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APPLICA4IG: FOR CONSTRU�7'",N PERMIT � <br /> TO BE COMFLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM• U GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> �DEMOLITION Ll COMBINATION C BUILDING ❑MECHANICAI �PLUMBING ❑ SIGN <br /> rNONE � �oa <br /> MAILADDfiESS ^ ` ���1� q n � � <br /> � � cm ' Z� �L 9�i�y 3 �i �— <br /> E�u.�- /a� �C� 73 '3 a S .�'.f,�.. <br /> �[ TEHANT � M /�DOj�ES� CITV ZIP PHONE <br /> � � y s� S� , CITV ZIP PHONE <br /> �RCHITECTOROESIGNER MAILAODRE55 <br /> P NE STATELICENSE! <br /> G NEFUL TR�CTUR MARAOD ESS �/ n9 �a ,,,�ry /J� � Z�P �� /)�(/� LulSON��OS� ✓�� <br /> x��. ���� Ca�sz� t,�i �o T <br /> ��n, Z�p PHONE STATE L NSE• <br /> MECHANICRLCONTRRCTOR MAILADOHESS �q//„_q / <br /> « i ry 7 <br /> ��n, Z�p PHONE STATELICENSE• ' <br /> PLUMBINGCONTFACTOR MAILAUORESS <br /> ./ CpNTMCT X:'cO�W�K <br /> /� <br /> DESCRIBE WO �NO SOUFNt FOOTRGE INVOLVEO <br /> CONTACT PERSON AND PHONE NO. <br /> T�- i.t_. 3a i' " oa <br /> P ti <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE eui�oa+ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDESCRIPTONOFPROPERTY(SMOWNBELOWORATTACHTNOCOPIES� WORK WILL BE COMPLETED WITH WHEIHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK oF AUTHORITY 1'O VIOLATE OR CANCEL THE PP.OVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING 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 /> PARCEL T I.D.NUMBEfi CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> /�� OS O� DDo7 <br /> LONSTRUCTIONLOANLENOEFl.N)DRESS.TELEPHONENUM�ER q-�a <br /> Y o e � <br /> SIpNATURE <br /> PROJE�DORESS �- � ��ryg�yNE554CEN5EN0. <br /> P <br /> ��B'� MECHANICAL FET— <br /> � FFE NO. TYPE OF E�UIPMENT <br /> Np, TYPE OF flXTURE OR ITEM q��q�HNDL(i UNITS--H.P. ' <br /> WATER CLOSET(TOILE� , FORCED AIR SVSTEMS—B.T.U. M E.A. ' <br /> BATHTUB � UNIT HEATERS—B.T.IJ. M ' <br /> LAVATORY(WASH dASIN) , CLOTHES DRYERS � <br /> SHOWER ---- � VENTILATION FAN ' <br /> KITCHEN SINK 8 DISP � pANGE HOOD � <br /> DISHWASHERi � WATER HEATER <br /> LAUNDRY TRAY � yyppD STOVE � <br /> CLOTHES WASHER , METAI FIREPLACE(WO�D BURNING) � <br /> URINAL � FIREPLACE INSERT —� <br /> DRINKING FOUNTAIN , HEAT PUMP � . <br /> FLOOR DRAIN � GAS PIPING � <br /> BACKFLOW PREVENTERS � EXHAUSTFAN � <br /> ROOF DRAINS—RAINLEADERS � ' <br /> � SINK(SERVICE—BAR,ETC.) ' � <br /> � , <br /> i , <br /> , SUB TOTAL S 1� � <br /> SUBTOTAI $ � pERM1T 8 ' '�, <br /> PERMIT 8 ' � TOTAL FEE S � � <br /> TOTALFEE $ � `y� . <br /> �1 One f:d-f�r� <br /> FOR OFFICE JSE ONLY: _ neceiar No. <br /> REARSETBACN SIDESETBACK PLANCMECKNUMBER ' FEE <br /> FRONTSETB�CK L��C� _l <br /> 1 S1�G FEES VALUATION FEE <br /> USE ZONE LOT AREA VACANT SITE <br />� G YES ❑ N� BUILDINCa �3 ��� � <br /> �Z �' ' <br /> NO.OFSTORIES octuvAxcr xo.Mm'�KUNcuxrts � <br /> TYPEOFCONST. caou� pLUMBING � <br /> // FIRES�INKLFRSREO'D BASEMENT MECHANICAL � <br /> s¢e oF e�oc. ❑ YES C3'�10 Z � <br /> 1 gS1 Nv HEIGHTIIMITATION ADDITIONALPLANCHECK ' <br /> OCCUPANCYLOAD FIREPLPRMREO'0 � <br /> i <br /> �� Ai p OTHER ' <br /> /Y � � <br />� REASON STATE BUILDING SURCHARGE ' <br /> EX$��. � <br /> INTANE BY PLANS�PR��ED BV CITY OF EVEHETT PUBLIC WORKS � <br /> � LOCAL SALES � <br /> nn��o� L _ 9 <br /> TAX COUE IS 3105 TOT^� <br />��� _. , <br />