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_. �v <br /> p APPLICATIG'� FOR CONSTRUC7''�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUI�DING DEPARTMENT HEATING SYSTEM: l.l GAS� ELECTr�IC � <br /> 259-8810 <br /> ! 1 DEMOLITION i COMBINATION � I BUILDING i �MECHANICAL i I PLUMBING f i SIGN <br /> OWNFR MAILADDPESS CIN ZIP PHONE <br /> ,Srad /�1��so-� 1222P� 6e�erl.� (�N�k ��1 M�k�l�-ro 13275 �N2- 9io7 <br /> TENANT MAIL AUDRESS CITV ZIP PNONE <br /> ARCHITECTOFDESIGNER MAILADDRESS CITY ZIP PHONE <br /> �PS�y� L��e s 2UIC "7S*'^ S+��c"fJ t� �Jti�f� �/� Z� 3 3�� 353 -os 3 / <br /> GENER CONTRACTOfl MAILADDRESS GITY ZIP PHONE S7ATELICENSER <br /> rlc� N'lksu� )202�1 �at.ly �9ik 1vJ M1�ck� �'�ro 98275 7Y2'O57i7 ��WfJI'"�"1T�!IOQW] <br /> M CHANICALCONTRPCTOR MAILAOOFESS CIN ZIP PHONE STATELICENSEN <br /> I� �fa�l�Ms�� �2�z�3 �3�.,c.11 P�k � rnHk l�eo �t�z �s �yz-85o7 6/zrrr��iE��vtzM <br /> PLUMBI GCONTflACTOR MAILA�DRESS GiV ZIP PNONE STATEIICENSEe <br /> � 's Pl,.w�lp�� S:�olro,��s(� 6�P - 1 <br /> CLASS OF WORN �J <br /> x NEW '.J ADDITION '�..i ALTERATION � '�, REPAIR '�, �� DEMOLITION I 1 W�ODSTOVEIFRPL INSERT '�. BUILDING RELOCATION <br /> CONTACTPERSONANDPHONENO. MUl7� C <br /> CONTRACTPPICEOFWOFK 1 ���'�'0/� 337- y733 -3��9—�5�� <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED �'(Z�$ M q r� . <br /> Z67lo 1���•-9 (nl(•, 4aruHP 13F� o �ri <br /> PROPOSEDUSEOF6 oiNc i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> I� �µ I � � I h APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALO SCRIPTIONOFPROPER SHOWNBELUWORA ACHFOURCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVF:lNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUl'HORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTrIER STATE OR i:OCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPEF7TY TO PERFORM THE WORI< FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> ��YL2 cJ�� GC it ti.Q X 2 . <br /> %a5�i �9 +� <br /> qt+� ,��-�u e s. �. ��e�t-f� x �� �4,� c� �v 7 Z- <br /> PPOJECTADDRE55 3iGHAtUa[ oniE <br /> � �(� O OS U¢DoUU - � i �sc�;e <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) Q � A/C—lVHNDLG UNITS—H.P. �_ ��. <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � _ <br /> SHOWER ' 'L CLOTHES DRYERS ' <br /> KITCHEN SINK&DISP / � Z VENTILATION FAN � <br /> DI£HWASHER � Z fiANGE HOOD � <br /> LAUNDRYTRAY ; 2, WATER HEATER ' <br /> Z CLOTHES WASHER � WOODLTOVE � <br /> URINAL ; METAL FIREPLACE&CHIMNEY ' ' <br /> DRINKINC FOUNTAIN � FIREPLACE IN�ERT � <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS � GAS PIPING _ � <br /> � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN _ <br /> SINK(SERVICE—BAR.ETC.)� � � <br /> i r: Y7 I � �ih " _ <br /> � B i <br /> i � <br /> i _—� <br /> SUB TOTAL $ ;— SUB TOTAL $ ; — <br /> PERMIT $ � PERMIT $ � _ � <br /> TOiAI FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: �a-t � ���� <br /> FRONTSETBACK AERRSETBAGK SIDESETBACK PLANCHECKNUMBER FEE RELEIPTNO. <br /> `�' r- / ,5� 3s 9� . ���. av (0333 <br /> us � LOTARE� VACANTS�IT/E FEES VALUATION FEE <br /> I� BUILDING � (J �V ��� <br /> ttPEOFCONT5.p0.fIWABLE iVPE FWNST.pCTUAL occUPANtr x0ovowFluNGUNrtS _, i <br /> y-y�� � 'rJ7J � �P PLUMBING � � <br /> _�d�lv —d—� � <br /> �31'IDSF�iG'�� NO.oFSTORiES BASErnENT MECHANICAL 2(J' � <br /> � 2 �D ADDITIONAL PLAN CHECK �' i � <br /> OCCl1PANCY L AD FIRE SPRNKLERS REQ'D HEIGH LIM��S � � <br /> u a�o ' <br /> SPRINKLER � <br /> REASON FOR SPFINKLERS O <br /> STATE BUILDING SURCHARGE �, i <br /> INTANEBV PLANSAPPROVEDBY CITYOFEYERETT PUBLICWORKS �Q � DO <br /> LOCALSALES � <br /> 23 L �/�/, TAX CODE IS 3105 Torn� �a � ; � ? <br />