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APPLICATIC"'1 FOR CONSTRlJCT'"`1N PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> _ -----_ _ I <br /> �UILDING DEPARTMENT �_HEATING SYSTEM: J GAS ELEGTRIC J <br /> 2'i9 8810 ---- - --- <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> ----- <br /> ---- --- — ----- - <br /> �nvr,i i� e,nu nn„n�s�. �.,r 7m — . r�u�u <br /> �rnn�__tnhsr--_-�ll�a 4�(� N .E�R��h�,ti� SY�a3-- ---�3-'�J`—o�-3S -- <br /> IIN4N1 M41lADD11f55 GIY )it� P� '�: <br /> nRC119FC1Of1[1C9GNfN MAIL�UDfiE55 GLV Zi� PNONE <br /> �{ew.t �,S OW►�G/✓ —. <br /> tIINI.R4lCOhIqAC10R MAILAD�RE55 CIiY ZIP PHONE SipTEV(ENSf • <br /> 5 R rn� f�5 ow n�rZ, <br /> A��U��N'C�l CONIqqClOfi M�il.A�pRf.55 LILV IIP PMONE StAIE IJCENS[• <br /> PlUMOiNG CONIRACTOR MAII�UDf1E55 C11Y Zln PHONE STATG LICENSE I <br /> fnNifiACiPR'R1EOpWOP�{,� _ — —_— ____— —_-.. <br /> 3�x, f a <br /> �_ <br /> f�ESOPiN[WOfiN�Ap50UAnFfOC,nGEINVOLVEJ CONTAf.TPER50NRNDP110NF.N0 Tw_ QQ�`n ' <br /> _��\V `� OL�Y—_—__ __ .___ YT 1—__ <br /> --A�'-0��-p- -��co __�����p �` —_ 33�{ -0435 _ <br /> SCJ�_��v_g_� i HEFEBV CERTIFV THAT I HAVE READ AND EXAMINED TMiS <br /> rnoroseo usc ov ouuown . APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT P,L�_ <br /> YhUL'T j � (Zp S�D QNT 141- PROVISIONS OF LAWS AND OfiDINANCES GOVERNING THIS TYPE O'= <br /> ircni oescnirrroNorrnnrenrv�s��owNnc�owor+anacNrwocoriesi WORK WILL BE COMPLETED WITH WH[THEF SPECIFIED HEREIW Oi�� <br /> PL►tT O F NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMB TO G.VE <br /> ���'--� 1°��� ' °f — AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF l.NV <br /> ��� C�'ST _ _ OTHEH STATG OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br /> ----- - -- -,-/-- -- PERFORAIANCE OF CONSTRUCTION.THA?I AM AUTHORIZED BV THE <br /> (� C,( OWNER OF THIS PHOPERTV TO PERFORM THE IVORK FOR WHIGH <br /> —_ >J-E����-�[- APPLICATION IS MADE AND I COMPLV WITH THE S7ATL <br /> rnncri tn.i o r+indnr n CONTFACTORS LAW 1827 fiCW AND 236.200 NlAC. <br /> COYS�nqf.tl�)NiOro�lE�1�CR RESS tFlCP��ONE UMPER <br /> P���� _ 1 ,�, r�- I��l,o,.�,,., �t- �a-�� <br /> R S�L: X,��„�,�,� -�,.�� - <br /> � a�v n�n�w s�i.i.,�•- <br /> MBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR IiEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WA'fER CLOSET ITOILET� A C-A HNDLG UNITS-H.P. <br /> � � �ATHTJB FORCED AIR SVSTEMS-B.T.U. M E:A. _ __ <br /> _� �AVATORVIWASHBASIN) UNITHEATERS-B.T.U. M � <br /> SHOWFR CLOTHESDRVERS _ _T- I <br /> �p KI fCHFN SINK 8 DISP VENTILATION FAN _ __ _ <br /> 'S4WFSHER RANGE HOOD <br /> Lt�L1N�RV TRAV WATER HEATER <br /> CIOTHES WASHF.R � WOOD STOVE _ <br /> URINAL METAL FIREPLACE(WOOD BURNIN3) ' <br /> DRINKING FOUNTAIN FIREPLACE INSEfiI � <br /> - -� <br /> FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTE GAS PIPWb � <br /> ROOF DRAINS-RA EADEFS yZ E%HAUST F";.N —�— <br /> SINK�SERVIGE AR.ETG.) . — <br /> '' ----�- <br /> -- y- —.__._ - . <br /> _ T— <br /> S118 TOTAL $ SUB TOTAL $ . <br /> — -- PERMIT $ -� - --�- PERMIT $ _ _ <br /> TOTAL FEE $ TOTAL FEE $ �_ <br /> FOR OFFICE USE ONLY: / �` �"" <br /> rRONtSfIDnC,x� R[aH5clnRcrc / SIpCSEtA� � rinNC��fJ1nN{q.f�� �� � / ��/���� <br /> �j g� � i �/ r�i� <br /> �-�- .G_. •-�• <br /> use tor�e iui nnE� V�GNL SI7E FGES VALUATION FEE <br /> �� VES . NO OUIIDING ,3z2� �1�'. /1/�'(' ' <br /> Iv�f�VLOqSi RT. OFSTORIES ocrev� r qnnpWw�., •.'• —'----"-- .--..-.------ ' • <br /> Y_ �L� u'i° �s 3 2°��„�i �•���M��N�_------- <br /> 9� NR <br /> SiZE�10G FST[0 • �SPi1iNNlER5RE0D B�SF.MENL Mf.C11�NIf.AI --` <br /> 7oJ'J ��ct�'oQ `//CS YES /FfJ --- _ _ . ; <br /> 1 N <br /> OCCt1Pn.Yf.V IOAD nn�M nnM�EOD HEq11i,1 IMnA71�N� _��DIIIONAL PI AN CIICCK l ��`�!� <br /> �/i� -- -Y�s- 3S -- ���,���� �(flXl/C� �—�c—', <br /> �EAS(1N � ` <br /> !ilAil 11UIIUINGtill11('.IIAIIGI �� ^� � <br /> __ —._ <br /> i��fnKe ev �'�A����o���A� � CITY OF EVERETT i�um ic wonKs ; <br /> IOCALSRLES .T <br /> � �,,,,� � -��- `)y TAX CODE IS 3105 rorni — - �!�!�� <br />