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APPLICATIOM.FOR CONSTRUCTIi�I PERMIT � <br /> /�y \ TO 9E COMPLETEO IN BLACK INK—PLEASE PRINT <br /> ( <br /> � HEATING SYSTEM: U GAS ❑ELECTRIG �l � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I_1 DEMOLITION L I COMBINATION �BUILDING I I MECHANICAL I i PLUMBING f] SIGN <br /> OVME11 M��I.��ORESS CITv 21P PHpNE <br /> TME ��nIG c�o, , P. o. 6ox 37o��M1s cF-�G , .SE9TL�il�/A. �IS�Z-y 266-?sG3 <br /> TENINT M�II�DONES CITV 21P PNONE � , <br /> S IM7� �T O f✓N67L <br /> �RLMTECTORDE516NEA M�IL110DRE55 GTv 1�� �MONE <br /> ��c eNo,,�Eatis <br /> 6ENER�L CONTRAGTOF MAIL�D�RESS LRV 21P PMpqF ST�tE LICENSE• <br /> �GLTCNC2 �^�DU,sTKiRt_ <br /> MF.CN�NIGALGONiR�C70H M�II���RE59 Gtv (iP P1qN[ Sf�TEIICENSEI <br /> PWMBIN6GONTR�CTOF M����DDRE55 Ciir Tin ��ONE ST�ikLiCENSE� <br /> C.p1TR�CTPRICEOfWOAN _--.. <br /> �LO� OJO <br /> DESCHIBE W011K�ND SWARE FOOTh6E INVOIVED CONT�C7 PERSON�M1D olpry[NO <br /> —p/���`�------ L.FONAnD f�5�3o25K � _z�`-3s`3 <br /> �7.. — — <br /> i HERElfV CERiIfV THAT I HAVE FEAD AND EXAMINED THIS <br /> PRpPp5EDU5E OF BUitD!rv6 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> C2[W SLL6�'�� PROVISIONS OF LAWS AND ORDINANCES GOVERNIN6 THIS iYPE OF <br /> LE6�lDE5GRIPTqNOFPROaEPiv15NOWNBEIOWOPAtTA�MiWpf,OPiE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT TNE GRANTII.G OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tot -- eiceK nF AUTHOPITY TO V�OLATE OR CANCEL THE PROVIStONS OF ANY <br /> OTHEF STATE OR Lt)CAL LAW REGULATING CONSTRUCTION OR THE <br /> ----"-- "–--"--- �� ---'-- --- PERFORMANCE OF CONS7RUCTION. THAT I AA'AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFOFM THE WORK FOR WHICH <br /> -----------�-----�-------�----�----� - -�-- APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> n�PGEI T�R I O NUMPF� CONiRACTORS LAW iB27 RCW AND P96 200 WAC <br /> Cp!$TRUCTqN LO�N�ENOER.�UDRESS �ELEPNONE NIIMAER — o �`.''_1 � /"/ "/r /� <br /> v�JM1�N'M �'���•/�� � <br /> PROJECTADDRESS ���� <br /> sr.Ncim� n��e <br /> �00� W. �i�Q.S/.✓O � �S'�`�'� cnnmamrs.vucmm�o - <br /> PLUMlIN6 MECHAN�CAL � <br /> N0. TVPE OF flMURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C–AMNDLG UNiTS–H.F <br /> BATHTUB FORCED AIR SVSTEMS–B T U M E A <br /> LAVAi:1RY(WASH I�ASIN) UNIT HEATERS–B.TU M <br /> SHOWEIi GLOTHES ORVEHS <br /> NITCHEN SINN 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD �— <br /> LAUNURV�fRAY WATER HEATER <br /> CLOTHES WASHER WUOD STOVE <br /> UHINAL ..� METAL FIREPLACE(WOOD BURNING� <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOO.`?OFAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS–RAINLEADERS --r EXH4UST FAN <br /> SINK(SERVICE–BAR,ETC� ; <br /> SUB TOTAL S SUB TOTAL R <br /> PERMIT S PERMIT E <br /> TOTALFEE S 10TALFEE E <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�CK RE�PSEiB�CN SIOESEH�CM v�1NCNECMNUMflER FEE RECEIPiNO <br /> useiorie LOTARE� WC�NI,PTE FEES VALUATION FEE <br /> ,-'� YF S f 1 NO BUILOING ,p � <br /> rYPf Of CONSt NO OF SlOPiES ocM�utr 'p d Owtu�ux�i6 — <br /> � "0�° PWMBING <br /> ��.__ � _'_ <br /> S11EOfBlUG FIRE51'NINNI.EPSREO'D OASf.MF.NI MECHANICAI <br /> 7 a ' Nu, ves � ---- ----- --------- — <br /> --` up"---- ---� ADDITIONAL PLAN CMECK <br /> (KCU^�NCY�00 FlNE�IARMf1EOD ��FIGH711M11�IION <br /> ___� u� OiHER ' <br /> AE�SON <br /> T <br /> StATE BUIL�ING SURCHARGE � <br /> M1�Nf BV P�ANS� POVE09V CITY OF EVERETT PUBL�C WORN$ ' <br /> � LOCAL SIILES T"— <br /> o.�r ��_I) •i J TAX CODE IS 3105 Tor�� <br />