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FROM:EUERETT BUILDING DEPT TO: 2066433475 JAN 17, 1992 2:13PM 8412 P.02 <br /> APPLICATIVN FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT `S <br /> BUILDING DEPARTMENT HEATING SYSTEM: OAS U ELECTRIC IJ <br /> "59.8810 <br /> I I DEMOLITION 11 COMBINATION BUILDING IIMECHANICAL I IPLUMBING I I SIGN <br /> OVMEh MMR ADORERS CRY 7W PHONE " <br /> 1 ontf iy�iv e� ed,±2drw ro 7/ya.r-r 9 soo7 �xc�� /y L1�f-a3--3 <br /> TENANT MAR ADDRESS CITY Lr p110NE <br /> II ARCNITFCI Oh DESIDNEn MAIL ADUnls C11 21p PIK7NF ' <br /> efsa <br /> GEN fNLCONTRACTOA MAX ADOACSS <br /> GTY x11 PHON LTATi1K:l NlCI �— <br /> cI1bJn C'-✓ U M <br /> MiCHANIOAL eonrnncrOAnR MAR wuneLe cnr ZIp ' <br /> rNONG STATE LICENSE I <br /> PLUMBMU CONTRACTOR MALLwDllCL3 CITv <br /> PHONIC STATE LICCNRi1 <br /> G ABS CJ WORK <br /> XNEW I I ADDITION I I ALTERATION I I REPAIR 11 DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br /> `1/ H �� CONTA T PERSON ANOPIIONFAO �� <br /> OON.AInF PNICE OF SOUA lO A / /(/. f <br /> O[SCRIOF WORKANU SCUARC pOOTAG[IM'01 VFO ' _— <br /> .UPddZ�dYUSfn�c:Yyi17-F�77� ��/.;,; <br /> PHOruulD uec or DllRnwn I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> K fU �eh/aG[x CC APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> L aLu 99!G..{BrnuNar vRcwiniv owN SELaw on nrr�cNFWgCOPILBj PROVISIONS OF LAWS AND ORDINANCE;GOVERNING THIS TYPE OF <br /> LGT OA (-- LLOCK WORK WILL BE COMPLETED WITH WHETHER SPF;IFIED HEREIN OR <br /> NOT. THE GRANTTNO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF CHIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> teAf 5�7e� a-9 CONTRACTORS LAW 10.27 RCW AND 286.200 WAC. <br /> ' PNOJLL`1 AOOOCSR Ile— --- <br /> q/271 3— <br /> F4MIIAF <br /> cor.uAPnea K.ua x0 <br /> PLUMBING 7 <br /> MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> --'S- WATER CLOSET TOILET) - I A/O-A(HNOLG UNITS-H.P. , <br /> 2 BATHTUB ) FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) i UNIT HEATERS—B,T. <br /> SOWER U. <br /> HI CLOTHES DRYERS <br /> If KITCHEN SINK 6 DISP VENTILATION FAN i <br /> DISHWASHER - <br /> ' RANGE HOOD _ �-- <br /> LAUNDRYIRAY I I WATER HEATER <br /> / CLOTHES WASHER _ —�— WOOD STOVE <br /> _ URINAI. METAL FIREPLACE 6 CHIMNEY �— <br /> _- DRINKING FOUNTAIN i FIREPLACE INSERT <br /> ., FLOOR DRAIN HEAT PUMP —• •"'T— <br /> BACKFLOW PREVENTERS _ i OAS PIPING <br /> ROOF DRAINS—RAINLEADERS I E%HAUST FAN - - •�— <br /> SINK(SERVICE—DAR.ETC. <br /> I . <br /> _.. SUB TOTAL $ _ SUR TOTAL <br /> _• PERMIT S _ PERMIT S <br /> TOTgL FEE S ' TOTALFEE S 1 <br /> FOR OFFICE USE ONLY: <br /> •fgNT firTRACN n[Aq R4RLCX 610E GGTLAf.K 1'LANGICOKHIIMB6R pit qU� ���� <br /> 'll NO <br /> UBt:Lxle LOT nnlA yecANt ant EBBS VALUATION FEE <br /> BUILDING <br /> irl OI C.OM�T•[.Al10WAlL ITPI Or CfINSI.ACAMI lCFWKFr Kn VAKTIIWF VXIIF <br /> PLUMBING <br /> iUl Op 01Iq NO,rY RTOR¢6 OAL6MGNT --"'- <br /> 2S�/� S FG MECHANICAL <br /> =UPANCr LOAU rmc SPpNKI Pq6 RE011 NE K:I)U-YITATION ADDITIONAL PLAN CIQCK �- <br /> -LG No <br /> IEABOfl pan 6rAwKI FR6 BPR Eq�1C7.�� t_ 10 , YD <br /> $TATE BUILDING SURCHARGE ) �� <br /> ITnKG BY mils npPSr CITY OF EVERETT PURLICWORKS <br /> !ll`d' <br /> V 1' LOCAL SALES <br /> 5/07 73 TAXCODEIS3105 TDIAL <br />