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APPLICATICY FOR GONSTRUCT`lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> �HEATING SYSTEM: J GAS J ELECTRIC ,.1 _ � <br /> BUILDING DEPARTMENT <br /> 259-"810 <br /> DEMOLITION COMBINATION � BUILDING MECHANICAL PLUMBING ` I SIGN <br /> GIYNER M � � .-!^✓`` ��� Z�P PMONE <br /> 19�SGJI <br /> ��,s a,� l`16✓�Iro f�IFIG AYEW� �L'i, ENL�7'1"'I" 9b�A6 86i6-Tlt!> <br /> TENANi M/•�l AUDRE55 G�TV 1��' �'HO'iE <br /> 1"I�IIC�u�G� 6� MGbIG4lr GBd-tiEt2,oJllo N4GIRK+ AY9 �YIiR�RT°���06 2�ad-�"i7.r1-� <br /> ARCHRECTORDE3IGNEP MRILFD�iFESS GITY ZIP P!�pNE � �R J �vp <br /> ,�e-! ♦HAI.t. Al�M IT1�GT�, 4ZOro 4i0'�"t' AV'Hy �YL'PeLri'T" °b?.04 <br /> GEUERAICONTRnCTOR NA:IR�DRE55 GITY ZIP PMONE STATELIGENSE• <br /> NRWII�IP coblaF�1Y.TGt-lL1'bR�X �ab . °L'V'��R�.T'T� �fJOrc 26°J�I°�I NEwL�Gb4bid <br /> MEGN�NICRL CONTqqpTOR MRIL AD�RE55 GTY ZIP PHONE SiATE LICENSE• <br /> PLUMBING CONTNACTOR MRIL ADDRESS QiV ZIP PHONE STATE LIGENSE I <br /> CONTRACf PRICE OF WORK <br /> !b ZI7, ODO. 00 _ <br /> DESCFIBE WOAN AN750U�[i00TRGE INVq.VE� GON'ACT PERSON AND PMONE NO� ��_�� <br /> �L�A <br /> �cvi�-w u ,�•r�tr,�.. -- <br /> � Q i HEREBV CENTIFV THAT I HAVE READ AND EXAMINED TFi1S <br /> raoroseo use oF euaon+c APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �i,�..�i � A(� PROVISiONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �e���oescr+irnoNOFraoaenrvisNowNee�owoanrtac�+Twocoriesi WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br /> ioT eiocK oF AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �� �,{�• a„`� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CQNSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPF.RTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND � COMPLV WITH THE STATE <br /> v�nee�rnx i o.rvuueea CONTRAC70R5 LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRU:TIONLOANLENDER.ADDFESS.TEIEPHONENUMBEF � <br /> _n Ib-Z7--9� <br /> PROJECT ADDRESS s�c���un� o�rt <br /> ��a r.�u�� Av�, ia.v�rr ��,.e�s,�Fss„� �sF� <br /> ����G MECHANICAL <br /> NO. TYPE OF FDCNRE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—AiHNDLG UNITS—H.P. <br /> BATH7U8 ' FORCED AIH SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORV(WASH BASIN) UNIT NEATERS—B.T.U. M � <br /> SHOWER � CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHWASHER RANGE H07D ' <br /> LAUNDRY TRAV ; WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIfiEPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS GAS PIPING � _ • <br /> ROOFDRAINS—RAINLEADERS ExHAUSTFAN ' � ' �� "�`f�� <br /> SINK(SERVICE—BAR.ETC.) � —�— <br /> '— <br /> SUB TOTAL $ SUB TOTAL 5 <br /> PEHMIT $ PERMIT $ <br /> TOTAIFEE $ TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBAGK REAR SEiBRCN SIDC SETBACK PIPN CHECN NUMBEi� FEE .��/O pE�t��� <br /> / J <br /> �� <br /> use zor+e �oT naee vncnNt sire FEES VIILUATON FEE <br /> :- YES �- NO BUILDING _�i� <br /> iYPE OF LON57 NO OF S�ORIES acuwuc� ��o x UNEuwton�'s i <br /> N h ""0� PLUMBING � <br /> -// F. R . �� � —�— <br /> SIZE OF�.DG FlRE SPAINKLERS PEO'D BAS[MENT � <br /> MECHANICAL <br /> I v * /, � S ..� VES �- NO ; — <br /> OCCUPqN�V�OAD FlRE nUNA RE0'D HEIGHT LIMITATION ADDIiIONAI PLAN CHECK <br /> 9 �J I y�s OTHEH —�7T� <br /> � <br /> RERSON // � � � <br /> ��(5� � STA7F BUILDING SURCHARGE �y�� <br /> iNTnKE Bv Plnr+S�P OVED BY CITY OF EVERETT PUBLIC WORKS ' � <br /> �i%j � LOCAL SALES <br /> oR,� � � �_ S � TIIX CODE IS 3105 ror�� ; 1� ') <br />