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IROM:EUERETT BUILDING DEPT ��J, TO: 2066433475 IRN 171 *992 2:13PM 11412 P.02 <br /> /4•. <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASL PRINT c <br /> BUILDING DEPARTMENT <br /> HEATING SYSTEM: RAS U ELECTRIC U <br /> -----r <br /> 259.8810 <br /> 1 1 DEMOLITION I I COMBINATION <br /> ___I UILDING l 1 MECHANICAL I I PLUMBING 1191-N <br /> N TEN MAR ADDNCFS <br /> I]tc7m °� PNCNk <br /> ° u r � ' t t 1 1 �-►?�(� �I d liut llK �IaC I L9LIL1:� 3 __ <br /> A TENANT MAR ACDnCSS Cm CIP ROME <br /> a <br /> y N <br /> ntiCNDFCII)fI DtSIDNEn MAILUMCS$ CRY UP DKfNF <br /> 0 'T b CtN[MLCTNTIRACT NAR ADDRCRS Y LP PHONE BTATF IICENSCI <br /> ° I.I �nneS wo( --cl-i�rrl Qcl " NIL u u — 1�>/�3 3 L't�cr 3 -cQ L <br /> N w <br /> _ MF MC <br /> CONTIKMAXR A"MMAX A" Mf YCITY 21P MONO STATE UCCNWIT <br /> ti <br /> O H PLUMUNUCONTRACTGNI MAX AUOIIESS CITY ZIP FNONC STAIR UCCNMF8 <br /> M n <br /> M ' ASS Or YIOIIK •• •. . <br /> zy x I EW 1 1 ADDITION I I ALTERATION I I REPAIR I I DEMOLI N I I WOODSTOVE/FRPL INSERT 1 1 BUILDING RELOCATION <br /> ,.I y ^� T PER60N ANO r1 �C ,� 1 �T <br /> O N CONTRACT PIDCE OF NOIIK •� Id �> �i 6je JL�2� <br /> ocAcalTVAvolut GDIMNIe BDIAITC%NdNFD <br /> In " I�It) ((?V� flILTIOfI <br /> co UK 04nnwp4 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> 1 APPLICATION AND KNOW THE SAME TO BE TPUE AND CORRECT.ALL <br /> lEOAI SOIIm1KN1DCP110PF tB110NUBELowunATIAONFOURCON s) PROVIWNSOFLAWS AND ORDINANCES GOVER141NOTHIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT_ —, SICCK OF ... NOT.THE GRANTING 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 THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> Y APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CO ACTORS (\/ <br /> I�LAW)8. 7 RCW AND 288.200 WAC. <br /> Z7WI ADIX"It , �— x ' ` Q Zy 2 tiIr <br /> ` 25/7 �'7C� al�lunrvrRMl No _ <br /> -� <br /> /C—�f PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSETOILED _ I A/c--AMNOLGUNITS—H.P. <br /> 1 BATHTUB — ' FORCED AIR SY67EM5—B.1,U. M E.A. — a <br /> c_ LAVATORY(WASH BASIN) —+ UNIT HEATERS–B.T.U. M i <br /> SHOWER I CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP i VENTILATION FAN I <br /> DISHWASHER _ RANGE HOOD _ —�— <br /> LAUNORYIRAY I WATER HEATER ' <br /> _L CLOTHES WASHER _ �— WOOD STOVE _�— <br /> _ URINAL _ ' METAL FIREPLACE 8 CHIMNEY _ <br /> DRINKING FOUNTAIN I FIREPLACE_INSERT _ <br /> FLOORDRAIN _ _ HEAT PUMP �- <br /> 1 _BACKFLOW PREVENTERS GAS PIPING ' <br /> �Ijo ROOF DRAINS—RAINLEADERS I L,/ EXHAUST FAN _ _ �— <br /> BINK SERVICE—BAR,ETC. <br /> I I _ <br /> --I— <br /> I" <br /> _ SUI)TOTAL f1 SUB TOTAL ZV4' — <br /> PERMIT S 0 _ PERMIT i <br /> TOTAL FEE S ' TOTAL FEE i <br /> '11 FOR OFFICE USE ONLY: <br /> PRONTRCTRA ALAN RGIRACX SIOC WWII � PLAN ODGOK NIIMBSR PAS RLCkIrI NO. <br /> USE Me <br /> K' L01 ANLA ANI- VAOSITE FEES VALUATION EE <br /> —I" BUILDING <br /> mwcmTS AIIONARt IItt OI CMI ACIIILL IKNNAGI IAn PWIL"YInt –_• .... .— <br /> ��y�F PLUMBINGAl I <br /> IUEOrM no NO.FIC ATOAFB 111AMIIGNT --_- <br /> 3174 S(fi MFCIIANICAL �4V <br /> 'J — <br /> v7 SL G�2 A10 _ .... .. <br /> ICCUPNICYtOAU FAIL BPAWI FRS REOU NCKRRLAIITA / ADDITIONM,PLAN CHECK <br /> NO SPRINKLER <br /> IkAeOfl Pbn APRIIM FRB `7 <br /> STATE BUILDING SURCHARGE <br /> ;TAKE BY rLulA AvvwvFufY CITY OF EVERETT PUBLICWORKS <br /> TAX CODE 18L9105 totAL <br /> D 701C <br />