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� � <br />� � <br />���(`� <br />O m O <br />roHm <br />� � � <br />�ii • <br />t� � <br />M <br />N <br />M <br />N <br />EO y <br />O � <br />1 1� <br />...,. ,-�, <br />APPLICATI(71N FOR CONSTRUCT�uN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />� HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION I I COMBINATION BUILDING �I I MECHANICAL I I PLUMBING I I SIGN <br />ownen ua�nnon[55 cnr zm ruuue <br />�Vuz6t i /-�cl.sii✓G AuTi��UP� ��Q��'. PO�Gd2 5% G1��7�C ��ZU/ v�'Jri l�Zl7� � <br />termi+t n+nnnuoeess cnv nr mio�+r: <br />nnamecronoesicur:n unanooness cirr zm ruoue <br />J>>'�.e/9�i✓ fG�J�racn /v�z�iet�rrT �'�W G�/�i � .Cva 9Fzo/ �F 3i�/ <br />r.���rnaconrnncron nmanooness , _.,, cnv ziP PIIONf: SipT[LICENSEt <br />���ur.minccoumnctan M�IL�UDII[5: <br />CLr15$ OF 1VOfiK <br />'' i NEW I I AODITION I I ALTERATION <br />� a� o00 00� <br />CONTRACT PRICE OF WORK <br />OESCBIBE wORN nN0 SOU�RE FOOInGE IhVOLVED <br />i i A i�..-,./i_ i�_ / vc .. . <br />lE WL OEGCfiIPtION OF PIlO�ERiY �SHOWN DELO� <br />�.oi OLOCK or <br />AODRESS <br />�6_i�–ao–a� <br />MBING " <br />iVPE OF FIXTURE OR <br />iINK & DISP <br />iER <br />TRAY <br />URINAL <br />DRINKIP <br />FLOOR <br />��Ty Z�p PIIONE S1�TELIC[NSc4 <br />-- ��— CIIY ].IP -- i`IIOIII: 61�iCLIC[NSC� <br />/ <br />REPAIR I I �EMOLITION I I WOODSTOVBFFPL INSERT I I BUILDWG RELOCATION <br />CONTAC7 PEIiSON N ruone uo <br />-r.., .� �,.,,.� ass� - 3i� i <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW � HE SAME TO BE TRUE AND CORRECT. ALL <br />inc��vouncori[51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />WOFK WILL BE COMPLFTED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL V1W REGULATING CONSTRUCTION OR THE <br />PERFOFMANCE OF CONSTflUCT10N. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON A ORS L�W .27 RCW AND 296200 WAC. <br />�t :sv 5 x An,,• �i�vLvL1C'/ /- 3 • !`Z <br />sc�+n�wrt o�re <br />'/.e. S% cnvnusnrtss�k�'rnnro ._ . <br />PERMIT <br />Torn�r <br />FOR OFFICE USE ONLY: <br />Ff10NT5Et94CK REApSETB�CK <br />USE 20111[�` lOT Mkn <br />L l ' <br />1YPEOfCONIS.AIlOWA01E iYPEOfCOHS1.ACNAI <br />�t'� G� (� D (O�i <br />�S�R�E OF�O�LD�G�.�� NO.OF STORIES <br />IYI /.1�-/FIII�� � <br />� � <br />OCCUP�NCY LO�D FIRE SPR1lNLERS f1E0'D <br />NU /rl�� �vo <br />REr150N FOR SPRINKL[RS <br />IIIi�KEBY PUNSAPPROVEDOY <br />$ <br />TYPE OF EOUIPMENT <br />NCrIUHNDLG UNITS—H.P. <br />FOFCED AIR SYSTEMS—B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />qANGEH00D <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIflEPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTF�N <br />SUB TOTI <br />3faa <br />SIpGS[TOACK PLANCHECKNUMBER <br />� <br />vncnm sre FEES <br />UUILDING <br />occuruKr rw o��jNFuixGuxns <br />¢11IXIf �� p�UM81NG <br />� <br />o.�5El.uri� MECHANIC�L <br />f1EiGti�i�nnnor! AD�ITIONAL PLAN CHECK <br />SPRINKLEA <br />STATE BUILDING SURCIIAf7G[ <br />CITY OF EVERETT aueuc wonks <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />5 L <br />RECEIPT <br />J <br />