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IF <br />tT7 to � <br />ay <br />a l-3 vJ <br />IC C7 <br />qz <br />O SO <br />i H b <br />N H <br />y r <br />m N <br />=09 <br />0. C] <br />H <br />Z y <br />Hq <br />N <br />H <br />CCg] C7 N <br />h7 � Cr+7 <br />Z 1­3 EA <br />H C EA <br />APPLICATION <br />FOR CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />G <br />eve rett I HEATING <br />SYSTEM OAS U ELECTflIC _ <br />__ <br />BUILDING DEPARTMENT <br />259 8810 <br />' COMBINATION <br />BUILDING XMECHANICAL <br />PLUMBING SIGN <br />DEMOLITION <br />M'M[q MAR ADDRESS <br />CITY ZIP PNON[ <br />/till '73cn1,i 5E rLICf/?P tun <br />9B�j <br />lvf� �±! Ll <br />TENANT MAR ADpRE55 <br />CRv ZIP E <br />ARCHITECT OR DESIGNER MAR ADDRESS <br />GOY Do PHONE <br />CiFNERµ CONTRACTOR MAII. ADOnE55 <br />CITY ZIP PHONE <br />L'CENSE E q <br />MECHANICAL CONTRACTOR MA IL ADDRF55 <br />CITY ZIP PIN)HE <br />LICENSEE <br />EvE.2soTI4roFj Ai <br />F_ ��'hFti� is <br />3'�la cf- EueeeIr,m'A <br />-� <br />, 2L <br />PLUMBINOCMIRACTO" MAIL ADDRESS <br />OILY ZIP PHONE <br />LICENSEE <br />CLASS OF WORK L! <br />I�t..rrl nlnu wnnn4TOvFfFRPL <br />INSERT BUILDING RELOCATION <br />NEW ADDITION AurnAAuun r,�....., __...__..._.. <br />)p1p0( <br />CONEACT PERSON AND PHONE NO <br />O " <br />CONTRACT PRICE OF WORK - <br />E WORN AND SQUARE FOOTAGEPVCLVED <br />ABC &U.Clar Jutw�9ca: TJ {n, r <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSEDu GF BMILDEM <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OR GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION DF PROPEnry ISHcW,$COW OR AITACH FOUR COPIESI <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT Nor.K OF _ <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />----- <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 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />7 , s+ s - <br />"l /�' arT'- <br />PROJECt A <br />APPLICANTS CRY BUSINESSLICENSE NO ANOBU ESSNAME <br />MECHANICAL <br />PLUMBING <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO, <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />AC—A;HNOLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B,TU. M E.A. <br />UNIT HEATERS—BT.U. M <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />_ <br />SHOWER <br />__ <br />VENTILATION FAN <br />KITCHEN SINK 8 DISP <br />RANGE HOOD <br />DISHWASHER <br />WATER HEATER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />_ <br />FLOOR DRAIN <br />BACNFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST fAN <br />' <br />SINK (SERVICE —BAR, ETC.) <br />SUBTOTAL f <br />_ SUBTOTAL f <br />1�o <br />PERMIT $ <br />PERMIT f <br />h 10 O <br />TOTAL FEE f <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />SE I DACK U <br />,I,E ZONE <br />BUILDING <br />- <br />TvM OICDNTS MIDN'AKIF <br />TYN LE LUNST E .IUN <br />AKnP <br />---- <br />pIUMBINO <br />MECHANICAL <br />JE OF BLDO <br />GUPANCY LOAD <br />I AEON FOR SPRINKLERS <br />'HAKE BY <br />NO Or STORIES <br />FIRE SPRNKLERS REOD <br />MANS APPIIOYED DY <br />BASEMENT <br />IR IGIR IIMIIAINMI <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />ADDITIONAL PLAN CHECK <br />_ <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />I I I I Etta, I NO <br />V- I <br />B <br />