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APPLICATIC^] FOR CONSTRUCT �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OYMER IAAIL ADDFE55 � C�TY 21P PHONE <br /> �vbv� f- �.Re�v� �l`��3 ��'� S� S�- ia�t'� 3�� - �3S <br /> TENRNT <br /> MAIL FQ�RE55 diY ?IP PHONE � <br /> � n� <br /> ARCHITEGT OR DE IGNEP MAIL ADDFE55 GTV ZIP PHONE <br /> GENERAL GONTRACTOR MRIL ADORE55 CITY ZiP PMONE STRTE UGENSE• <br /> MELHANICRLCONTRRCTOF MAIIRDDPE55 GTV ZIP PNONE STATELIGENSEI <br /> PLUMBMGCONTRACTOR MRILADDRE55 CITY IIP PMONE STATELIGENSE� <br /> � ` � f�� '13 [K57�'UrL� iv.uy�zsh 33�/303 �b�sP�c�r.a5ic <br /> cuss a wor+K . <br /> � NEW ' ' ADDITION � ALTEFATION � REPAIR DEMOLITION WOODSfOVE'FRPL INSERT . BUILDING RELOCATION <br /> "---- CONiACT PERSON ANO PMONE N0. <br /> LONTR�CT PF10E DF WORN <br /> DESCRIBE WORK AND SOUPRE FOOTAGE INVOLVED <br /> PPOPOSEGUSEOFBUILDING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DESCRIPTION OF PROI'ERTV ISMOWY 9ELOW OR ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFI�D HEREIN OR <br /> �or niocK oF _ NOT. THE GRANTING OF A PERMIT DOES ROT PRESUME t0 GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL UW 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 /> �F��,,Li-��� 6/�-3��3 <br /> �„M, --- o., � <br /> PROJECT�OOPE55 L <br /> G,� y+ - t� 011/� crcveuswEssuceNsruo <br /> PLUMBIN(i MECHANICAL <br /> Np, TYpE OF FlI(TUHE OR ITEM FEE NO. TYPE OF EQUIPMENT FEET_ <br /> �_ WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. �— <br /> LAVATORV(WASH BASM) � __ UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHESDRYERS ' <br /> KITCHEN S�NK&DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAV ; WAT�R HEATER <br /> CLOTHES WASHEF � WOOD STOVE ' <br /> URINAL ' METAL FIREPLACE 8 CHIMNEV � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP - <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ' <br /> � <br /> SINK(SERVICE—BAR,ETC.) I , <br /> T <br /> I 1 <br /> 1 I <br /> 1 <br /> SUB TOTAL $ �i SUF3 TOTAL $ ' <br /> PERMIT $ PERMIT $ <br /> TUTAL FEE $ TOTAL F[E $ <br /> FOR OFFICE USE ONLY: <br /> PLANCHEGNNOMBEF FEE PECEIPTNO. <br /> FPONT SETBPCN REAR SEiBACN SIDE SETBACN � <br /> usezor+e LJTRRER VACANCSITE FEES VALUATION FEE <br /> BUILDING ' <br /> ivPEOfGONT5.4llOWABIE TYPEOfGONST.AGTUaL af.uwNtx HO OrpyhwxGUHrtS � <br /> � <br /> r,aoua PLUMBING �_ <br /> SIZE OF BLDG. NOAF STORIF.S BASEMENT MECHANICAL � <br /> OCCUPANCY LOPD FIRE SPPNNLERS REO'D HEIfiHT LIMITATION ADDITIONAL PLAN CHECK � <br /> i <br /> SPRINHLER � <br /> � <br /> 9EASON FOR SPRINKLERS � <br /> STATE BUILDING SURCHARGE <br /> INiRKE F1Y PLAlIS PPPROVEDOY CITY OF EVERETT PJBLIG WORKS I <br /> � LOCAL SALES —� <br /> TAK CODE IS 2105 TOTAL � <br />