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FRDM:EVERETT DUILDING DEPT TO: JAN 17, 1932 2: 13PM 8412 P.02 <br /> Oft <br /> APPLICATIvN FOR CONSTRUCT ION F ERMIT <br /> TO BE COMPLETED IN BLACK INK--PLEASC PRINT 4= <br /> BUILDING DEPARTMENT HEATING sysT eM: ons U ELECTRIC 13__ <br /> 259.0810 ,/ <br /> 1 1 DEMOLITION I I COMBINATION b BUILDING I )MECHANICAL I I PLUMBING I i SIGN <br /> OWNER AWL ADDACAS CITY !N PHONE <br /> _ y ' Pr_ l�1/14.0 L66 7 6411 2313 <br /> TFNAN MAIL AOOnCSS CRY CIP PHONE <br /> AR�CHITFCC ON UtSI(ONCR MAIL AOUNESS CRY ZIP rIIONF <br /> LL�s' CA, �LL'/Zile <br /> 0lNCf1AL CO CONTRACTT OR �) MAA ADDRCAC CITY ZIP PHONE BTATF ITClNSCI <br /> MFCMANIUAL Cd1TnACTOA MAX AUUIIIB! oily CM mow B1ATl UCCWFF <br /> PLUMBING CONTRACTOn MAIL AUDnCsS CRY ZIP PHONC BTAII UCCNAFa <br /> F`I'ss Or WOnK .. - .. <br /> IILNEW 1 I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPLINSERT I I BUILDING RELOCATION <br /> � <br /> j �C n /� CONTA SON AND PHOM/F�NO. <br /> CONTRACI PHICL OF WOnK I'N / / /'QL• 00 may` <br /> OCSCRMF WORK ANU SOUAn!fOOTAQC II PFO <br /> �'— <br /> PRDIKABeBB6larousnwo I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL U! CIIIP1NfNN PRDPFPTY(6N BELOW DRf�TTACN FOUR - PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> '2f, �/ h/,. 'r �/ WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> "17LOT 1 ;J _ BLODK a (K.Y� YGI NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THP. PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> P% PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br /> PhOJkCt AODIICAA tA:wAluPt ,� IMTf <br /> 2b03-57y4" t• 2/114_ <br /> W LnHmAu rt:n No <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET LTOILET) AfC—AAINDLG UNITS—H.P. <br /> L. BATHIUS FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) i— UNIT HEATERS—B.T.U. M _ <br /> SHOWER ' CLOTHES DRYERS <br /> KITCHEN SINKS DISP _ i _ VENTILATION FAN <br /> DISHWASHER / _ ' RANGE HOOD - — �- <br /> LAUNDRYIAAY I ..I WATER HEATER <br /> CLOTHES WASHER _ �— WOOD STOVE <br /> _ URINAL _ ' �� METAL FIREPLACE A CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> _ -ROOF DRAINS—RAINLEADERS_ _ I i(�' EXHAUST FAN ' <br /> SINK SERVICE—BAR,ETC. <br /> 1 � <br /> I ' <br /> SUB TOTAL f /'�" , SUB TOTAL f 411) <br /> PERMIT L PERMIT f <br /> TOTAL FEE $ TOTAL FEE s ' <br /> FOR OFFICE USE ONLY: <br /> Jsk�'410NTA AT ROAR AST CN LID[SC Af.K IYN/CIMCKNUMBER P! 'Ak CEIP N0. <br /> Z 1 ver �i e PA J L 5 <br /> LOI A:ItAQ VACANT BTI! B VALUATION FEE <br /> R - 5 12- 1 I BUILDING <br /> Yrt OICONTS.AIIOWAKE IYPC IX CORSI.ACILIAL LKOFwcr w w w tLw;m,it -- <br /> 1./-� PLUMBING <br /> Ili—WOIfKI <br /> NO.Or BTO?IFB BASEMEN MECHANICAL <br /> 4 X GA.4 — <br /> YCCUPANCYLOAU FYIC SPRNKI FAS PEOO HECIITLIMITA710H ADDRIONAI.PLAN CHECK I <br /> L ' A I <br /> _�• Q /\I,> -7 SPRINKLER /(/) <br /> 'kA80H POn6PRINgf A6 -- . <br /> BTATEBUILDINO6URCHAROE --�— (T./•M���I <br /> linKE Br PL/-S APPnor PITY OF EVERETT PUBLICWORKS I <br /> '17 LOCAL SALES <br /> 2./c-/,73 TAX CODE IS 3105 TOTAL <br />