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, APPLICATION FOR CONSTRUCT�.-QN PERMIT � <br /> :;' TO BE WMPLETED IN BLACK INK—PLEASE PRI�v i <br /> HEATING SYSTEM• ❑GAS �l ELECTRIC O � <br /> . BUIi.DING DEPARTMENT � <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION I�d BUILDING I_I MECHANICAL ❑PLUMBINO I I SIGI <br /> OWNEfl ' MAI�AODRESS GITY ZIP PHONE <br /> En ineer' s Invest. Co 18309 - 17th P1. N. W. Seattle, WA 98177 <br /> TENANT MAILADDRESS CITY ZIP PHONE - <br /> MCHITECTORDESIGNER MAILADDRESS CITv ZIP PHONE � <br /> Ch�rles Mor an & Assoc. 7301 Becerl LaneZPEverett, PW�A 98203 .sweces888 <br /> QENEflALCONTMCTOH MAILAODRESS <br /> ' CITY ZIP PHONE STATELICENSEy <br /> MECHANICALCONTMCTOR MAILADDRE55 � <br /> PIUMBINGLONTMCTOfl MAILADDFE55 <br /> CITY ZIP PHONE STATELICENSE� <br /> CUSS OF N'UFN • � <br /> C7�NEW L] ADDITION ❑ ALTERATION LJ REPAIR iJ DEMOLITION ❑ 'WOODSTOVFJFRPLINSERT,�"�O BUILDINGRELOCATI01 <br /> � CONTACT PERSON ANO PHONE NO. � <br /> C�`�RACTPRICEOFWORK Charles Moraan 206 353-2888 <br /> DESCfl�:EWOFKANU50lIAREFOOTAGEINVOLVED � . <br /> rAoroseouseoFeui�oiNa i HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THi <br /> _�artment bUi ldln - (1N i 'i $ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. A! <br /> PROVISIONS OF LAWS AND ORDINO.�:i:ES GOVERNING THIS TYPE C <br /> LEGALOESCRIPTIONOFPFOPERN(SHOWNBLLOWORATTACHFOURCOPIES� y�ORK WILL BE COMPLETED l^11TH WHETHER EPECIFI2D HEREIN C <br /> LOT BLOCK oF � NOT. THE GRANTING OF A PERMIT DOES P:OT FRF.cUME TO Gi\� <br /> � i�� �� n,/ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF A� <br /> See attached � - Y�j� OTHER STATE UR LOCAL LAW REGULATING CONSTRUCTION OR TF <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY 7H <br /> OWNER OF�THIS PROPERTY TO PEFFORM THE WORK FOR WHIC <br /> � � APPLICATION IS AfADE AND I COMPLY WITH THE STAT <br /> � CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> ' East of Y6th Ave. S. E: , x����,� ����/4S� <br /> Nnrth nf 1 1 �fh� Rt C E'r - 51GNATUNE wTE <br /> . PPOIECTADDRESS � �l — <br /> / GRV BOSINESSIICENSE NO. <br /> PLUMBING ` � MECHANICAL <br /> FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT _ <br /> WATER CLOSET(TOILET) � AI�AIHNDLG UNITS—H.R . <br /> -BATHTUB ' ; FORCED AIR SYSTEMS—B.T.U. M F..A. <br /> LAVATORI'(WASH BASIN) � UNIT HEATERS—B.T.U. M - <br /> SHOWER � CLOTHES DRYERS . � . <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER � � RANGEH000 <br /> LAUNDRYTRAY ; WATERHEATER <br /> CLOTHES WASHER • � WOOD STOVE <br /> URINAL ' ' METAL FIREPLACE 8 CHIMNEY� � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ' <br /> � FLOOR DRAIN � HEAT PUMP -• � � <br /> � BACKFLOW PREVENTERS ; GAS PIPING . ' <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN - � � <br /> SINK(SERVICE—BAR,ETC.) � �,, ; <br /> i <br /> , ID <br /> , <br /> , 1 — <br /> SUB TOTAL 5 ' SUB TOTAL S <br /> �1 PERMIT S � PERMIT $ <br /> TOTAL FEE S ; � TOTAL FEE $ <br /> FOR OFF,ICE USE ONLY: p¢cEivTr+o. <br /> FflONT6ETBACK ' REARSETBACK SIDESETBACK PLANCHECHNl1M0ER .FEE-� <br /> ao � o � .5 ' '�3� , � /// or�a <br /> 4(rtn r� <br /> USE20NE LOTAREA VACANTSITE /� <br /> F[ES —VALUATION � FEE <br /> �- � BUILOING � • s7 GJ7 L �,��-_ <br /> TVPEOFCONT5.�ILLOWABLE lYP OFCONSi.AC7UAl Ottuvex:r xo.orowauxGuxrtS i <br /> n � / 'L ouv pLUMBING ' <br /> //`- <br /> SIZEOFBlDO. NO.OFSTORIES BASE�M/ENT MECHANICAL <br /> �L y�� � " AC`DITIONAL PLAN CHECK `7 I ' rb <br /> OCCU ANCYLOAD FIRES,P/RNKLERSREO'0 HEIGHTUMITATION/ ' <br /> � l �t � � 'SPRINNtER--_ '�h1I�N'�I J � <br /> RFJ.SONFORuPRINKLERS. � � ' v <br /> 1� � ; .� S7ATEBUILDINGSURCHAFiGE � <br /> � <br /> INTAKEBV PLANSAPPROVE�BY CITYOFEVERETT PUBLICWORKS • � <br /> �� y� LOCAL SALES TOTAL " � <br /> � ,�'S- TAXCODEIS3105 �S'/J;G, <br />