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APPLICATIQ' � FOR CONSTRUCT'�N PERMIT ,;� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br /> cv�hFn <br /> �-- -- — --------- <br /> — - - - <br /> BUILDING DEPARTMENT �HEATING SYSTEM j(GF.S J ELECTRIC J _________ J <br /> 259-8810 <br /> DEMOLITION COMBINATION �G BUILDING I MECHANICAL I 1 PLUMBING SIGN <br /> QM(NER I ^ I.IAiI APIJOG�55 rfRY lIP FNONE -- -.. <br /> / <br /> � �5:� � o�ns � --� ,ni ?2y I �/ �, S I $�J l�,��/ ���`�L �7y� -�1�� � <br /> iENANT M�RAUORE`d QTY IIP PHpf�E C --�--�- <br /> �RCNREC70 DESiGNER IA�ILADDilE55 ( CITV 2iV ' PHONE <br /> -}' /� � � �YS�E <br /> , , �-��0�� <br /> N( - <br /> GE ERAI CONTq�C70R MM��DOP..55 CITV ZIa PNpNE �T�T!IICENSE• <br /> MECH�InCUCdRR�CTON M�IL�DDRESS GTV IIP PHONE STA1cl�G[NSE/ � <br /> PLUMB�N7CONTR�LiOR M�IL�DDRE55 G*" 21P PNONE ST�TEL�CENSE• <br /> �TR�CiPRICEOFWORN -_' . <br /> i� c7cx�) � <br /> OESCR�E O�SOu�REFOOi�OEINVOLVED CONT�C7PERSON�NDPNONENO � <br /> r , /- i � . , s <br /> C�„5��,.v'�- �� —L�_ .._� - 7 �L _ <br /> 2 - SI"� Y I10y4�_ i HEREPV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSE OF BUII OING� APPLICATION AND Y.NOW THE SAME 10 BE TRUE AND CORRECT. ALL <br /> � 5� � e�� � PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> LEG�LDES/�,�nIPTIONqFPpOPERTYISHOWNBlLOWOF�ifA�HiWOGOPIES� WOFK WILL BE COMPLETED WITH WHETHER SPECIF�ED HEREIN OR <br /> ior_lp-- g��K I � NOi. THE GFANTING OF A PERMIT DUES NOT PI?ESUME TO ;IVE <br /> �Q �Q S{�0✓� A� L/ / OTHER STATETOR LOCAL LAW REGULATING CONSTFIUCOT ON OR AH[ <br /> — PERFORMANCE OF CONSTRUCTION. THAT I AM AUTrIORRED�V T��E <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> a� ELTAMI Nu�BER APPLICATICN IS MADE AND I COMPLY WITH THE 6TMF <br /> �q �lU � CO�TRACTORS LAW�B.2�RC AND 296200 WAC <br /> CONSTRUC'10NlO�NIENDEH.A0DNE55 TEIEPMONENUMBER ��^C�`�5 � � <br /> � / a z� 9� <br /> PROJECTADDFESS .�t- lL�'-�.L��-_'� /lr)�1Jt�� <br /> :�." � nve <br /> �� S� (tivPv �1Y � <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE Oq ITEM F�" N0. TVPE OF EOUI�'MENT FEE <br /> WATER CLOSET(TOILETI A C—AHNDLG UNITS—H.P. ' <br /> EATHTl1B ' / FORCGDAIRSYSTEMS—O.TL. M E.A. � <br /> LAVATORV(WASH BASIN) —T— UNIT HEATEFS—B.T.U. M • <br /> SHOWER _ CLOTHES DRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> _ DISHWASHEfi RANGE HOOD ' � <br /> LA.iNDRV 7'R�.V ; WATER HEATER <br /> CI.OTHES WASHEF W(�OD S�OVE � <br /> URINAL METAL FIREPLACE�WOOD BURNING) - <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEAOERS EXHAUST FAN <br /> SINK(SEFVICE—BAR.ETC.) � -- <br /> � <br /> --:- <br /> SUB TOTAL $ ' SUB TOTAL E <br /> PERMIi $ —�— ?ERMIT y ' <br /> TOTAL FEE S TO7ALFEE E <br /> FOR OFFICE USE ONLY: <br /> FpJNi5ET0FC% REn��flnCK SIOESELP.�CN/ PI��YiM�n�4,lqpR� FEE 1���� RFC�PI�/� <br /> .�� j j%� L�) <br /> use zoNe ior�nee WC�Nt SrtE FEFS VALUATION FEE <br /> �~ VES NO <br /> — � 9UILOING — ��� �I 2 7 „�I .) <br /> Iv�f Ot(ONSt NO OF S1ORiES rcmvµrr �o nrpy;fu 4a ir,4 ----- 1Y.{ <br /> �" PIUMBING <br /> .�-�� 2 �-3 - _.. �� ; �z:> <br /> 9 F O�,gL�iF � FIRE SPRINNIECS REOD 9�5[vES vNO MFCNANICAL �n j <br /> z 's �en /vJ _ _ ,,.� <br /> oJCUPANCYLOAM iIRERLANMRF.O[t HEimrtuMiin➢oN AJ�ITIONALPLANCHECN <br /> �N N An' f`�,Q f i <br /> '•- "� OTHEH <br /> RE�SON �L7 �L�' � <br /> ___ _ <br /> STA1F.BUILOING SURCHAHGE _� . - <br /> MLqKE BV P�ANS�PPpOVED AV CIiY OF EVERETT vueuc woAks <br /> LOCALSALES r"` ,'G; � <br /> _ ��.,�� TAX CODE IS 3105 TOTAL � <br />