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; APPLICATIC 7 �OR CONSTRU�T� )t� PERNiIi ���' <br />� i-L. TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />��� � <br />� HEATING SYSTEM: ❑ GAS �J ELECTRIC U <br />BUILDING DEPARTMENT <br />259-8810 <br />LI DEMOLITIO � ��MBINATION fl BUILDING i7MECHANICAL ❑PLUMBING �_ SIGN <br />OYJh[R � � RIARApJAE55 CRV ZiP PNONE <br />,�>,>ld `y�9ii ��,��a�'.���i ��,�� �,�oo, �.so-��i�� <br />�Eryp�y� h1AILAp�RE55 CITv ZIP PHONE <br />�JaM�..� <br />�RLHITECTOROESIGNER MNLAOORE55 Cltt ZiP PNONE <br />y5 C) �-+ <br />t7�� <br />�H <br />�ozx <br />ayx� <br />H z� <br />� H� <br />'�J H "+J <br />V1 H <br />y t3' <br />[�:1 O L� <br />H t7 <br />��8 <br />,n � f) <br />ay� <br />rHH <br />8 `� <br />f� C f/� <br />��� <br />z H [n <br />H O V1 <br />�� , _� <br />'�� <br />!`^o � <br />"m s <br />p �'6 1 <br />N ,"�� <br />�� � <br />ID }. SLH <br />i i AFr;` <br />L �y <br />}` G'�r� <br />PLLIMB�N3CONTRACTOR MAILMDRESS CITV ZiP PHONE STITEUGENSE� <br />CC�QRACT PPIGE OF WOR <br />2/D <br />��SCRIBEN(�RNRVDS AREFCOTAGEINYOLYEO CON�AO�PE`SONMIDPHCAENO. � � .�^ / / �,�. �. _ S�� .- <br />i• .�i _. <br />OF <br />lCanLC[SC iPT�O C TflOPERttISNOY.NBELOWOHFTTAGHT•/OCOPtE51 <br />ior oixK oF <br />v�.�-.tc_�nzio uuuoen <br />GONSiFUCtION IO.V � �[ .OER. nDUFE55. TELEPHOKE NUtAOER <br />TYPE <br />WATER CLOS <br />KITCHEW SINK 8 DISP <br />DISHWASHER <br />IAIINDRV TRAY <br />5�� T� <br />PERMIT <br />FOR OFFICE USE UNLY: <br />FRONTS[tf1ACH PEARSLiI1nCK <br />USE ZONE lOT AfiEA <br />iYPEOfCONSC NO.OFSTOPiES <br />S2EOF�LOG. FIRESPRiNNIENSREdO <br />IiEA50N <br />mrnK[ ar <br />oare <br />SIUE SCiPACK <br />I NEflEBY CERTIFV TI1AT i HAVE READ AIdD EXAh11NED THIS <br />APPLiCATION AND KNOW THE SAME TO BE TRUE AND CORFECL ALL <br />PflOVISIONS Of LAWS AND ORDiNANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH �'�NETHEF SPECIFiED HEREIN OR <br />NOT. THE GRANTING OF A PER611T DOES NOT PRESUAIE TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW PEGULATING CONSTRUCTION OR THE <br />PERFOFiA1ANCE GF CONSTRUC'ION. THAT I AM AUTHOR12ED BY THE <br />OWNER OF TNIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS IAADE AND I COh1PLY WITH THE STATE <br />CONTRACTORS LAW � 827 RCW AND 296200 WAC. <br />.. �it-s.a--� ..� � 1 �`-GdC � c' o - Q `� <br />MECHANICAL <br />NO. TVPE OF EOUIPMENT <br />AIC-A-HNDLG UNITS-H.P. <br />FORCED AIR SYSTEh1S-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />CLOTHESDRVEPS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STO�e <br />METAL FIflEPLACE (WOOD AURNINf <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />TOTAL <br />3 <br />FEE <br />0 <br />� <br />n res � No eu��o�ra�; _ — �C 1 <br />attur.�cv xu.�.r.wni�n.�uNns —� <br />cnouo PLUMOIkG I <br />BaSEu[Ni MECIIANIC�L <br />f-i YES ; 1 NO <br />��EiGNiL�MiiniiON ADDITIOMALPL�NCHECK <br />OiHEfi i <br />_- � <br />STATE BU'IDING SURCHAfiGC: � <br />CITY OF EVERETT Puuuc woivks <br />LOCAL SALES ' <br />TAX COOE IS 3105 TOTA< <-;.' - <br />���� <br />