Laserfiche WebLink
BUILDING DEPARTMENT <br />259•8810 <br />TO BE COMPLETED IN BLACK INK—PLEASE PRIN7 ���� <br />�HEATING SYSTEM: U GAS U ELECTRIC U_ � <br />f_l DEMOLITION I I COMBINATION I I BUILDING <br />OWNER MAII��DRE55 GIfY <br />vE,�B !f /�/Y-�2_i� SE� Fu���cn <br />I I MECHANICAL f 1 PLUMBING J� SIGP <br />21P PHONE <br />TENANI MAII�UDRE55 CIIY 21P P40NE <br />�RGNITELTOfl0E51GNE11 IUIIAU�f1E55 GILV ZIP P1qNE /,jE)Q/f✓NC O{J.i�-3 <br />1gEY�k�" y' il/60it/ �'O. po BoxSzEq [ yN,cia•000 95�0�1� 776-�'�3� <br />6ENERI1lCANTOAGiON MdIL��PRE55 GIIY IIP PIIONE SU!EIIGENSE� <br />MECHANIGAICONTHAG70R M�IL�DDRE55 <br />MI1R AUDRE55 <br />GITY IIP <br />GONTf1A.:T PqICE OF VNRN O O <br />,��' /o, a3o <br />DESCRIBE WdIN AND SOU�RE FOOTAdE INVOlVEO <br />�/aB�C..'/G/4T� qN <br />/NSil�i LL (.'�, i Sc�s' o F G TTf2S •- S5'-/�I <br />Tbs'F�� e,.v n,•oQ-rN Nv ��sr w <br />2"�IS�FA./I�/) Fk"6ES'THNDin� S/4N�39.�7�� <br />PqOPOSED USE OF BUIlDINO <br />M ED /CGL L <br />IEOAL DESCRIPTION OF PIIOPEIITY �uHOWY 9ElOW �..R �TT�LN TWO COPIES) <br />l0T BIOCN OF <br />30ot8'=aS! - oa s— <br />P�RGEL TAN 10 NIIMOER <br />CONSIRUCTId� L WN LEADER, ���RGSS.IELCPII( <br />-� z/ =~ i �• <br />OR ITEM <br />KITCHEN SINw <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS--HAINLEADEFlS <br />SUB TO <br />PERMIT <br />TOTAL F <br />FOR OFFICE USE ONLY: <br />FRONTSEIDACN N[�f1: <br />�' � <br />,. <br />USEIONE "IDlAREA <br />�2 ,,,yp �b <br />�ypE p{ LONS�, NO.OF STOHIES <br />SREOF&DG_ IIRESPRINNLERSREO'U <br />JCLUP/JICYLOAD FIIIE/LAPMRGOU <br />NE�uON <br />INTAkEBY PL�NS(/�PPROVEDOY <br />r �,. <br />� +4 <br />nn�r � - i� — <br />21P <br />G� <br />CONTAGT <br />PIIO`1F. <br />PNONE <br />r-v �7�1 � 1 <br />J PIIONL NO. <br />ST�TE IICENSE / <br />6U7E LILEnoE I <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THI <br />APPLICATION AND KNOW TIiE SAME TO BE TRUE AND CORRECT. AI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE C <br />WORK WILL BE COMPLEI�ED WITH WHETHEH SPECIFIED HEREIN O <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF AN <br />OTHER STATE OH LOCAL LAW REGULATING CONSTRUCTION OR TH <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TH <br />OWNER OF THIS PROPERTV TO PERFOHM THE WORK FOR WHIC <br />APPLICATION IS MADE AND I COMPLV WITH THE STAT <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />x �/ Rn ��� � � /�—�7 / <br />SGNAIUIIL � �/ / � f1 / D��F <br />-. ,� �� <br />(IIYIIIKINii[IR.f11V MI <br />FEE NO, TYPE OF EOUIPMENT FEE <br />� A/C—A/HNLLG UNITS—H.P. <br />—�—� FORCED AIH SVSTEMS—B.T.U. M E.A. � <br />�� —� UNIT HEATEFS—B.T.U. M � I <br />VvATER <br />METAL FIFEPL <br />FIREPLACEIN <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />0 <br />SIDESETO�CN PIANGNCGI(NUMOLN <br />�b' y41�'�7 <br />v�curtsrtc PEES <br />i� ves n No pUIL01NG <br />pCf.��nKr M p VM1liML�M1�15 <br />480� PLUMBING <br />e�5E1AEN� MECHANICAI <br />CI YES I� NO <br />NEIGIrt UMnAiION AD�IiIONAL PLAN CHECK <br />' _. . v <br />STATE DUIL�ING SUFCNARGE <br />CITY OF EV[RETT ruouc wonKs <br />I.00AL SALES <br />TAX CUDE IS 3105 rora� <br />TOTAL S ; <br />NIT S i <br />\L FEE S ' <br />NECEIPT N0. <br />� b5',���- <br />IATION FEE <br />, � <br />�,�,,- ��.�> <br />— � <br />� <br />--� <br />i <br />i <br />—i— <br />� <br />'_, <br />� <br />� <br />/ �� <br />