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� �y � <br />Q7dx <br />q N <br />9Hfn <br />� <br />y i-�+ <br />�H� <br />��� <br />x <br />��� <br />pH <br />� � � <br />Y H L�7 <br />� <br />t HH <br />g� <br />n �� <br />� � Cil <br />xHCn <br />HOcn <br />A�9tl"R'�.i6s�i �`ii� �V� V��5��7V\i� J,Y ��[779E�T everelt <br />�� � ,, TO BE COMPLETED IN INK—PLEASE PRINT I� <br />l <br />CITY OP <br />everett <br />BUILDING DEFARTMENT <br />259-8810 <br />DEMOLITION <br />COMBINATION <br />DDR[SS <br />I_i`7�Z 1�1= <br />AflC11RECTOFDESiGNEP I.IAILADORE55 <br />GEN[R\�CONiflACTOR MAILAUOFE55 <br />N[CfO�NIC4LCON�qACTOR <br />LoDfi�'k� � <br />f-LUAIpMG GOHiRACTOR <br />' I NEW AODITION �QLTEFATION <br />' 1 �-/�J�^�� cG` <br />CONTq�LTPHICEOFWORK �`�� / � <br />LCSCRiBE WOBK AN� SOVARE FOOTAGE RlVOiV[f] <br />lta;r L1- (���� ��aN H,U.! <br />PPOPOSEO USE OF BU�L�iNG <br />l[GAL DESCRIPiiON OF PROPERTV ISMOIYN OEIOYl Oq AT <br />LOi BLOCK OF _ <br />ITEM <br />LAVATORY(WASHE <br />SHOWER <br />KITCHEN SINK 8 DI'. <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />11RINAL <br />DRINKING FOUNTA <br />FLOOR DFAIN <br />Bf�CKFLOW PREVE <br />FOR OFFICE USE ONLY: <br />FRONiSETpACH REARSEIB\CK <br />115EZONE LOT4PEA <br />hFEOfCOfI15ALlOWhBlf 7YPEOFCONS7.ACi0Al <br />3RE OP BL�G NO.OF STORI[5 <br />OCCUPMICY�O�D PiRESPRIIeI[NSR[O'D <br />RE�SON FOR SPRR1KlER5 <br />MrAM.[E3v rLnNSnrrROJ[o8r <br />��. <br />HEATWG SYSTEM: �y <br />BUILDING <br />C Y <br />" �L, s W Sc�FT <br />GITY <br />GiV <br />GIiY <br />rtr <br />a SW L IJM <br />LItY <br />S <br />❑ ELECTRIC U <br />�' MECHANICAL PLUMBING <br />2iP PIIONE <br />IFiI�' Z�IZ-� 81 <br />21P PHOt�E <br />ZiP PHONE <br />ZIP <br />ZIP <br />0=1" <br />PHOIIE <br />REPAIR DEMOLITION '. ' WOODSTOVFJFRPL INSERT <br />I LONiACTPLA50Y�NOPHONENO <br />SIDF. 5[TFIACN <br />LICENSE • <br />LhICENSE • <br />L CEt�� <br />SIGN <br />BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND EX�MINED THIS <br />APPLIGATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TFIIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEflM1T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEPFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITN THE STATE <br />CO�ITRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGtIATpFEpFCO11TRACT FOR UTNOqREDAGEHT OATE <br />� <br />� / � � - „�f� 12 ���qn <br />AVPLIC 1i5CiNpt15:E55LICENSENO.ANDEOSINESSNAM1I[ <br />FORCED AIR SYSTEMS—B.T.U. M <br />UNIT HEATERS--B.T.U. M <br />CLOTHES DRYEFS _ <br />VENTILATION FAN <br />RANGEHOOD <br />WATEH HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />. / , I ". �, <br />SUB TOTAL 5 � <br />PERMIT S /,`�-! —_ <br />NU6�OEf1 � FEE � RECE�PiNO <br />BUILOING <br />MCCP.rILv �:OOipb[LLIIILI:':i15 <br />c+mu= PLUMBING <br />9nSErAENi MECHAfJICAL <br />nEiG��r ui.�irnuou ADDITIONAL PLAN CHECK <br />OTHEfl <br />STAT[ �UILUPJG SURCNARGE <br />CITY OF [VERETT PUDLIC WORKS <br />LOCALSALES <br />TAX CO�EIS 3105 TOTAL <br />