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ovi��i'll <br /> ARPLIC/�TI�.N FOR CaINSTRU'C1 �OId PERMIT � <br /> TO BE COMPLEiED IN INK—PLEhSE PRINT <br /> r.,��i,�nmwn <br /> CITV'OP — � <br /> everett l HEATINGSYST[M: �GAS ❑E�ECTRIC I] __ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MEG`IANICAL PLUMBING S _ <br /> nc�n�u I / i.�nnnnnr+ess <br /> cnv zir r��oNe <br /> � � � _L�,���lMr„��/, �/�- ��l. f'� )Y cry� �� N, ��r ri�i(�c ; 3� � 7 ), `I <br /> .��5 PlIONE <br /> ba � y m:m�r nnooress <br /> )J `'` ZiP PMONE <br /> y �� y .T. AIqIL AC`DRf.55 GITV --- <br /> �� � ii..���rccronnEsic;r+er+ �(��L. S 1' C�`ey :��i / � 5.� ��-'7dC� <br /> y Cy (�y � 'f�]\ SQ�4) �I )r )i � ZIP PNONE IICENSE� <br /> �-�t1. �— MAiL�D�RESS CITV <br /> K �j � <;[t�tNAICONTR4Ci0F __ <br /> m � O n,v� Z�p PNONE LICENSEI <br /> y 4 c�TY <br /> MECHANIC�LCONiPACiO� MAILA��FESS <br /> O C1 � C�T� Z�p PHONE LICENSE� <br /> H <br /> PWMOINGWNTRACTOA MAiLpODFlE55 <br /> M � �R <br /> � ` •q• CLPSS OF WORN � <br /> Z ra � NEy�r � ADDITION ' ALTERATION REPAIR . DEMOUTION �. � WOODSTOVFJFFPL INSERT �. BUILDING RELOCATIO^! <br /> y 'j CCNiACiPER50N�NDPHONENO. - <br /> `" fx�°� D(� �l% �S�1SF <br /> M <br /> y CONilinf,iPRiCEOFWORN <br /> H <br /> O U1 p[5�Ri0L1YORMAN�SIXIAREFOOtA•EINVOIVED _ <br /> �p !y /�, 1 " <br /> �'�' �� PPOPOSEou�oFnuif�"� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> y y� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> 7 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGRL�ESCNViIONOFPROPERTYISHOWNOELOWOP4iTACNFOUPCOP�E51 yyORK WILL BE COAIPLE7ED WIT4 WHETHER SPECIFIED HEREIN OR <br /> �ot_�_ �i°CN �"" /�—� NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OA CANCEL THG PROVISIONS OF ANY <br /> "�� OTHEF STATE OR LOCAL LAW REGULAI ING CONSTFUCTION OA THE <br /> I)� e1a��_!_C.d_��� PERFORMANCE OF CONSTRUCTION.THAT, ''d AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOR�9 THE WOflK FOR WHICH <br /> qPPLICATION IS MADE AND I COMPLY WITH 'iHE STATE <br /> CON'RACTORS lAW 18.27 RCW AND 296200 WAC. <br /> SIGNATUREOFLOYT9ACiOROFlAUTHOHR[DAGENT OATE <br /> X���ti�l��J1 —��i- �'� <br /> pFJJEGiA�L�HC55 p�P� ANTSCITVBUSMESS�NCENSENO ANDOUSINESSNAAIE <br /> ' � � � — �� �r MECHANICAL FEE <br /> I ��1 PLUMBING FEE NO. TYPE OF E�UIPMENT <br /> � NO. TYPE OF FIXTURE OR ITEh1 _ <br /> � WATEF CLOSET(TOILET) NCrNHNDLG UNITS—H.P, � <br /> � _ BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> '�� LAVATORY(WAS'I 9ASIN) UNIT HEATERS—B.T.U. M �— <br /> � �'� SHOWER CLOTHES DRYERS � <br /> � —��_ VENTILATION FAN ---`— <br /> ' ' KITCHEN SINK 8 DISP � RANGE HOOD <br /> � DISHWASHER WATER HE4TER <br /> LAUNDRY TRAY WOOD STOVE <br /> I �� CLOTHES WASHER METAL FIREPLACE 8 CHIMNEY <br /> URINAL FIREPLACE INSERT �����— <br /> DRINKING FOUNTAIN HEAT PUMP <br /> � !��► FLOOR DR91N GAS PIPING <br /> ►t 1 BACKFLOW PREVENTERS EXHAUSTFAN �— <br /> � ROOF DRAINS—RAINLEADERS <br /> SINK�SERVICE—BAR,ETC.) � � <br /> •; ' ! _ — <br /> I �/�� . _ _� . <br /> � I SUBTOTAL 5 IQ <br /> ` SUB TOTAL 5 pERMIT 5 <br /> I I t�� PERMIT S 7pTALFEE 5 '� <br /> �� TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: — rEE R[GE'PT��O <br /> R[AR SEl IACH � SIDE SCETBRCK PLqAN C/HECN NUMOER 1 <br /> cnoNT sETo�c^ � Z O o2_ '�w�ic J , L(O U� �✓� �DQ � A <br /> �� FEES VALUATION FEE <br /> US[20R lOT nP[A VnCANT SI'iE C �[�� <br /> �/ f���� _ CJ �UILDING � Z�O��-lv 73-`L_.2 <br /> 1�G4! <br /> lYP[Of CON15 AIIOWABLE �Y�E Oi COt15i ALIURI ou��ptr n9��nnlw`�Lu��:S PLUMBING vTn�T <br /> �-h� =� R�3 � �I�G ' <br /> "�ZE OF OL�('i NOAF STOiiiES �ASEMENT MECHANICAL __ <br /> 2721 5F + �j �(� -- ; � <br /> i F G � � ADDITIONAL FLAN CHECK <br /> OCCUPANCYLO�D FIRESPPNHLEft;�WD HE�GIQII(M�IiATION � ; <br /> A' / up v� OTHEti <br /> _� A �—/' <br /> i�I:ASON�Ofi SPA�NNLERS STATE Ol11LD�NG SURCHARGE � 'Sv <br /> i,��:.AF�r a�nr�,nrv�+ovcoor CiTYOFEVEflETT PUouCwORNs 2� �' J <br /> �'�� LOCALSALES Id�j�a -�_ _ <br /> `� ���=`� T11X CODE IS 3105 rora� <br />