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FROM:EVERETT BUILDING DEPT TO: 2066433475 IAN 11?, 1992 2:13PM nli12 P.02 <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: AS U ELECTRIC U <br /> C 259.8810 <br /> y I I DEMOLITION 11 COMBINATION .,CI�p iJIILDING I I MECHANICAL I I PLUMBING I I SIGN <br /> OWNIN MAL AOMICAI / CIT' IV PNONL <br /> �] �I Qi n; wrJ.�C11105 IUUID (�1�(f Br %om Brlicuue 9806) L,144-2323 <br /> T'4 TFNMT MAL ACOnus CITY ZIP RIME <br /> j ARCNITFCI ON miaNEn MAX ADDRESS env LP RKN/F <br /> x U5 . 132313fJor+ly �V�P1knw� 88005 � tD-303(n.tATF1�ENKE. <br /> OENEfWLCOHfAACYOl1 MAL AnCA <br /> �8 ('�Ltbnrs IND P gj�WgM -Ql Uqq-2323 CW11TT2icmJ <br /> MFCNunU wrtnACion MALAWKEII Cllr ZIP RIoMf BIATEUCENCFF <br /> �Y <br /> yy M <br /> PLUM ONO CONIMCTOR MIL A00019111 env 7P FHOW STAINUCthlAFS <br /> CIH <br /> 0#611 arronK <br /> ty y H EW I I ADDITION I I ALTERATION I I REPAIR 11 DEMOLITION C PER I I WC IDSTOVWRPL INSERT I I BUILDING RELOCATION <br /> AND <br /> Imamo <br /> � y CONTRACTPNICEUpWDRK ��31��� .C10 . . ' � <br /> DE�ANI U SIE <br /> y [Dolt InnwR 1 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �I �C�. APPLICATION AND WS A THE SAME ORDINANCES BE TRUE AND CORRECT.ALL <br /> PPOVILGDAL SCIIIP10 Of PAOPF ISMM IELow Un ATTACH FOUR COPIES) WURK ) ILL OF COMPLETEDND WITHWHTHER SPECIFIEING D <br /> HEREIIS N OF <br /> WORK WILL BE COMPLETED WITH WHETHER 6PECIFIEO HEREIN OR <br /> LnT�_—_ ILCMI OF P 17 THE 3RG LITING OF A PERMIT DOES NOT PRESUMC TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ru�M Y 1 ll ITIG{hIQV�(Al 1 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 /> • APPLICATION IS MADE AND I COMPLY WITH 1HE ST:TE <br /> CONTRACTORS LAW 16.27 RCW AND 298.200 WAC. <br /> PNOItCI AooniAx 2530 ,... rtyyT �, FUYnIMu `•t O2^ 2d� _ rr lq <br /> V7C-� �T Sc�J CIIrytAiNYLI .IM, NO Tom_ _I <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. I TYPE OF EOUIPMENT FEE <br /> WATER CLOSET LTOILETI _ 1 AIC--A/HNDLG UNITS—H.P. <br /> BATHIUB �-{' _ I FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) _ _ %1 UNIT HEATERS—B.T.U. M ' <br /> SHOWER •• ' _ • CLOTHES DRYERS ! <br /> KITCHEN SINK 8 DISP _ —mss. VENTILATION FAN _ I <br /> DISHWASHER RANGE HODD _T <br /> LAUNORYIRAY I WATER HEATER ' <br /> CLOTHE6 WASHER _ WOOD STOVE <br /> _ URINAL _ METAL FIREPLACE 8 CHIMNEY <br /> I_ DRINKING FOUNTAIN ti FIREPLACE INSERT <br /> FLOOR DRAIN ' HEAT PUMP _ 1 <br /> BACKFLOW PREVENTERS i GAS PIPING <br /> ROOF DRAINS—RAINLEAOERB _ 1 _t_/ EXHAUST FAN i <br /> SINK SERVICE—BAR.ETC. I 7 .. <br /> 1 1 <br /> _ SUB TOTAL S i SUBTOTAL 8 <br /> PERMIT S _ PERMIT { I ••• <br /> TOTALFEE 8 ' TOTAL FEF—_ <br /> FOR OFFICE USE ONLY: <br /> -nONT xrmACN nCAA BETRACK Sim EOSACK 1'LNI CI ICCK NIIMSEA FEE RECEIIINO. <br /> Use EUN +� L0I ARRA VACANT SIM FESS VALUATION FEE <br /> BUILDING <br /> TYFeMVINOT MICWAILL lYrtDICONIT.ACIWL xwwa W!WMILKAIII • '- — /�� <br /> PLUMBwIC — �U <br /> M aof no <br /> NO.tK'Arp1i/ WEMENf MFCIIANICAL <br /> Sif .. <br /> -Tcv sF c,ZA /IBJ _ .... . <br /> =UPANCYLOAU rww PRNKIFASRECD NE4IITLYIITA;f0M ADDITIONAL PLAN CHECK �I <br /> N0 SPRINKLER •�" <br /> ItA ran arANKI FRS <br /> STATE BUILDING SURCHARGE ( 1� <br /> viAKEBY PlN11APPwwrI'bY CITY OFEVERETT PURLICWORKS ) -- <br /> LOCAL SALES <br /> Jti 6/1 TAX CODE 15 3105 TOTAL GG 1— <br />