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APPLICATIC 1 FOR CONSTRUCT _JN PERMIT <br /> Vm��1\ TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> I" <br /> BUILDING DEPARTMENT HEATING SYSTEM: XGAS ❑ELECTRIC L1 <br /> 259-8810 <br /> DEMOLITION 5'4COMBINATION V-BUILDING (MECHANICAL )OLUMBING SIGN <br /> OWNER MAIL AD E CITY ZIP PHONE <br /> �M�.✓/sE✓ �c 3N'y8 E✓ T 9�Z03 �sj /266 <br /> TF NANT MAIL ADDRESS CITY ZIP PHONE <br /> ARCHITECT OH DESIGNER MAIL ADDRESS CITY ZIP PI�`•JE <br /> 2 k/M �isi6.✓ 20 _ :rlq Aae 5. %fz ,. >vo,4Z5 WF9 : `�Zo 77z/- Savo <br /> GENERgI CON`RAL10R MAIL ADDRESS CITY ZIP PHONE STATE LICENSE A <br /> 1'rJJLlfo dA14ieJ(.no.Nl -.<40044S, � �x 2s/9 f/-3s-T-Sln V /L1il4 Gs <br /> MECHANICAL CONTRACTOR MAIL AODRF.55 CITY ZIP PHONE ST..TE LICENSE A Q$ <br /> 1SFJ,P,,Qen/�1�AArr„vG s� c /i.8 t3Et�Aw4�/g.v y�nzL_�Z6—�r3•✓ <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> CLASS OF WORK <br /> XNE-W ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUII.DING RELOCATION <br /> .t lCON[T�ACT PERSONANDPHONE NO <br /> CpZ�fef PRICE OF WORK t/1' o r..7/L,C 44,LE/J+C �CM7^Y <br /> DEBCRyE WORK AND SOUARE FOOTAGE INVOLVED '- <br /> Wooer � ' s�eucTia•/-12 <br /> PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LEGAL DESCRIPTIONOF PROPERTYISHOWN BELOW OR ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> Lot BLOCK of NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �h B✓ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> : . tT OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> •i,` /L 1 APPLICATION IS AND I COMPLY W <br /> CONTRACTORS LAW 1A0.2D7ERCW AND 96 00 WAC ITH THE STATE <br /> x <br /> ,L• PROJECT ADO'IESS <br /> Co <br /> , srt'Nepm p II <br /> %U^/ �t� 1 CHV RI IW SS 1.11 NSi 110 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) I hC—A H IOLG UNITS—H P. <br /> BATHTUB I FORCED AIR SYSTEMS—B.T.U. M E.A. ) �— <br /> f LAVATORY(WASH BASIN) I 1Lq UNIT HE4TERS—B.T.U. M <br /> i J SHOWER CLOThw DRYERS / <br /> KITCHEN SINK 8 DISP I 7 VENTILATION FAN <br /> DISHWASHER I '7 / RANGE HOOD <br /> LAUNDRY TRAY / WATER HEATER <br /> ` 1 CLOTHES WASHER r WOOD STOVE — <br /> II URINAL 'dETAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN =IREPLACE INSERT ; <br /> FLOOR DRAIN HPAT PUMP <br /> BACKFLOW PREVENTERS GA i PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN Ill �— <br /> SINK(SERVICE—BAR,ETC.) <br /> L <br /> I <br /> 1 <br /> SUB TOTAL 3 _ SUB TOTAL $ <br /> PERMIT $ PERMIT $ <br /> TOTALFEE $ TOTALFFE $ <br /> FOR OFFICE USE ONLY: <br /> j FRONT SETBACK REAR SETBACK SIDE SETBACK PLAN CHECK NUMBER FF! RECEIPT NO <br /> USEZONE LOTAREAVACANT SITE FEES VALUATION FEE <br /> - 2- -/ /7 BUILDING 68 14 V I <br /> oo <br /> TYPE Of CONTS ALLOWABL! YPI w. <br /> CONST ACTUAL WUN6 NO 9M ONG UaR —� ' <br /> GA r PLUMBING 3T- <br /> SIZE OFBLDG NO OF STORIES BASEMENT MECHANICAL 9V <br /> /Z 3s sf •.u N� — <br /> OCCUPANCY LOAD IRE SPNNKLERS E 'D HEIGHT LIMRpIION ADDITIONAL PLAN CHECK T_— <br /> I P/A `V' CID ' <br /> REASON FOR SPRINKLERS 1 J — �a�0 <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS it7 <br /> A LOCAL SALES <br /> �./Z� <br /> J0 o z TAX CODE IS 3105 ToraL L50 <br />