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A�PLICATIL�� FOR 1'�ONSTR,UC7 .ON PERMIT ��Tr <br /> TO BE COMPLETED IN BLACK INK—Pi..EASE PRINT <br /> �HEATING SYSTEM: �CI GAS J ELECTRIC � U _ _ � <br /> EUILDING DEPARTMENT <br /> 259-8810 <br /> BUILDING MECHANICAL �PLUMBING SIGN <br /> DEMOLITION COM8INATION � 1� <br /> U�yN�� @AL.AODFl[55 <br /> CiiY 21P PHOrvE <br /> -I�. .\l -' '.t[..i�. C�E"'�..� �i1°- y <br /> y (��! � � �� ��� � .�A MAIL�D�RE55 �� GIIY � ZIP PNON@ <br /> ea {9 �NANT <br /> 7 CITV 71P PHOAE <br /> p A � 4�iCHiTECTOPDF9GNEP MNL�DORE55 <br /> /�� _Gl.� �1 G� 'L t 7�f� �1) �7Z <br /> � � � l� '.•iu�..qn<.�-t� \�f' .FT� �V'- IZE�I1 � �� /hvi,_ t�•1.�� PHOLE ST�TELICENSEM <br /> GENER•0.CONiRACTOA M�ILADDR[55 <br /> CIIY ZIP <br /> .� .:��. �i ��0 7C. �_' . 1 vS ��""�I�v_�.��rO�iCN�-_ <br /> c -. ,{.�:.,:. •j � ,�.. � 1�— <br /> ��'' � 'Wl�C`•." � �..�` -'�,• ,Z � •- _ CiiY y 21P V�IONE STAT[LIC[NSEe <br /> � M � l.IFCl/ANICALCON�9ACTOR SI�ILADDRE55 <br /> N N '.-�i�41��."(�'� (. �3" ^'�� - CItY ZIV PMONE STAiELICENSCn <br /> � � � i'lU1.IBIPIGCONiRAC�OR MNLA�[1RE55 ' <br /> � O . �_�c)...St�JS . <br /> O N ('"('�l�-t�t=c I-I�arvr.��. -- <br /> M � c�nssoF�vonK _ <br /> M • � x NEW ACDITION � ALTERATION REPAIR DEMOUTION WOODSTOVE�FRPL INSERT BUILDING RELOCATI <br /> y' M � f•+•_.�I.L 7`/) Y� f ' -- CONTACTPERSONANOPHC�lE�lO - . <br /> b H '\�.�;',".::��1� ' - Ct.. .,.n.—� 3`7� --7��t2�_.. <br /> ��� p.� CONTF�CTPRICEOFWC�RKS� -I�JiUc . — �--J''- <br /> y OESCRIDE WORK AND SGU4RE FOOT4GE INVOLVED <br /> M <br /> O N �v �`-v.J,:�K-c��'11G.-�, <br /> —�- I HEFEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � � r PROPOSEOUSEOFBUIL�ING � � 7 r� <br /> / J APPUCATION AND fWOW THE SAME TO 6E TRUE AP1D CORRECT.ALL <br /> � y �� —1-� PROVISIONS OF LAWS AND ORDWANCES GOVERNING THIS TVPE OF <br /> LEG4LD[SCRIPTIONOFPROPERLY�SHOWNOELOWORNTACNFOURCOPIES� yyORK WIIL BE COtdPL6TED WITH WHETHEA SPEGFiED HEREIN OR <br /> �ot Fi� e�ocK oF ����K'� ��`��'� — NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> LC-1rvY� _ OTHER STATE OR LGCAL LAVJ REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUC1lON.THAT I AM AUTHOR2ED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOFK FOR WHICH <br /> --- APPLICATION IS IdADE AND I COMPLV WITH THE STATE <br /> CONTRA TORS LAW 1827 RCW AND 296.200 WAC. <br /> / <br /> 'J 2� � , -:.. � � �,� � <br /> —"�---�' — �4,a., �� ;�. � �,.« <br /> s�.��a, :�. <br /> PROJECiApDRE55 <br /> a.vo�s�vi:;� rsnro <br /> i� —�� PLUMBING MECHANICAL <br /> I NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � ��1� �j WATERCLOSET�TOILET) /'�� A:C—NHNDLGUNITS—H.P. _ . <br /> 1 1 BATHTUB _ ^; ( FOFiCED AIR SYSTEIdS—B.T.U. M E.A. _ <br /> / LAVAIORY(WASH BASIN) 'L-O' UNIT HEATERS—B T.U. M <br /> '�� _ ii� CLOTHESDRYERS <br /> _' s SHOWER VENTILATION FAN <br /> i � I KITCHEN SINK 8 DISP � ' I �— � <br /> '� ' DISHWASHER J � � RANGE HOOD <br /> � -- LAUNDRY TRAY � WATER HEATER <br /> i � CLOTHES W�SHER WCOD STOVE �— <br /> �� URINAL � METAL FIREPLACE 8 CHIMNEV <br /> I DRINKING FOUNThIN RFEPLACE INSERT <br /> ' FLOOR DRAIN HEAT PUMP . <br /> �. ' � BACKFLOW PREVENTERS _� GAS PIPING <br /> I �'1 ROOF DRAINS—RAWLEADERS _�_ EXHAUST FAN <br /> � � SINK(SEFVICE—BAR.ETC.) — �. � �Jil _ <br /> � — "1 l — C SL`� <br /> J �__ _ <br /> �1 � ' _ <br /> � <br /> I SUBTOTAL S SUBTOTAL S <br /> '� — PER�.41T S PERMIT 5 <br /> �t� TOTA�_FEE S <br /> �� TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> SIOESGT�4CH PLANCH[CNNUM[iER FEE PECEIPTNO. <br /> FROMSEI�ACK AEARSLIDACN 3y 7. �� � J� � <br /> �� , � 3�i Y� Y <br /> vncn�+T srte FEES VALUATION FEE <br /> USEZONEI LOTAREf � _ <br /> � BUILOING �j� �' C� <br /> iYYE0IC0105.A1 VlFB:E tYPEOFCONSfACiOt�L occqpupc� i.aa�Of:i�u•av':°s p�UMOING ��� <br /> pI].EqOFBLOG. NO.oFSionIE BaSErn[Ni MECHANICAL ��0� <br /> �V 8 I S4''�•+5�� 1�(� � ADDRIONAL PLAN CHECK L � �� <br /> � OCGUPPNCY LOAD FiRE SPRNK)URS RF.O-0 NEiGHT Li IT4�ON <br /> N Z SPflINKLER <br /> REASON FOP SPRINKlERS L/ i� U <br /> STATE BUILDING SURCHARGE <br /> INTANE BY PlA9S PPROVED OY CITY OF EVERETT PUBLIC WORKS Ly'�/v � <br /> i � <br /> LOCALSALES � ���� <br /> ��h TAX CODE IS 3105 TOTA� , . <br /> ,_- � <br />