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APPLICAT10�1 FOR GONSTRUCTI.�JN PERMIT /; � <br />70 BE C��dPLETED IN BLACK INK—PLEASE PRI�. ��� <br />HEATING SYSTEM: CI GAS ❑ ELECTRIC L] <br />BUILDING DEPARTMENT <br />259-8810 <br />! I DEMOLITION I I COMBINATION fu�BUILDING Iv(MECHANICAL ��LUM9ING I I SI�,N <br />ARCHIiECT OR DESIGNEF <br />GENBfi�L CONTRACTOR <br />�j, I-So%� <br />AIEGHA�iC�L CONIRAGtON <br />PWld01NG <br />CONTRFCT PRIC[ OF WORN <br />DESCRIBE WOi1M K AND SOUAI <br />R14�� �� <br />MPIL AODRE55 <br />MAIL ADDRE55 <br />isdat-a � ir,�.'cc <br />MML AODRE89 <br />7S Po�� D�• <br />MAIL ADDRE55 <br />:»,:.. o - SG' <br />OOTAGEINVOLVED <br />� �,.i-z. v� 7 c4 <br />CITY <br />��� %��� Sna�r, � <br />dTY <br />CITV <br />CIiY <br />I?d Si o h. c�.; <br />CIiY <br />6��=� �,. wh <br />crtv <br />ZIP <br />ZIP <br />Ii1' <br />>�=;., <br />LIP <br />zir <br />.�`.�o �'% <br />PMONE <br />P�IONf STATE LICGNSE � <br />_1.��-08/7 ('c F I u HS oGS NJ 1 <br />PINNL SI ILLIClNs1.I <br />7s'��,��i (�k'F('�r ;�a�,r� <br />PHONE STATL LICENS[ N <br />GSa-�i,� s�v�r, �p 13�/�l <br />CONTACT PERSON AN� PMONE NO. <br />i HEREBY CERTIFY TNAT I HAVE READ AND EXAMINED THIS <br />PROPOSED E OF Blll� iN�-y�i ,,� APPLICATION AND KNOW i NE SAME TO BE TRUE AND CORRECT. ALL <br />'„�,,t„p ,/a�i�.��4-��'Lt� a PROVISIOPlS OF LAWS AND ORUINANCES GOVERNING THIS TYPE OF <br />LEfpL�ESCRIPTI OFPROPERTV�SM01 OELOWORATTACH7YlOGOPI 5) 1NORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEHEIN OR <br />��� � � S�(� NOT. THE GRANTING OF A PERtd1T DOES NOT PRESUME TO GIVE <br />�or� BLOCN -- GF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAVJ REGULATING CONSTRUCTION OR THE <br />n n _ pERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WIiICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />PARCEL TAX IA. NUIdBER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />CONSTRUCTION LOAN LENOER AODRESS, TGLEPHONE NUlA9ER jjj,,,//////777 <br />v �� � �_ � _ (, �— <br />PROJECT ADDRESS � l si�ne onie <br />f/�� /� ���J CILYpUSiNC5511CCN5CN0 <br />PLUMBING MECHANICAL <br />N0. TYPE OP FIXTUFiE OR ITEM FEE NO. � TYPE OF E�UIPMENT FEE <br />WATER CLOSET(TOILET) <br />�. BATHTUB <br />3 LAVATORY (WASH BASIN) <br />SHOWER <br />� KITCHEN SINK 8 DISP <br />� DISHWASHER <br />LAUNDRYTRAY <br />j CLOTHES WASHER <br />URINAL <br />DflINKING FOUNTAIN <br />F100R DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK� ��'. <br />� �• p <br />USE20NE LOTAf <br />�-- 3 � <br />TYPF OF WNST. NO. OF <br />� <br />REASON <br />INTANE BY <br />AIC—NHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WQOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL 5 <br />PERMIT $ <br />TOTAL FEE $ ' _l_ <br />SIDESETBACN PLANCNECK <br />�, s � <br />47) � <br />FliiE SPRINKLEPS f1E0'D <br />FIRE nLAR�d REO D <br />PLANSPPPROVE�pY <br />J �v <br />DATE 'z / 9 /9$ <br />� '� YES �_l NO BUILDING <br />GI1�AId� k00FUW[1litlGU'Ii15 <br />xaur I PLUMBING <br />2-3 _ <br />�SEMEr�T / MECHANICAL <br />i�. YES I, NO <br />JGHI'LIIdITATION ADDITIONALPLANCH[CK <br />Z� OTHEF <br />STA7E �UILDING SURCHMGE <br />CITY OF EVEflETT PUBLIC WOFhS <br />�or,n� sa�Es <br />TNX CODE IS 3105 TOTAL <br />PERMIT <br />FEE <br />30 <br />REGEIPT NO. <br />����� <br />� <br />