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APPLICATI�M FOR CONSTRUCT�9N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATWG SYSTEM: J GAS ❑ELECTRIC �, <br /> BUILDING DEPARTMENT <br /> 259-2�10 SIGN <br /> ; i DEMOLITION COMBINATION i BUILDING MECHANICAL I '' PLUMBING � <br /> OWNEF IdAILF ORG55 CITY 21P PNON[ <br /> i �t�,� j���_��� I 1q I 2�1D f41lc �'c's��`IP.�I?-�'� <br /> TENANT MAILApDRESS —ZITY 21P PHJN[ <br /> qTY �.�Q�j[ PHONE <br /> ARCHiTEC OFOESIG , MRRA ORES; I� � �101 � ���/� , <br /> l0 <br /> GEN[R L ONTRACTjIp 1AIL ADDRE55 LITY Z P PIIONE STAtE UCENSE� <br /> ��" <br /> ] L l�6) <br /> MECHANICAL LONTR�CTO MNL ADDRE55 GTY ZIP PHONE SiR7E LICENSE� <br /> PlUMBiNG CONTRACTOR MAI: AD�RE55 CITY ZIP �'HONE STATE LICENSE• <br /> GON g�/A��� RN <br /> ;. <br /> DFySC?�QE_V;•�5K AND U � QOTA F.INvrJL+EO�� CONTALT PERSON ANO PHONE N0. <br /> U�Vb� �� <br /> �ryiDY!') e ' ia����a�r�-- Ji <br /> 4�-�� <br /> ���r� <br /> � I NEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> PROPOSED euttort+c APFLICATION AND KNOW THE SAME'f0 BE TRUE AND CORRECT.ALL <br /> 1^ � � ppOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NI'E OF <br /> � � <br /> LEGALOESGRIPTIONOPPPOPERTY�SHOWNBELOWORPTTACHTVJOWFIE51 WORY.WILL BE COMPLETED WITH WHETHER SPECIFIED HER I <br /> NOi. 1'HE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ioT eiocK ov AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> C� �Q CO� y�/ �.(n�—. OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> •�" C.-J V�-�1 `� � pERFORI,IANCE OF CONSTRUCTION.THAT I AM AUTHORI2E0 BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICAI�ION IS MADE AND I COMPLY WITH THE STATE <br /> rnr+ce T�i.o.NUMaea ^� �.�_ __L CONTRACTORS LAW 1827 RC AND 296200 WAC. <br /> .� w L>���..-`.�r � . <br /> CONST�RMUGTIONIOANLENUER ADJORE55 7ELEPHONENUMBE1R, �- ` <br /> _4J�C�2 I� /.�Y S•G • �y� sicrvntSnE o�it r � <br /> PROJECT ADDRESS u*v ouswas uccr+s�„o <br /> PLUMBING MECHANICAL <br /> FEE NO. TYPE OF EQUIPMENT FEE <br /> NO. TYPE OF FIXTURE OR ITEM prC—A�HNDLG UNITS—H.P. ' <br /> WATER CLOSET(TOILET) ' <br /> � FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> BATHTUB ' ; <br /> LAVATORY(WASH BASIN) i UNIT FiEATERS—B.T.U. M <br /> � CLOTHES DRYERS ' – <br /> SHOWER ' <br /> KITCHEN SINK 8 DISP VENTILATION FAN __—�— <br /> DISHWASHER RANGE HOOD ' <br /> LAUNDRY TRAY ', WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> METAL FIREPLACE(WOOD BURNING) <br /> URINAL <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN . <br /> SINK(SERVICE—BAR.ETC.) <br /> SUB TOTAL $ ' SUB TOTAL $ <br /> PERMIT 5 PERMIT S <br /> TOTALFEE 5 <br /> TOTALFEE S <br /> FOR OFFICE USE ONLY: ReceiaT r+o <br /> PIANCNECK/UMB R, fEE/�/ ; ^. /� /OS��� <br /> fFONT SETOAGK RE�R SETBACN SIDE SET�AGK � ��,[' y <br /> � � � .�7 �' � <br /> USF ZONE �aT AAE� <br /> O vncnNt sire / FEES VALUATION FEE <br /> C / � VES N� OUILDING �D C� �� <br /> IYPEUiLON5t1 NO.OFSTORIES C^cu�n>cv noO�Vn[u'�xGu>ii5 <br /> I ��+��" �' pLUMBING <br /> 7ZN 6y ; <br /> SIIEOFOIOG. FlPESPRINKLERSFEO'D BASEMENT MECHANICAL <br /> '7G��Aol� � TI. Ne r YES �C NO i <br /> ADDI710NAL PLAN CHECK <br /> Oi LUPANCV L0��0 FIR[AL�RM RE00 HEIGHT LiMR�T10N � <br /> � NrC �l�i� //7J OTHER <br /> � REnsON STATE BUILDING SURCHARGE O <br /> INTAKE BV PLAN��'�'ROVED BY CITY OF EVERETT PUOLIC WORKS — <br /> M LOCAL SALES //J ; <br /> �s ' TAX CODE IS 3105 TOTAL � <br /> onT[ (y ?� / <br />