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APPLICATIQ'� FOR CONSTRUCT.�N PERMIT e�e�e« <br /> �E���� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> a�r oF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> i DEMOLITION `i COMBINATION ' BUILDING fC MECHANICAL fJ PLUSdBING SIGN <br /> pyMEq M�ILADD(iE55 //Ob � ,�y� . GITV 21P PHONE <br /> F�rn.� ��� < .r;NT P��y . f�F�F�{ 9��� �39- a433 <br /> iENANT MAILAODRE55 CITY ZIV PMON� <br /> va -f-��.a- -�ti //oo f+�_ 1lv� �'u�F� `f�2a l <br /> �RCN'TECT R DESIGNEF M�IL��DRE55 CITV 21P PHONE <br /> GENERQCONTHACTOR MAILADDHE55 CITY ZIP PHONE LICENSEt <br /> �vokacJ �2� �u.Eer �v�. a'E-.�9 �c`�C� r-!'�S'o�/ 7��-/7/7 <br /> MECNANIL�LCONTRACIOR AIhILADDRE55 ��N ZIP PHONE LILENSE• <br /> �rfo- ,�T.,vr' l3slf9 /�uro��- ,SFfI-;��£ y�'��33 �4-a34o lv�+aoTl�rla73'M,� <br /> PlUMBMG LONTRACTOP � MML�DDNE55 GITY ZIP PNONE LIGENSE/ <br /> ClA55OF N�ONK <br /> -_. NEW L ADDITION ALTERATION . i REPAIR .�-! DEMOLITION ` '�. WOODSTOVE/FRPUNSERT C BUILDING RELOCATION <br /> LONTACT PERSON�ND PNONE NO. <br /> �rar <br /> CONTAACT PRILE OF WORN A�f/��OrJ �i -O 3�� — <br /> OESCRREW�7RK�NDSOURREF T�GE�r1VOLVED <br /> 51 T/ U �Tt�KlK�- <br /> PROPOSEDUSEOFBUILDING � I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> ���_`f �„p�..f APPUCATION AND KNOW THE 5AME TO BE TRUE AND CORRECT.ALL <br /> � LEOAL DESCRIPTION OF VROPERTY ISHOi'.V BELOW OR A77ACH FOUR GOPIES� PROVISIONS OF LAWS AN�ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT e�ocK 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 /> A�PLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 29E.200 WAC. <br /> SIGNATUREOFCONiR�GTORORAVTNORIZEDAGENT DATE <br /> _ X�� � �/4-f/ <br /> GUA (3�rfi�uGr <br /> PRPIECTADDRE55 <br /> IDD �PPLICAN'S CIiY BIISINE55lICENSE NO.AND BUSINE55 NRME <br /> p��s�pp MECHANICAL <br /> 1q. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER CLOSET(TOILET) � FV�MHNDLG UNITS-H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS�.T.U. M E.A. ' <br /> UVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M � <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 6 DISP VENTILATION FAN � <br /> DISHWASHER � HANGE HOOD � <br /> LAUNDRYTRAY ' WATER HEATEfl <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ' METAL FIREPLACE B CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR ORAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS-RAINLEADERS � E%HAUST FAN � <br /> SINK(SERVICE-BAR,ETC.) � � <br /> � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL $ ' U <br /> PEAMIT $ � PERMIT $ <br /> TOTAL FEE $ TOTAL FEE $ <br /> FOR OFFlCE USE ONLY: __ <br /> FRONT SETB�GK FERR 5[TBRGK SIDE SETBALK PUN CHECK NUMBER FEE RECEIPT NO. <br /> USE 20NE LOT ANER �ACANT SITE FEES VALUATON FEE <br /> BUILDING � <br /> TYPE Oi CONTS.ALLOWBBLE TYPE Of CON57.ACi11RL D[tuwHtr x0 0�vx[luNGUHrtS � <br /> ceour PLUMBING � <br /> SREOfBLDG. NO.OFSTORIES BASEMENT MECHANICAL �'VO <br /> i <br /> OCGUPANCY LOAD FlRE SPRNKLERS REO'D HEIGNT LIMIiATION ADDITIONAL PLAN CHECK <br /> i <br /> 01HER ' <br /> REASON FOP SPRINKLERS <br /> STATE BUILDING SURCHARGE i <br /> INTAKE BY PLANS APPROVEO BV CITY OF EYEREIT PUBLIC WORKS � <br /> LOCAL SALES � 1 <br /> TIU(CODE IS 3105 TOTAL <br />