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APPi.GCATIC ! FOR COIVSTRIi �'f ,iV pE:RMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br />BUILDING DEPARTMENT HEATING SYS7EM: GAS i;� ELECTRIC 'J <br />259-8810 — <br />DEMOLITION COMBINATION X BUILDING MECHANICAL PLUMBING <br />°v+NE� r.�nanooness Z��, SIGN <br />v� � e�J� y�b ��.Y NNONE <br />�,A�„ o • a- � B�IDZ �.�� rP�✓t ��_�v,P.c.e�, �.Jl� �fs��g �a3b2'� Fc <br />���, ri{oN[ <br />1\ �/ <br />COHiRACTOR <br />:AICONiRACiOR <br />/1 �O <br />noo�ess <br />;nocn = <br />a . �o,� <br />C11Y <br />C� <br />11P <br />Ir. <br />zm <br />zq�P <br />zlr� <br />. � PH01�11��� /'V �.�i•�� <br />STATE LICENSL> <br />�rnor�E srnreucens=r <br />� c3� ze�3_air� �t��.�i�,,,� <br />PHONE ST�iE LICENSE a <br />CLA55 OF WOBK <br />. NEW DOITION �LTERATION FjEPAIfl . D[MOLITION WOODSTOVEiFRPL INSERT � BUILDING RELOCATION <br />�O \1/ y� r" C0. CTP�ER5�0 AtlDP�NO�NENO. � ` `\ � <br />CONTRACTPFICEOFWOflK �` �/�j^U� �"�=�����]Cd.�+��J�-1 ��E.-'lo�t,�/�n �Cu�L <br />o enio� ��or+rc n�io ouaRe FooTnce i,vvoiveo ` <br />.��,.�—(�' �s-ti; � u, � r��-P�,� � `_ �� 2 �' - Zr2..�-- � 3 �-I g <br />CPi70PO5EDUSGOF`p' �aow� i HEREBY CERTIFY THqT I HAVE READ AND EXAMINED THIS <br />6sA �7n1 �" � G`� �^G I e. �$ �GST. 1�J 0 rG h <br />'�y APPLICATION AND KNOW THE SAME TO BE TRUE AND CURRECT. ALL <br />L[GALOESCiiiP710�lOFP OPERTV�SNOLYNOELOWORAiTACHFOURCOPIES� PROVISIONS OF LA'NS AND 03DINANCES GOVERNING THIS TYpE OF <br />�oT o�ocK oF WORK WiLI BE COMPLETED WIrH WHETHER SPECIFIED HEREIN OR <br />� NOL THE GRANTING OF A pERFdIT DOES NOT PRESUME TO GIVE <br />//(,� ;� AUTHORITV TO VIOLATE OR CA;dCEL THE PROVISIONS OF ANY <br />—L-� - ,� �y <br />PiiOJ[C7AD BS <br />� i <br />i ���c %_ ! <br />PLUMB�NG <br />N0. TYPE OF <br />WATER CLOSET <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUC710N OR TNE <br />� PERFORMANCE OF CONSTqUCTION. THAT I AM AUTHORIZED �Y THE <br />��� n�'� OVlNER OF THIS PFiOPERTY TO PEFFORM THE 6'iORK FGR WHICH <br />APPLICATION IS MADE A"JD I COPAPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KIT�HE� SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAI4 <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—aniNi Fnr <br />OR ITEh1 <br />SUB TOTAL S /; - ) <br />PEfiMIT S . �. C% <br />TOTALFFG g ... <br />FOR vFFICE USE ONLY: <br />FRONTSETOACN REAFSET�4CK <br />Kr 5-n�G-- <br />usezowE ioTnaen <br />C—� <br />iYCE OF CO!!i5 AL! q7lAOLE iYPE Of CO'!4. hL7UAL <br />�AJ :�N <br />IZE OF BL�G NO.OF STORIES <br />i �F �.�. '(: I . � <br />OCCUPANCVLOpD FIPESPRNKLERSREOD <br />� � <br />INiAKE �Y <br />PLnNS APPROVE 0 OY <br />NO. <br />0 <br />rUFiCED AIR SYSTEMS—B.T.U. M <br />�INIT HEATERS—B.T.U. M <br />CLOTHES DRYEqS <br />VENTILATION FAN <br />RANGEHOOU <br />WAiEfl HEATER <br />WOOD STOVE <br />METAL FIREPIACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT Pi �MP <br />GAS PIPING <br />EXHAUSTFAN <br />�Q� P�- ru.iJ D� <br />-1DESETpACK pUf.�CV'� ��,1BER F� <br />3� <br />vncnr�t srte FEES <br />/J O <br />BUILDING <br />atn..;c. rmo�auu�n;e'e.:s <br />r.rv ., <br />j � PLUMBIN� <br />3 EhfENT IdECHANICAL <br />IVU <br />1EIGH7LIIAITATION ADDITIONAL PLAN CHECK <br />SPRINKLER <br />S7ATE OUILDING SURCHARGE <br />CITY OF EVERETT pUBLIC WOFKS <br />LOCALSAI.ES <br />TAX CQ!]E IS 3105 70TAL <br />� ;�_;l <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTALFEE 5 <br />RECEIPT <br />�s� 7� <br />a•� <br />FEE <br />