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*� 9 <br /> �/jPle;� ppp��CATI�*�'� FOR CONSTRUCT!'Ol,d PERNlIT � <br /> c� J�y.9 f TO BE COMPLETED IN BLACK INK—PLEABE PRIN i' <br /> 3 UIL�G DEPARTMENT HEATING SYSTEM�.�.1 G��'J ELET �%TR�C G <br /> 259-8810 / �T' ��c�fs <br /> ❑ DEMOLITION ❑ COMBINATION � BUILDING ❑MECHANICAL O PLUMBING ❑ SIGN <br /> OWNER MAILAODFE55 CITV ZIP PHONE <br /> X Metco Homes, Inc. 18913 Bothell �verett Hwv. Bothell, WA 98012 Phone 481 -0665 <br /> TENAII. MAILAOLaE55 . CIN ZIP PNONE <br /> AR IT TOfiOESIGNEfl IAAIL DDRE55 � CIT�I' ZIP PMONE <br /> ���.�-��,� l�/s�c7 I'«.c N<<zcc�,�,�, �� S.c����� �%<�/����� ���s��//��. <br /> GENERALCONTRACTO�i MAILAODRESS � CIN �" 21P PNONE STATELICENSEK <br /> �( Metco Homes Inc 18913 Bothell Everett Hwv Bothell . WA 98012 Phone 481 -0665 <br /> MECNANICALCONTflACTOR MAILADDflESS GTY ZIP PHONE STATELICENSER <br /> �IPfc oc ���J�1 7 <br /> PLIIhIBING LONTPACTOR MAIL ADDFiESS CITY ZIP PNONE STATE UCENSE u � <br /> CONTFACT�'"�F WORK�yo n�o � ' ����� �� <br /> U /l <br /> �ESCRIDEWOflKAND50UAREF00TA EINYOLVED CONTACTPERSONANDPHONEN ^ '' -� S' !� �v � r�_ �/7 <br /> t (/ <br /> v� h� a.�r Q o�z�C�f�- • � ' iel � �/� �/� � �'/�OG6S <br /> �C��(��((� ;�c:rinP I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDI�EOFDUILU�c �• p APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL . <br /> ��(-> 5�l/(///Z(���( PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS IYPE OF <br /> LEGnLUESCRIPTiONOFPROPERTY(SHOWNBELOWORATfACNTWOCOPIES) WORK WILL BE COMPIETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT D6ES NOT PRESUME TO GIVE <br /> �oi BLOCK-- OF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> X Merrill Creek - Phase 2 W25t OTFIER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TNE <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 STAiE <br /> PAPCELTA%I.�.NUMBEfl CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONST I�CTIONLOANLENDEfl,ADOflESS,TELEPHONENUMBER % �� — <br /> ��� �m� �� � � /��1��� l� �0_31- 4¢ <br /> PROJE DRES n ��� F=�'�f(� 5 NAiUPE o.ie <br /> CiiV Bu9�+E55 LiLENSE N0. <br /> PLUMDING MECHANIL'AL <br /> N0. TYPE OF FU(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> J, WATER CLOSET(TOILET) � A/C—A/HNDLG 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 ' CLOTHES DRVERS <br /> KITCHEN SINK&DISP � VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY WATER HEATER ' <br /> CLOTHES WASHEH � WOODSTOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING� � � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTEFS ; GAS PIPING <br /> ROOF ryRAINS—flAIKLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � � <br /> — � <br /> � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE S ' TOTAL FEE S ' ' <br /> FOR OFFICE USE ONLY: <br /> FFONTSETOACK REARSETBACK SIOESETBACK PV.IICNECKNUMBEP FEE R'cCEIPTNO. <br /> .� <br /> usEzoNe �OTARcA VAGANTSITE FEES VALUATION FEE <br /> ❑ '/ES ❑ NO OUILDING � j �'— <br /> iYPE�FGONST. NO.OFSTORIES aNvu¢Y x0.0fOWlluM1Guxni i <br /> � / �P �- PLUMBING i <br /> T <br /> SIZEOFOL06. FIqESPRINKIERSflEO'D BASEMENT MECHANICAL <br /> (�) �'� /UD ❑ YES �1 NO � <br /> OCCUPANCY LOAD FIRE ALAFM FlEO'D HEIGHT LIMITATION ADDITIONAL PLAN CHECK i <br /> I� OTHER i <br /> REASON <br /> STATE BUILDING SURCHARGE � � � ) <br /> INTAKEBY PLANSAPPROVEDBY CITYOFEVEREIT PU�LICWORKS i <br /> l�M LOCAL SALES � <br /> Dn7E 7�j �� TAX COUE IS 3105 TOTAL � i�� <br /> . �� <br />