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APPLICATIQ ' FOR CONSTRUCT' �N PERMrT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE FRINT <br /> -- <br /> -- - - - ._ ._ _ _ __ _ _ , <br /> BUILDING DEPARTMENT HEATING SYSTEM: .J GAS J[LECTRIC ,J __ __. __ ._, � <br /> 259�8810 - - --- <br /> DEMOL!TIO� COMBINATION � BUILDING MECHANICAL PLUMBING SIGN <br /> owru� nun ano�r:ss cnv --- m� --- rHONe ---- <br /> -�6_BoEi�� ca.f p.e. (3ex 3'7�7 µ�s sN�3 S6��i�' wB-. 98�Q-`/ 3`F'z"73T9 ---- <br /> �FNANI M�ilq0�FC5p ('il�—t Ti�' � P�iON[ <br /> �h"1 C __�15 p�•+NC1✓ <br /> nnr.�i.recrannFsi,NFA unnnonness cirv rm pHonE <br /> (d9fAALCON1�4CtOR IA4it4ppRf55 (:ITY ZIP PIIONE SI�iFUCE1lSEI <br /> �..'V(�K,/aR�'A� ��QlI.E <br /> Idl L�UNiCAI LONLqAGtOfi MAiI pODPE55 CITY IIP PHONE SiATE IILENSE� <br /> PWMOMGCONiMCiOR Id�IIADORE55 GtY :�a PPONE ST�1ElICENSE� <br /> CON'P�CL PPICE O�WORN <br /> Of SCRi�XK�ND$OURRE FOOUGE INVOLVED CUM�C PPi50N RND Pr'pNE Nf= — <br /> �y <br /> (ZQt.oGwT6 TR.�a�lSk- �{e— f{(� fAw N�lff- (.16:o.J��il. AsTEWIBOd.SK/ Z(ri��slr <br /> � C�Mr� �'5��� �'~M4v't ' I HEREBV CERTIFV THAT I HAVE READ AND EXAMI,yED THIS <br /> raonoseousr or pi�iimNc APPLICATION AND KNOW THE 3AME TO BE TFUE AND CORRECT. ALL <br /> aMPL��/� BtiEO�K Ttif�'�LI.rK.. PROVISIONS OF LAWS AND OPDINANCES GOVERNING THIS TVPE OF � <br /> lEGnIDESCAIPiIONOFPqOnERTVISNOWNBCIONORnTTACNTWOCOP1115� VJORK WILL BE COMPLETE�WI7H WHETHER SPECIF:ED HEREIN OR <br /> IJOT. THE GRAhI'IIJG OF A PERMIT DUES NOT PFESUME TO GIVE <br /> �or e�ocK -- ov AUTHORITY TO b�IOIATE OR CANCEL THE PROVISIONS OF ANV <br /> UTHER STATE OR LOCAL LAW REGULATING CONSTRUCTWN OR THE <br /> — PERFORAIANCE OF CONSTRUCTION, THAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTV TO PERFOPM THE WORK FOR WHICH <br /> - -- APPLICATION IS MADE ANp I COMPLV WITH THE STATE <br /> nnAce�ue i o r+uMaea CONTRACTORS LAW 18 27 RCW AND 296.200 WAC <br /> CONStP'JCiI(.N LOnN LFNDER.AD�PESS.TEIIiPNONE NUM9G n <br /> ,�� � i�(�� <br /> PROJE TAODR 5 sir,v+nmr -�uu� <br /> �J �,. e�ciwe ,cD. �e—Y/3 ��,.A�s,���s���,,.� �„ <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—A'HNDIG UNITS—H.P. <br /> BA7HTU0 FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY�WASH BASIN) � UNIT HEATEFS—B.7.U. M <br /> SHOWER � CLOTHESDRVERS <br /> KITCHEN SINK 8 DISP ; VENTILATION FqN <br /> DISHWASHER RANGE HOOD r <br /> LAUNDRY TRAV WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAi FIREPIACE(WOOD BURNING) <br /> DRINKING FOUNTAIN fIREPLACE INSER7 ; <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTEFS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EJ(HAUST FAN <br /> SINK�SERVICE—BAR,ETC.) <br /> — � — <br /> — -- — T— <br /> SUF TOTAL $ SUB TOTAL S <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ TOTAL FEE $ <br /> POR OFFICE USE ONLY: <br /> �RONISFLflACN REARSE1p4C.N �SIDFSPiflAf,N PI�Nf,F(CN IIM@'R I[E PfCFIPINO <br /> ,y ;c� � <br /> use�orie l01 RqE� MUN15rtE FEES VALUATION FEE <br /> vEs No oua�ir+c � n'i <br /> trPF Of CONSt NO Of STOFIES acur�v�� nn o�trv��:i+r;ry�� ----- —�4= <br /> J� /� �, / '"'� PLUM814G <br /> SiT[UF 9LM: FIRE SI'PINXlERS REO� BASEMENt MFCHANiGAI � <br /> I��I .S ,F�. N 7 VES NO — -- -��-- <br /> OC�.�I:PANCVLO�O FliIEP�AfIMREOD NEIGN1lIMitR110N ADDI110NALPLANCHECK <br /> r � N � OTHER �'---� <br /> liE�50N _-- <br /> S7A7E BUILDING Sl1RCHAHGE <br /> �L—. <br /> i�;iaKF�a�— vi�Ns n �yeoa. - CITY OF EVERETT auouc woaks <br /> ��r� LOCAL SALES <br /> �>a,, y- �q _� TAX CODE IS 3105 TOTAL <br />