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APPLICATIQ^1 FOR CONSTRUCT' �N PERMIT � <br /> TQ BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: CI GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-881� <br /> ❑ DEMOLITION ! ! COMBINATION I ' BUILDING i l MECHANICAL I 1 PLUMBING � SIGN <br /> OWNEA MAILRDOR[SS CITY ZIP FIIONE <br /> CQ. 'U��L� �L'�'.fJl�Z l.Df7'� �'�3� /s/L':%1'l'.C}`- ��f�l-� �/�,7.�/ �`l�I�� — <br /> TENANT MRiLADOR[SS CI1Y ZiP PMONE ' <br /> ARCHRECT�R OESIGNER MAIL ADDRESS CITV ZIP PMONE <br /> GENEBALCONTflRCTGR ::A:LADDfiESS CITY ZIP PMONE STATEL�CENSE� <br /> 7(f�?'^�/.1/'� /���3�i� �1'--:'17>,C�r (/✓!' ���/.�'� ,2'�•/��.y 7r/f-' _7J9 ;Y 3//L'� <br /> MELH/NICRL CONTRRCTOF MAIL FODRE55 CITY 21P PIIO ST�TE 11�EN5E• � <br /> PLUMBINGCONTRACTOR M/lLRDDRE55 CIiY 2!P PYONE STATELICLAiEe <br /> CONTRACTP ICEOFWOFK <br /> � ���n � — <br /> �ESCRIBE WORK�ND SOU�RE FOOTRGE'4VqLVEO CONTACT PERSON AN�PMJNE NO � / / <br /> f.��7G�J7�/.�7 _ <br /> � �j> � ��,�� _ �.�-5 -/�.�.�=. <br /> /.�57/JR/— L.(/� <br /> �S ,J i HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BWIDING APPLICATION AND K��OW THE SAME TO BE TRUE AND COFlRECT.ALL <br /> �>��-�-� PROVISIONS OF LAWS AND OPDINANCES GOVERNING THI;:TVPE OF <br /> LEGALDESCRIPTIONOFPROPERTV�SHOWNBELOWORNTTr1GMTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIfIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ioT BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 7F ANY <br /> OTHER STATE OR LOCAL LAW REGULATMG CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED L9Y THE <br /> OWNER OF THIS PROPERTY TO PERrORM THE WORK FOR 1YHICH <br /> APFLICATION IS MF�DE AND I COMPLY WITH THE STATE <br /> rnAce�tnx�o.nuMeea CONTRACTORS W1B.27RCWAND29G.200WAC. <br /> CONSTHUCilONLOANLENDE�,AD�RESS.TELEPMONENUMBE(i / • � J , <br /> � � 1>.� ,��l� � �-- <br /> PROJECT ADDRESS si ac�.+nmt o.*c <br /> y/.s-7/�1vi+'c— ,9!/C� urreus��+EsSt�G[v5trvo <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlI(TURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) AiC—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SVSTEM$—B.LU. M E.A. <br /> LAVATORY(WASH BASIN) i UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHE$DRYERS <br /> KITCHEN SINK&DISP VENTILATIOM FAN _ <br /> DISHWASHER - RANGE HOOD _ <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL METAL FIREFLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPIACE INSERT <br /> FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTEfiS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETCJ <br /> SUB TOTAL S SUB TOTAL 5 <br /> PERMIT $ PERMIT 5 <br /> TOTALFEE S TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FP.ONT SEtBFCN REA ETOACH �� � SIpE SETBACK P�AN CHELK NpMB FEE RECFiPT NO <br /> s �or G ' a ��� ��. ��� °� _ <br /> USE ZONE LOT FREA VACANT SITE FEES VALUATION FEE <br /> -1 YES �O BUILDING ��__ <br /> nPEOfCON51 NDOFSTORIES Mrueavcr eao�mmub6ux,-5 <br /> �nouv PLUMBING <br /> SR[OFBLDG. i1RE5PPINKLER5RE0'D BASEMENT MECHANICAL <br /> [' YES ;-1 NO <br /> OCCUPANGVLOFO FlREPLARMREOD HEIGHiUM1TATI0N <br /> ADDITIONFL PLAN CHECN <br /> OTHER <br /> R[ASON <br /> STATE BUILDING SURCHARGE � <br /> INtAKE BV PLANS PPROVED BY CITY OF EVEflETT PUBLIC WORKS <br /> 1�„ LOCAL SRLES � � <br /> oq 1 �_ TAl(CODE IS 3105 rorn� `-'��;' .r <br />