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APPLICATIC 1 FOR CONSTRUCT' IN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT <br />259-8810 <br />HEATING SYSTEM: U GAS I <br />fRIC U <br />Li DEMOLITION <br />COMBINATION <br />I BUILDING <br />xMECHANICAL <br />PLUMBING I 1 SIGN <br />ER <br />OnEIR <br />MAIL AN: ^�' <br />ZIP <br />P53-SS�a <br />T� <br />1b _�ihE" <br />N <br />q <br />TENANT <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE. <br />GENERALCONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE STATE 'LICENSE IN <br />cnY ZIP PHONE STATE LICENSEE <br />PLUMBING CONTRACTOR MAN ADDRESS CITY 21P PHONE STATE LICENSE E <br />COBjRACi PRICE OF WORK <br />Wp . Ci <br />DESCRIBE WORK AND SCUARE FOOTAGE INVOLVED <br />— <br />CONTACT PERSONA HONE NO <br />1 rsn <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />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 />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />I_ BUILDING <br />PROPCI;D <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL TAXI NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />14 PROJEC ADDRES`S <br />� Si_ l�A� ��}QSG\\ <br />D—V ATE <br />CRYRU9x1ESl LILENf(IK) <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />ABC—A/HNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />I <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />; <br />SHOWER <br />I <br />CLOTHES DRYERS <br />, <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />, <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />I <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />I <br />DRINKING FOUNTAIN <br />) <br />FIREPLACE INSERT <br />; <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />, <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />, <br />SINK (SERVICE —BAR, ETC.) <br />1 <br />SUB TOTAL E <br />SUB TOTAL S <br />PERMIT $ <br />_ I <br />PERMIT $ <br />TOTAL FEE $1 <br />TOTAL FEE $ <br />/Oei' UC) <br />FOR OFFICE USE ONLY: Qa, tvla <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO �. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />O YES ❑ NO <br />BUILDING <br />TYPE O/CONS7 <br />NO OF STORIES <br />aECIIFANtY <br />Ip OO'A[MK,c VIlil6 <br />PLUMBING <br />i <br />NAUNA <br />SIZE OF BLDG <br />FIRE SPRINKLERS REO'D <br />BA <br />MECHANICAL <br />' <br />.us i -', NO <br />' <br />ADDITIONAL PLAN CHECK <br />' <br />I <br />OCCUPANCY LOAD <br />FIRE ALARM AEG D <br />HFIGHT LIMITATION <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />, ' <br />INTAKE BY <br />APPROVED BY <br />CITY OF <br />EVENETT <br />PUBLICWORKS <br />FPL/ <br />LO <br />TOTAL <br />TAX CODE IS 3105 <br />