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APPLICQTIC 1 FOR CON�TRUC7✓ 7N PERMIT ;� <br /> TO BE COI�APLETED IN BLACK INK—PLEASE PRINT V..��o�rr <br /> �/ <br /> , _ — ---- – -- <br /> EUILDING DcPARTNIENT � F�EATING SYSTEM: J GA3 iJ ELECTRIC J __ __ � <br /> 259-887G <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> C�4qEF M4r FDDfifSi �-v 26� PN04E <br /> 1 <br /> � ` /, <br /> ��I�U t ���/�. 1_ � l G�'��/�(i. f '� f i ! �� � /_'r -P!�i 1� CC..�i1 2 � �> —y � � J <br /> — ! f � C�- (�+� � 1_ <br /> 'Dlnr�i AUR�DORE55 Uiv pry ' vNpNE �. <br /> C r- �`rZ y � i��= r L. �. �= G � i <br /> F';'.;i��t[LTOR��E5IGIJEP M�LLAOIXiESS CITY iW p�p� <br /> r�t'�C9ALC0lITiUCTOfi WLRDDRE55 CItY ZIP P1qNE STATEULE��.SE• <br /> .�ICOTDe L �/�c�a�,= n7 y <br /> �..rCHpNIL�LCpNTP��TOR MAl�qppqESS � LRY ZIP PNONE $T�7FLPCENSE• <br /> �/�tli . IKc �lr- 5. 17 - �sonn [iiiryPb 1-'9�tlr�col� W9�o3G� �Fr�l.ct �/a [ 7 <br /> PLUMOINGGONTqAGTOq IMILAppRES6 pITY IW PNONE STATE�ICENSE• <br /> 7r <br /> �._. - 3.� <br /> CnyiRACT PPIGE OF V/Ofi( .. <br /> �a �'=� <br /> ,.�!:�itt3E WpIK RN�8011ARE FOOTA6E INVOLVED -C�NTAC�SON AH�GHONE NO. <br /> _ T e. 1 �/��?,. l✓/7./ j <br /> ___ �i� �i,. �. <br /> I HEREBY CERTIFY THAT I HAVE READ AIJD EXAMINED THI� <br /> r:+ov�seDUseOvetmnmc pPPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT.ALI. <br /> E �� V/��. PROVISIONS OF LAWS AND ORDIIJANCES GOVEFNING TH�S NPF OF <br /> U6/.LDESCqIPTqNOFPqOP[RiY�SHOWNBELOWOP.ATTACNTWOCOPIES� WORK WILI BE COMPLETED WITH WHETHER SPEGREU HEREIN O� <br /> �� � NOL THE GRANTING OF A PERIu11T DOES NOT PRESUME TQ GiVE <br /> ���r AUTHORITV TO VIOLATE OA CANCEL THE PROVISIONS OF ANV <br /> OTNER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF GONSTRUC710N THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOA WHICH <br /> APPLICATION IS MADE AND I COMrLY NJITH THE S7AlP <br /> l�4RCELIA%I.Q NUMBEF CONTRACTORS LAW 7827 RCW AND 296200 WAC. � <br /> __ �� <br /> CONSTRUrTI09lOA4LE4�ER 4DIXiE55,TELEPHIXJENUMBEP � /�,( <br /> \^ � rA� .l A �� . :� -'.1 , / _-l�l�!E J 'I J- J ��r <br /> PROJECT ADDRESS Q �� v 4 � — <br /> � �� �-. � /„ _ - i��ict�rn - - —� <br /> PLUMBING � MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EDUIPMENT FEE <br /> __ WATER CLOSE7 fTO�LET1 �— A�G—A�HNDLG UNITS- H.P. <br /> DATHTUB FORCEDAIRSVSTEIdS--O.7L1. M E.A. <br /> LAVATORY(WASH BASIIJ) UNIT HEATEHS—B.T.U. M <br /> SIIOWER CLOTHES DRYERS �— <br /> KITCHEW SINK 8 DISP � i VEIJTILATION FAN � <br /> DISHWASHER FANGE HOOD � —T— <br /> _ LAUN�RYTRAV WATER HEATER � - <br /> CLOTHES WASHER i WOOD STOVE ; - <br /> URINAL METAL FIREPLAG[(WOOD BURNINGI <br /> . DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> FLOOR DAAIN � HEAT Pl1MP � <br /> BACKFLOW PREVENTERS GAS PIPiNG <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SRJK ISERVICE—BAR,ETQ) � - <br /> � I <br /> �_' <br /> 1 <br /> __ sue rorn� $ � sue rorn� s � <br /> PERIAIT 5 PERMIT $ /� ; - <br /> TOT.4L FEE $ T07AL FEE S r'; �' <br /> FOR OFFICE USE ONLY: <br /> �'�ONiSETAACrc qEARSETBACN 6NESE7BRCK PLANCHf N oEf� iEE r+[GEi�iNO <br /> 7 <br /> � <br /> u;ezorve LOTAAGA VACRNT6ITE FEES VALUATION FEE <br /> '��7 YES i� NO Buann+c ' <br /> ;+rFOiCONSi. NOOF6TORIES Oxuwdn tqanxiioNcmnrS -- -- - <br /> �A�� PLUMBING <br /> SiIEOFBLDd. FlRESPFMKLERSREdD BASEMEM MECHANICAL �— <br /> f 1 YES �I NO <br /> '!=CUPANCY LnM FIRE RuiiM i1EOD HEiOMT tnAIT�TIpN 4DDITIONAL PLA.N GHEGK � <br /> OTYER i i <br /> :•.Fn9pN T �I <br /> ,IATF AUI�OING SURCHARGE <br /> .: m- i ri nN511PPROVFD BV CITY OF EVERETT ruauc woaks <br /> •,�M LOC4L SALFS <br /> I """ '= '-1 'r• � TAX COUE IS 3105 TOTAL <br />