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. . ..�., <br /> APPLICATION FOR CONSTRUCTIJN PERMIT '���''E'" ` ; <br /> „,��,,,�,,,,,., TO BE COMPLETED IN INK—PLEASE PRINT � <br /> c:n i o� <br /> eve rett HEATING SYSTEM J GAS CU ELECTRIC ;J _ 1 <br /> BUI�DING DEPARTMENT <br /> 259�8810 <br /> �� ty" ✓DEMOUTION COMBINATION BUILDING MECHANICAL _ PLUMBING SIGN <br /> �� OWIII N I� MMl��D9E55 ❑iY !IP P11C`:: <br /> �o G�E_�'[r__� Ut�_�',rs� d, E �Y��(Err 9��0� a'� �7l _ <br /> �L y y IfN�Nt MML�DDFES'� u�� ZIP PNONE <br /> H Z � — <br /> nRCHrt[CT011D6�GN[R MAh�DOf11I55 CItY ZIP V�qhE <br /> k n <br /> � <br /> O O GENER�LCOHLR�CNR M�IL�DDRE55 LIiY ZIY P11p1E LIC[NSEI <br /> �v,� �A�a��>/ o2iif B�9KF� Ev€€�rT %�a°/ �sP-us7C <br /> MFCH�NICALCONiRAC10R M�ILpD(1flE:'�5 CILY ZIP PNONE IIGENSf:� <br /> pj.iE� PWM�IHGCONiR�C�OH M�LLAO�HESi f.l1v ZIF PNONC LIGEHSE� <br /> � � g -- <br /> C�7• O C1A550�WORN <br /> � y� NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEiFRPL INSERT . BWLDING FELOCATION <br /> LONL�GT PFRSON AHD V�IONE NO <br /> H H [,(�iNA(;1 VRiLE OF WORn <br /> y �..i �ES BEWORn�N�SWAREFOpTAGErvVOLVEO � <br /> "�y �L(i<r 1 /� h J�2, <br /> vn aoseouseoaemi I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> � �'�-- APPLICATIJN P.ND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> y 0 y �.ec�tveccnr,r�PROOERtt ISHOWNBELOW OA RTTALHFWR WPIE51 PROVISIOMS Of LAWS AND ORDINANCES GOVEHNING 7HIS TVPE OF <br /> WOFN VlILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior o�ocrc or NOT TNE GRANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br /> AUTHORITV TJ VIOLATE OR CANCEL THE PROVISIONS Of ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCl:OF CONSTRUCTIOtJ.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APFLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RC W AND�96200 WAC. <br /> SiGN�ipREOFCONiH�C10RORAULNORIlEDAGEHf OAiE <br /> �� <br /> �.R✓�JECi�DDRES' /�(� �-y� '�/ �^p9 � ������C—� _ <br /> N /�� !//l�IC �Y��F/ / W . /ppr:�� �NP�ICAl1i5GtVl1�ISP�(SSI�CENSENO R]NUSMESSNAME <br /> PLUMBI�lG MECMANICAL <br /> (C�, NO WATERCLOSfiT�TOtLEREORITEM FEE NO. AC—ArHND G NF SOUH MENT FEE <br /> , � � — BATHTUB — __ , — — FORCEDl+IRSYSTEMS—B.T.U. M EA. <br /> ! LAVATORY�WASHBASIN) UNITHEPTERS—B.T.U. M <br /> �_ . SHOWER CLOTHE:�DRVERS <br /> ' HITCHEN SINK 8 OISP VENI ILAIION`rAN <br /> � DISHWASHER RANGE HOOD <br /> I LAUNDRVTRAV WATER HEATER <br /> _ CLO7HESWASHER —T �NWDSTOVE <br /> ��' URINAL METAL FI9EPLACE 8 CHIAINEV _ <br /> I � DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUlAP <br /> I� BACNFLOW PREVENTERS GAS PIPIIJG <br /> I , 1_' _ FOOF DRAINS—RAINLEAOERS EXNAUST FAN y— <br /> SINK�SERVICE—BAR,ETC.) _ __ _ i_ <br /> � '��~� - — -- -- <br /> : I <br /> suo totn� 5 sue rora� s <br /> PERMIT $ r PERMIT S <br /> TOTAL FEE E TOTAL FEE S <br /> �� FOR OFFICE USE ONLY: <br /> lIIOFISEIB�LK I1IARSEipALN SOFSEIBACN i'i�NO�l.CnNUMPER iR �CCHCINO <br /> useTor�e �ioi�i�[n vecemsrte FEES VALUATION FEE <br /> nun rn�:r <br /> --- � <br /> �rre o��oxrs uinw�nie IY%01 CONSI ALNAI ��..,=,x. . ��.�.,. -. ---.-. . .-.-_ - - . _. --- . -- ---�`-- <br /> •°p° PI IIMpING '__' _ <br /> SRE Of BLD6 NO OF STORiES B�SEMEN/ �,�(<;rypNICAL � ' <br /> OCCUP�NCVl0�0 iIRESPRNnLFRSREUO NEIONiIiMifenn�i ��1UIiIJNRLPLANCHECK <br /> U1Mf R <br /> RE�SOf1 fOR SVpMK�F RS <br /> _. _ _ ' <br /> — —_— — <br /> SiFiCPUILDINGSURGHRRGE i v�� <br /> _. .._ __ I .._ __ _--__ -'__"_ —_ <br /> nan.t n�. � aur.snrnar,vtour GTY OF EVERETT ru�uc WORKS � <br /> LOCAL SALES — � <br /> TAX COOE IS 3105 70TAL � ; , <br /> -- ;, � <br />