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i _ .,�..�� <br /> APPLICATI�,�I FOR CONSTRUCI.�N PERMIT � I � I <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � _� �, <br /> ------- — --- ---- -- -- -- — � 1 <br /> HEATING SYSTEM: J GAS U ELECTRIC J ___ _ __ - -- <br /> BUILDING DEPARTMENT --- - — <br /> 259�8810 i <br /> DEMOUTION COMBINAT�ON �/ BUILDING MECHANICAL PLUMBING _ SIGN <br /> . OWNER M�IL�D�ilE35 S 3veA �'/ GIfY ���-- ZIP PMONC � <br /> PHi( 7Jla �i�e i2 .�d' E�/e���rr 9G�'�r, _;�- - s ':�7 <br /> TENANt M�II�DDRE CItY IIP P�� <br /> ��� A1ICHREGIORDESFiNER M�II�DDRESS CITV ZiP P�qNE i <br /> p � GEHER�L CONLR�GTOP M�R AODRE55 CItV SiP OHONE S1�LF LICENSE/ , <br /> ��1"1 <br /> MECH�NILAL CONTRACTOR 1AAIL�DpRESS Qiv 21P PNONE STQE L�C4NSE R <br /> ��� PIUMBiN6CONTH�CtOR MM/�D01�E55 CiiV ZO' PUONE SiREIiCENS[� _ <br /> ���111 ,QoOinfo,-� y,(un+D���9 La7s/,fCvorr"'H/Du ur�vV fi1/r.vis7 3r.f6/7 / .�co� NF+�z ,�,ez <br /> ��� ,C/USSOf WW1N . <br /> p� NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE;FRPL�NSERT BUILDING RELOCATION <br /> M ,/ c�oNjr�cr rrns�/���r+n r�wnE no <br /> Cd1TR�CiVRICEOFWORN �7�/DOO L„� t �Cl! -�f'���7� <br /> �R DESCRIBE WORN�N�SWARE�OOLAGE INVIXVEb <br /> �� �nS�isCC �iire SP.e�n/:.+Qirl �.o ��rv tv r,— � <br /> PROPOSEOUSEO�BI➢I�iNG i HEREBY CERTIFY THA7 I HAVE READ AND EXAMINED TlIIS <br /> � � APPLICAiION AND KNOW THE S�ME TO BE TRUE AND COPRECT.ALL <br /> in�� ESCBiPtIfNOFPROPERiV15110WNBElOWOR�TT�CHFWPCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS?VPEOF <br /> �M WORK WILL BE COMPIFTE�WITH WHETHER SPECIFIED HEREIN OR . <br /> �� ioT oiocn or NOT. THE GRANiING OF A PERMIT DOES NOT PRES�IME TO GIVE <br /> �r AUTHORITV TO VIOLATE OR CNNCEL THE PROVISIONS OF ANV <br /> {A OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUG710N 7HAT I AM AU7HORIZED BV �HE <br /> . ._ _.. OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPIV WITH THE STATE � <br /> CONTRACTORS LAW iP 27 RCW AND 236200 WAC I � <br /> s�rs y C.�y .eo/ Ev�.>�,-� x.',,;�*,�F��--io:Z� 9/ _ �,I <br /> veaec*eooness °�° <br /> ii <br /> ---- - �--�--- --. . .__ i <br /> •.���.v�s..,,.���., , � <br /> � PLUMBINO MECHANICAL ' <br /> � -� NO. TYPE OF FI%TURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> ���� B TH UBLOSET(TOILET) __ A'C—A HNOLG UNITS-4 P ___ j <br /> FORCED AIR SVSTEMS—O.T.U. M E.A. <br /> ' I � LAVATOFV(WASH BASIN)_ UNIT HEATERS—B.TU. IA __ -- � <br /> � 1 , ___ <br /> SHOWER CLOTHESDRVERS <br /> �� KITCHEN SINN 6 OISP G'�� � VENTILATION fAN <br /> i ��1 DISHWASHER �� /J/��,yY FANGE HOOD ___ ! <br /> LAUNDRY TRAV rv8������� WATER HEATER <br /> CLOTHES WASHER (i� �j �vtiril� I� WOOD STOVE '� <br /> ' 1�� URINAL �� /Ai�Wyw�y-� � METAL FIREPLACE 6 CHIMNEV ' <br /> � I `�' DRINHING FOUNTAIN _ n.,n'd . ��� FIFEPLAC[INSERT _ �_ �I <br /> FLOOR DRAIN 1���� �� HEAT PUMP <br /> . BACKFLOW PREVENTERS _ GAS PIPING i <br /> ROOF OFAINS—RAINLEADEF , _ EXHAUSi FAN _ <br /> '� �I�I SINK(SEHVICE—BAR,ETC.�_ --- <br /> ' 1 1 SUBTOTAL E SUBTOT�L S i___ <br /> � PERMIT S _ _ PERMIT _S __ _ <br /> � _ — TOTALPEE S TUTALF[E $ <br /> ��� FOR OFFICE USE ONLY: <br /> FRpNiSRBA�M REAqSL1B�CN S�OFSEIBAGN ��'I1nq[nffx�Nful�Ap[� I(I �I`cLu`INO <br /> useto�+e iorenEe vnr.nr�rsni �L F 3 VALUATION FEE <br /> T <br /> - <br /> nwi oiNc <br /> nri or mxrs u iaweei[ rvv�rn mNs�euuni � I � �� ----- � - - ----�— -—. . . <br /> �A I .;•• .••� PWM�ING � <br /> /V �-N__ IZ3 � 2_ — _ ----_ <br /> !;R.��Eof�OLyy[�Gy� NOo/�JSt�omFS �+����!'� �� MCCMANIGAL <br /> ��oi//i � /� __ _--—_ . _ —_— � _ <br /> -- "'�—-- � — q�DUIONMPUNCHECK ��k' i �� 1 <br /> OGGl1P�NCvIO�D RRFSPiiNKLE��SN[00 R�Cdtl10�i�n�W�� <br /> 13 - -- ---- <br /> _____ SPi71NKl.[R �' ' ' 1 <br /> nusalronSrnWe�rns - —'—' — -- � --�i <br /> SfATf BWL�ING SURCMARGE <br /> imere ar r�nrc:u�ruovrnnr - CITY OF EVERETT runuC Woaks � <br /> LOCAL SALES <br /> � ' TAX CODE IS 3105 rora� �� � j � , / <br /> J � ' <br />