.unE <br />CRV BOSiNE55lICEN <br />MECHANICAL <br />3'/a `73 <br />I I �C-A/HNDLG UNITS-H.P. <br />! FORCEO AIR SYSTEAIS-B.T.U. M E.A. <br />DRYERS <br />ON FAN <br />; \ WATEp HEATER <br />� WOODSTOVE <br />; METAL FIREPLACE � <br />� FIREPLACE INSERT <br />HEAT PUMP <br />' GAS PIPING <br />� � EXHAUST FAN <br />VACANT SITE <br />❑ YES � O <br />O[LpCAtICV NO Of pWFLLMLpN05 <br />�ASEMFM <br />❑ YES �( NO <br />HEIGHT LIMITATION <br />CITY OF EV�itETT <br />LOCAL SALES <br />TAX C(!UE IS 3105 <br />BUILDING <br />PLUMBING <br />IdECHANICAL <br />ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />PERMIT $ � <br />TOTAL FEE $ � <br />; �y • % <br />RECEIPT NO. <br />VALUATION FEE <br />ro � <br />, �� <br />i <br />i <br />� <br />/ � <br />i <br />� <br />L ; � <br />i <br />i <br />2/2 ;�c <br />