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APP�,ICATIOt` FOR CON�TRUCTI� V PERMIT ,' <br /> TO BC COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDING DEPARTMcNT LHEATING SYSTEM: J GAS J ELECTRIC J ___ _ =l <br /> 259-8810 <br /> DEMOUTION COMBINATION �BUILDING MECHANICAL PLUMBING SIGN <br /> OWNf� A�nr,ApDRE55 /Crtv DA FHONF <br /> �O�iNs c�a. P a. �o�c 37 o-I � �•^ds olf--i3, SsR�rcE , wA • 9b°i�y 35��--7379 — <br /> TE�IRNL Ri�pppRE15 CITV ��— ZIP � PMONE <br /> /',�L�'/N6 • <br /> M1ROatEGiOnCEiiG4EP NniIADORE55 CITY ZIP PHONE <br /> �OdiNG - <br /> GENERAL CO4LRAC10F Nu�ADOPESS CITV ZIP PNONE SiAtE LIC[NSE� <br /> Lr V E2 6�,..6'6� MeBl�- <br /> �dECN4NiULCUNiR�CtOR Au���DOFESS GTv iJP pHONE SIDTEIiCENSEr <br /> Pi.'J�!B�NGCONiR�CTOR 6Ui�e00RE55 Lrtv !iP PHONE ST:.iELiCENSE• <br /> CC"+iAAC'MR�.CE OF WORN � �I� <br /> DLSCRipE WORN�Nf)$OU�RE f00TAGE INVOIVED �ONiA�T PERSON AND P��OnE`�) <br /> /Z6c..o�irrt� %2�-rC..tsl�- /3�"•�✓� �2C.F Lc�o,v�n.�� �s i E�.� &v2 sk i 2�6 •-3SC•� <br /> OF� inlr6��t- Wg��� �:ppl�^2Jcr EN?'�y v� I HEREBV CERTIFv THqT I HA`JE fiEP,D hND ExAMINED THI$ <br /> PROVCSEb 115E 0�Bt1LL01NG APPLICATION AND KIJO'.N THE SAME �i O BE TFUE AND CORRECT. AI.L <br /> PROVISIONS OF LAVJS ANU ORDIN4NCE5 GOJERNING THIS TVPE OF <br /> IEG�LUESLRIP1i0NOGPf10PEATvi5H01YNBELOWON�TT�CNTWOCOPiE51 WORK WILL BE CU�dPLETED WIiH WNETHER SPECIFIED HEREIN OFl <br /> e�a� or NOT. THE GRANTIYG OF A PERMIT DOES NOT PRESUME TO GPo'E <br /> LO1 AUTHORITY TO VIOLATi: OR CANCC-1 THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL lAW REGUTATING CONSTRUCTION OR THE <br /> --- -- — PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROP[RTV TO PFRFORM 'HE WORK FOH WHICH <br /> - – APPLICATION IS MADE AND ! COMPL` WITH THE STATE <br /> P�RLEL TRYID NU�ABER CONiRACTORS LAW 18.2%RCW ANG 296.200 WA". <br /> CONSrAUG1lOVLOANLENOER.�0�RE55.TElEPNONE NUMBEF <br /> �, . �.-.�.-�� -�/lq�, <br /> PROJECT ADD ESS �����+���^� ���� <br /> 3003 GA,�• CAr,�,a .tD, 1�S"—SsG ��.��•s,N,ss,��,tiz�v-� — — <br /> PLUMBIN6 MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENI FEE <br /> WATER CLOSET(TOIIET) A�C–A�HNDLG UNITS–H.P. <br /> BATHTUB FORCED AIR SVSTGMS-9.TL. M E.A. <br /> � LAVATORY�WASH BASIN� UNIT HEATERS–B.T.0 M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINrC 8 DISP VEN71l.hTIOM FAN <br /> DISHWASHEF RANGE f100D <br /> LAUNDRVTRAV WATER H�_ATER <br /> CLOTHES WASHER WOOD S10VE <br /> URINAL METAL FIREPLACE(WOOD BURNING� <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> _ _.�_._' <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFIOW PREVENTERS � GAS PIPING —� <br /> FOUF DRAINS–RAINLEADERS E%HAUSi FAN <br /> SINK (SEFVICE–BAR.ETG) <br /> ____'– i–.__ <br /> SUB TOTAL b SUB iOTAI S <br /> PEAMIT S PERMIT S <br /> TOTALFEE S TOTALFEE S T <br /> L�� <br /> FOR OFFICE USE ONLY: <br /> FRONt5ET0<CK RE<RSEiAACN SiDESEtBACK PLaNCHEC Nl1MeEn FEE �ECEi�iNJ �— <br /> / j /(�� <br /> usezoNe iarnFen v�c�Nrsrte FEES VAWATION FEE <br /> . . VES �_� NO BUILDING <br /> ivVF0�C0il51 NOOFSTORiES ttcu>np xot,r�m.[u�+ccv�s -— ' <br /> �°�p° PLUMBING <br /> Si1E0iBL�G iIRESORINNLER5RE0'D BASEAIENT MECHANICAL <br /> – VES - NO <br /> OLCUPA11LY10A0 FiqE�l�R1APE0D NEIGHT�iM11�nON ADDITIONALPLANCHECN i <br /> OTIIER <br /> REASON — ---T— <br /> STATE BUILDING SURCHARGE <br /> IN�AMEfv FL�NSAPPROVEDBY CITY OF EVERETT PUBLIC WORNS <br /> LOCAL SALES <br /> DAiE TAX CODE IS 3105 TOTAL <br />