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FRDM:EUERETT BUILDING DEPT TO: 2066433475 Jr" 17, 1992 2: 13PM 4412 P.02 <br /> APPLICATJ�;N FOR CONSTRUC110N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: 0 GAS U ELECTRIC IJil <br /> 259.8810 <br /> I I DEMOLITION I I COMBINATION BUILDING I )MECHANICAL I I PLUMBING I I SIGN <br /> OWNER MAIL AODnC61 CRY zIP PHONE <br /> C ("1) t �.. 0, iac % Pll I r 12 7W 1 1\c�. c `>Y j l ( y'I-73Z 3 <br /> TFNANT j MAIL AI.)Onc51 <br /> CIN zip iIIONE <br /> I Ih���, Lir ' �ev0e �iFc ' (t,( -72& 303( <br /> ARCHITFC16N De610N[n AAAA UK[Y C11 21P rI10A'F - <br /> t c. 1�1v L� "c1 i <br /> 'I I(,) >I-�rI P rrzw 131 Ily�c ��rll)� zu(<, <br /> OW[nAL NniACTOR MAXI AODRCSS CITY IIP PHONE STATF I.ICENSE8 <br /> MFC11ANn1AL CONTRACTOR MAA AUTAIEYY CIIY 21P PRONG <br /> 61A11!LICCNSF/ <br /> PIUMBINU CONTRACTOR MAL AUOt1EN9 CITY zm PHONE 6TAlE—LI CCN,VF <br /> c,AGS cw WOnK �— <br /> N NEW I I ADDITION I I ALTERATION I I REPAIR 11 DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br /> /� I <br /> ,CONTRACT YWCe Uf WORK 41I ),1IL-)�)I•� 0 • �.yOCSr.RInFWORKANIISOUAnEFOOTACCINVOVF[I `Joru-) CcllSi �L(: .� 31- I r- rc �YnOlroueouseorouAnwR HEREBY CERTIFY TH .T I HAVE READ AND EXAMINED THIS <br /> 111� �`CS1(l('✓1 C C PPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IONOrPRwfltTY(SHOWNBEumOnATTACHFOURCOPIES) ROVISIONS OF LAWS AND ORDINANCES GOVERNINGTH.STYPEOF <br /> LOT� BLOCK OF ORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> OT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> UTHORITY TO VIOLATE OR CANCEL THE PRO'iISIONS OF ANY <br /> THER STATE OR LOCAL LAW REGULATING CONG7RUCTION Oq THE <br /> ERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> WNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ONTRACTORS LAW 18.27 RCW AND 285.200 WAC. <br /> '7& ZD `'l�` C C x <br /> PROJECT AOoncAA EII:xA1 � /J� (� ANLL...'., •�,� �',-- <br /> CII�PIP!MAV IdNA NO "' <br /> PLUMBING I MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO, I TYPE OF EOUIPMENT FEE <br /> WATER CLOSET TOILET) _ I A/C•-AlHNDLO UNITS—H.P. <br /> L BATHI UB ' FORCED AIR SYSTEM$—B.1.U, M E.A. _ <br /> 9 LAVATORY(WASH BASIN) 1 UNIT HEATERS—B,T.U, M <br /> SHOWER -7D' CLOTHES RYERS -- <br /> I KITCHEN SINK 8 DISP _ VENTILATION FAN <br /> HWA <br /> DISSHER ' I RANGE HOOD _ T— <br /> LAUNDRYTFWY ; WATER HEATER <br /> _ CLOTHES WASHER _ �— WOOD STOVE <br /> URINAL _ _ Z METAL FIREPLACE&CHIMNEY <br /> DRINKING FOUNTAIN tiI FIREPLACE INSERT <br /> FLOOR DRAIN ' I HFAT PUMP _BACKFLOW PREVENTERS <br /> PREVENTERS ; I GAS PIPING I <br /> HOOF DRAINS—RAINLEADERSEXHAU6T FAN �— <br /> SINK(SERVICE—BAR,ETC. - <br /> I <br /> SUBTOTAL S SUB TOTAL _ $, <br /> PERMIT f _ PERMIT $ ; <br /> TOTAL FEE $ ' TOTAL FEE $ I • <br /> FOR OFFICE USE ONLY: <br /> •nONT SrTAACK / nCAA 6F19ACX SIOC GGTYACK rLANCNCCK NIIM"A PEe ALCEIPI NO. <br /> 10ONA 3997 1,-) �03/S <br /> nE zOf Ie� LOI An 0 7VA VACAll S,111 FEES VALUATION FEE <br /> _ 15 _ c� J BUILDING <br /> TR Of CCMi[.AIIpA'ABl! iTK Of fINSi,IQLIAL G[[III'ACI r[WA ItMnl1 _ <br /> �— /J j I PLUMBING (J <br /> 112E DI OL flp no.Or 6TOA IF6 OASCMGNT <br /> —7,3,, No"f (:•oN[. Z /,/0MF.CIfANICAL I-- <br /> X.CUPANCYLOAU rmc SPANKI FRS AEOLI HEK:HTLIMITATtON ADDITIONAL PLAN CIIECK <br /> A N o — JD I— <br /> 'EABOf1 fOn 6rRWKl iR6 <br /> STATE BUILDING SURCHARGE ' <br /> NTAKG BY PLANS APPROVFII BY CITY OF EVERETT PUBLIC WORKS C)i <br /> ..1 N LOCAL SALES <br /> q3 TAX CODE IS 3105 TOTAL <br />