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-�,�:�. <br /> A�PLICATI4 _J FQR CONSTRUC7_ �N PERMIT � <br /> TO BE COMPLET[D IN BLACK INK—PLEASE PRINT T <br /> BUILDING DEPARTMENT HEATING SYSTE.L• IJ GAS ELECTHIC L,� <br /> � _-- _ <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHI�NICAL PLUMBING SIGN <br /> OWNER ` M�IL 40URC55 . LTV pIP PNpp'I <br /> �' . ,�v�vcn"y-/�6NL.�.: � ivsi .—., _ /y/< _ ,;yrlr5i S�� ��'/k! �A — 'J �� Sis.zl�Y �s� -�,zc. <br /> TENANT AIMI�DpRESS CITV ]IP PIpNE <br /> �ar�E <br /> ARCNITECTORUESIGNER M�II��OFESS dTV 2iP PNONE <br /> �.Si�n., Li. y l9/f ��aisn , Sl Ec�o,zsT 9e1c'_ 3<:£ -o.s� # / <br />�` GENEP�L TR�CiOA AI�Il�0�RE55 PMONE <br /> d7V 21P STRE LICENSE 1 <br /> �—��^�:c.�r- �/r//�n' �n ' /�//� ,rjy��'STS,F cf�E/T 9E.2�4� �y';- 77C1`� C�CLMNLYXfHL <br /> I,IELNANIC�ICONTR�GTOfl M�IL�O�PE55 CRV IiP P.IONE SiRTELiCENSE� <br /> �� � <br /> PILMBINOCONTRqCT011 M�IIA�DRE55 CITV zIP ✓HONE STqTEIIG[NSE/ <br /> C�LAS�; WOqK <br /> ��L✓NEW � ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE.FRPLINSERT 9UILDINGRELOCATION <br /> �— �C . 0��� CONT�CTPERSON�NDPHONENO <br /> CONTR�;T PNICE OF WpRK �.S GF CfY��� � v �' '• + �s S'-7�.b <br /> DESCRIpC WOP\NND SOUAIiI i00T�GE INVOIVE� �7 — <br /> Nv� /.� �� " /a 5%cw. � ,al..id ✓i �S r 4 c� J� � .S'/7F��i� �.G�c.aln! <br /> PROPOSEOUSEOFBl11lDING i HEREBY CEFTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �f'^R -R. � S .- .t APPUCATION AND KNOW THE SAME TO BE TRUE AND CORPECL ALL <br /> LE6Q�ESCflPiqNOFPqOPE 1v�5HOWNBEIOWORAT7';HFOUqCOPIE9� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHiSTYPEOF <br /> �oi �s __ BLOCK ov .�Ii �nT G�7 1��1 I WORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> NOT THE GRANTING OF A PERA!IT DOES NOT PRESUME TO GIVE <br /> AUTHOFITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> — OTHER S7ATE OR LOCAL LAW RF.GULATING CONSTRUCTION OR THE <br /> PEFFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE <br /> _ OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONT qCTORS LAW 1827 RCW AND 296200 WAC. <br /> '�)G �ENA i' x � /✓/1 ry <br /> rRaecr�ooness .f��\L��Crr�:..--L y'1�—/`"J <br /> YGNetun[ neR <br /> Xx � � U'4 � blYBl/SM1CSSIN.FNSf NO <br /> PLUMBINO MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT PEE <br /> WATER CLOSET(TOIIET) ., NC—ArHNDLG UNITS—H.P. <br /> BATHTUB ; FORCED A'R SVSTEMS—B.T.U. M E.A. <br /> _ LAVATORV(WASH BASW) UNIT HEATE9S—B.T.U. M <br /> _ SIIOWER � CLOTHES D9VERS �— <br /> KITCHEN SINK 8 DI.SP . / VENTILATiOf�FAN <br /> DISHWASHER RANGE HUOD �, � <br /> LAUNDRVTRAV ; WATERFEA�EFl ,� <br /> CLOTHES WASHER ,. _ WOOD STOVE ; <br /> URINAL METAL F�REPLACE 8 CHIMNEY —~ <br /> DRINKING FOUNTA�N FIREPIACE INSERT � <br /> FLGOR DRAIN HEAT PUMP �— <br /> — � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN �— <br /> SINH(SERVICE—BAR,ETC.) — <br /> � �— <br /> SUB TOTAL S �;J.'� SUB TOTAL S _�_ <br /> PEFMIT $ PERMIT S ' <br /> TOTALFEE S T07ALFEE $ <br /> FOR OFFICE USE ONLY: <br /> �flONTSEiB'R / PERISETB�/ SIDESE7BAC/ PIANCNECMy CER FEE `� RECEI iN0 <br /> 4/ � l.t,� n� U �l�9;� <br /> useza+e LpiAREA v�eeNtsitc FEES VALUA710N =Ei. <br /> T <br /> BUILDING /_� �/� — ; J,� <br /> IYPF Oi CONIS�IIGW�BI[ tYP[Oi WN51 ACNAI CrCvw4[r xu q qvluiNGuxrtS -- J�h� <br /> –___�� ��.� PIUMBING .�� �� 1 <br /> 52E OF BlDp NO OF STOFIES BASEMENT <br /> � S f Q I � MECHANICAL <br /> i <br /> i _ m0 �_� <br /> OCCUPANCYLOAp FIFESPRNNlEP5NE0� MEIGIIiLIMI1RilON ADDITIONALPLANCMECN � <br /> I � � <br />( nE�SONFORSre�NKLERS � �v �� SPRINNLER ; <br /> STA7E BUILDING SURCHARGE � - <br /> '� O <br /> INT�REBV PUNS�PPqOVFDBY —_ i <br /> CITY OF EVERETT PUBLIC WORKS .� �,.� <br /> J r LOCAL SALES �' � <br /> 5����c�� TAI(CODE IS 3105 TaTAi �� ; ,—� <br /> 5d � , .�" <br />