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� <br /> � ; /CFPLICATIC � FOR CONSTRUCT"'�l PERMIT � <br /> , , <br /> ,_f_, TU 9E COMPLETED IN BLACK INK—PLEASE PRINT <br /> �l. ; - " •r ,�. __, <br /> � I��� <br /> ""'"""""""`" '"" HEATING SYSTEM: �!GAS J ELECTRIC ❑ <br /> .......,.._...............�... <br /> B U I l D I N C��A�A�1�iR ETT <br /> 259-8810 Public Works Dept. <br /> ! DEMOLITION ' COMBINATION J BJILDINC f :MECHANICAL �1 PLUMBING xSIGN <br /> OKTiER tARIL Fppa�SS SUI� CIiV ZIP PHOM1E <br /> �crvA� Enr�rsa z�i� �ncaya�. �:o �r�rr 9���, �'9-�3s� <br /> TEtUNi MAtt FPDFE55 CITV ZIP PHONE <br /> �v[ iaW� RNrra �os' c'ot6yA�• �r�.E�T 9f2oL GS9 -y933 <br /> ARCNR[CTORDESIGNEA IdAILA��FESS GiTY 21P F�GNE <br /> GENERAL LONtRACTOR IAAIL AC1L`RES$ C�TV 21P PMONE STATE LIGENSG t <br /> �yoQEunfE 5/inl /NC• �7a3� ,qv�eA A�N. S�ATI� ' QP/33 �/Z-y937 SNoRESI/i JL' <br /> IdECNPNICALCANTF4GTOF MAiL40DAE55 CIIY IIP PNONE SiATEI�GENEE• <br /> PWN�BINGCONiRACTOR AIAIL ADDRE55 CITY Z�A PHONE STATE VCEN>E e <br /> CONTRAGT PR�E OF WOP.K /��� � � � <br /> DESCFIBE WOPK AND SWPRE f'OOTAGE INVOLVEO CONTALT PER$ON AND PHONE NO M�K .�.I C"NA20f S`+�z� F/�/ <br /> /AISTAlI.. 2 -6 n X //= p'� S/A/GCL�-FAcE <br /> �G�CTU�. l(/�4Lt, S,YA/ <br /> � HEREBY CERTIFY THAT I HAVE REAG AND EXAMINED THIS <br /> PaorosEo use oF eui�o�Nc � OrD pE�Go,�iN4 A�.'PLICATION AND KNOW THE SAME TO OE TRUE AND CORRECT.F�L <br /> H PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> �e�a�oescaianorvoFrnoPearvisNowveeiowonurncNrwocoviesi WORK WIIL BE COMPLE7ED WITH WHETHEF' SPECIFIED HEREIN OR <br /> �ot 3��' siocK� o� ��T OF EJ�E�T NOT. THE GRANTIKG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTICN OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF TNIS PROPERTY TO PERFORM THE WORK FOR WHiCH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STFTE <br /> PARL �az i o.r+uraaea CONTRACTORS LAW�8.27 RCW AND 296200 WAC. <br /> =GGT- oG3-Doa �iJ�� <br /> CONSTRUGTIONLOANLEN�ER.ADDRESS."IEPNONE NUMOEP p <br /> PROJECTI�DDRESS��O v�. ,_. . swr+,u,�e 07�0 � o+*� r 36 — <br /> s �o�sv ,o ��..��=�.��ss,,,.,,sr„� <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF Fl%TURE OR ITEM 'FEE N0. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � A'C—A�HNDLG UNITS—H.P. _ <br /> BATHTUB FORCED AIR SVSTEMS—B.T U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—D.T.U. M � <br /> --�- <br /> SHOWER CLOTHES DRVERS <br /> KITCHEN SINK 8 DISP ; �'ENTILATIOtJ FAN <br /> DISHWASHER RANGE NOOD <br /> LAUNDRY TRAY INATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE � <br /> URI'��AL METAL FIREPLP.CE(WOOD BUFNMG) ' <br /> DRIRFMG FOUNTAIN FIREPLACE INSERT i _ <br /> Y•LOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS P�PIIJG <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR.ETC.) I �� <br /> � ' i <br /> ' �� <br /> � <br /> � <br /> SUB TOTAL 5 SUB TOTAL $ ; _ <br /> PERMIT $ PERMIT 5 _ <br /> TOTA�FEE $ TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�CK R RS ACN � �I�SETBACN PI�NCHEGN UMBER FEE FECEIPiNO <br /> useza+� ioTnr�en vacnrvrsrte FEES VALUATION FEE <br /> � +� rJ YES �. NO BUILDING �$r 1 �t <br /> NPE Of CON57 NO.OF STOPIES P'tweHC° uo 0�DwHUNG u4u5 �j/ <br /> tnoov PLUM�ING � <br /> SIZEOFBLDG. FIRESPRINNLERSREQ'D BASEMENT MECHANICAL � <br /> '._ YES ❑ NO --------<_ J �.., � <br /> occuPnr+r.v�Ono FIRERLARMPE00 NeicHn�Miuibn ADDITIONALPLANCHECK /h ',��h <br /> orf{�r� -��7�'� <br /> PEASON // �./� ^ <br /> STATE BUILOING SUFCHARGE ���L <br /> INTAKE BV �'LANS�PPROVED 0Y CITY OF EVERETT PUBLIC WORKS � <br /> �M LOCALSALES <br /> on,E lQC t� TAX CODE IS 3105 rorn� _ �� �j� <br />