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v <br /> �q� APPLICATIOK fOR CONSTRdJCTIC .J PEiiMIT � <br /> TO BE COMPLETED IN BLRf,K INK--PLEASE PHINT <br /> BUILDING DEPARTMENT HEA7ING SYSTEM: U GAS U ELEC7RIG L] <br /> 259-6810 <br /> � DEMOLITIQN COMBINATION BUILOING MECHANICAL ! i PLUMBINO �SIGN <br /> 01YNER M�IL�DORESS CITV 21P PNONE <br /> Tt �s� iy��,C�P �i .�'.0 L3d�.� 'sew7 Gys- oyc s� <br /> N�NT MAR ADONEfiS CITV IIP PMONE <br /> r �� �� I � II <br /> RCNITEC70R DES NER MMl�DDRESS GITY ZIP PNONE <br /> r- -�' , �r.i o.r�C e..cr S ,� ��i 3 v .z ss�`f t�r�.ere�r.�n�i <br /> O NERALCd1TR�CiOR M� AODNE55 CITV ZIPy� PMONC 6TATELICEN9E� <br /> MECM�NILKCONTR�CT011 MAILADDRE55 CI'Y EIP P�E STRELIGENSEI <br /> �� <br /> PLUMBINOCONTR�CTOR M�ILADUNESS CITY 21P PMONE STQELILENSEI <br /> �� <br /> C1A85 OF 1WNN <br /> I I NEW I I ADDITION �AITERATIJN � � REPAIR � DEMOLITION WOODSTOVbPRPI INSERT '�. �' BUILDING RELQCA110N <br /> — fANTACT PERSON N!D P1qNE NO <br /> f:O�TR�CT i'HICE 9F WOHI( �S��'��I ��==—���� <br /> OnCBCRyIBE VJ.01,1r ANO 60U�RE FOOT�OE INVOIVED <br /> anoros�ouseoF uaona � ��fi � i HEFEBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> ��� ���J�� • APPLtCATION AND KNOW THE SAME TO BE THUE AND CORREC2 ALL <br /> �E ��Riv� pRpP RTY(SIIO�Vt�UW OR I ITACM FIX1R CqPIE81 PROVISIONS OF LAWS ANC ORDINANCES�OVEHNIN6 THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot ��H � NOT. THE GRANTIN6 OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE�OF CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PEflFORMANCE OF CONSTPUCTION.THAT I AM AUTHORI2ED BY iHE <br /> OWNER OF THIS PROPERTV TO PERFORM TNE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br /> �or �� r ��.�i./1�.�..�� s-/^'17� <br /> PROJECI ADORESS 6qN�tU1�,�`O�/ o"�E <br /> / <br /> crtv eus.+Ese icEwsE Mo <br /> PLUMlINO MECHANICAL <br /> Np, TYpE OF FlXTURE OR ITEM FEE NO. TYPE OF EOU:PMENT �E <br /> WATEfl CLOSET(TOILET) � A/C—A/HNDLG UNITS—��i P. _ _� <br /> BATH'iUF1 ' FORCEDAIRSVSTEMc;�—fi.TU. M E.A. ; <br /> LAVATORV(WASH BASIN) � UNIT HEATFRS—B.T.U. 6S � _ <br /> SHOWER ' CLOTHES URYERS __ __' _._ <br /> NITCHEN SINK 8 DISP � VENTILAT�JN FAN _ � <br /> --T— <br /> DISHWASHER � RANGE HOOD <br /> LAUNDHV THAV ; WATER HEATER � <br /> � <br /> � CLOTHES WASHER � WOODSTOVE ' <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � __. <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> --T— <br /> �LOOR DRAIN HEAT PUMP _ ' <br /> BACKFLOW PREVENTERS ; OAS PIPINO T— <br /> ROOP DRAINS—RAINLEADEFS � EXHAUST FAN ' .__ <br /> SINK(SERVICE—BAR,ETC.) '- <br /> � — <br /> — � —�-- <br /> � <br /> � — <br /> _ — <br /> SUB TOTAL S ' SUB TOTAL S ' __ <br /> PERMIT S � PERMIT S �__ <br /> TOTALFEE S ' TOTALFEE S `_ <br /> FOR OFFICE USE ONLY: �- 3 <br /> fRONT 6ETBACN RE�R 6ETBACK SI�E 6ETB�CN P�I1N CNECN NUMBE <br /> FEE REGEIPTNO. <br /> �REA (1 (I V�CANT6ITE ' FEEB VALUATION FEE <br /> USE ZONE , <br /> C -/ �. '�b / y,4 ,�o euaoiNa '��_ <br /> IYVEOFCONiS�ILOW�BtE T�PF LOxS�A U�l �qavr �a�`���'�"�S � <br /> �� PLUMBINO ' <br /> --�--- <br /> 6����pp NO OF STORIES BASEAIENT MECHANICAL � <br /> AODITION�L PUN CHECK ' <br /> OLCUPIINCYL0�0 FIRF.SPRNNlER5RE0'D MEIOMTIIMIT�T10N � � <br /> �uJ q: SPRINKLER � <br /> —__�_ <br /> REASON FOR SPRINMLERS i S"tJ <br /> STATE BUILDINO SURCNAROE <br /> INTAME BY IRANS�PPROVED BY CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES � <br /> G � Z TAX COOE IS 3105 rot�i �f.2 � SO <br />