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,�.E,..o,„� ',_.PP'LICATION F0►_ ���,eH <br /> °�^°F �ONSTRUCTIOfV <br /> everett PERMIT � <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETEp IN INK- PLEASE PRIhT <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDlNG ❑ MECNANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAILADORE59 CITY ZIP PIIDNE <br /> BETHANY HOME 3322 Broadway Everett , WA 98201 259-5500 <br /> •nCI11iECT0110E9�ONER MUL�D�PE59 CIlY ZIP PIIONE <br /> GENERALGONiRACIOR MAILAD�NE9S GI1Y 21P PHONE UCENSE• <br /> OLc�/1�G� <br /> MECHpNIG�L GONTMCiOq MAIL�OOPESS Clrv ZIP FIIpNE LICENSE� <br /> PWMBINOCONiRAptOq M�ILApORESS CI1Y 21P PIIONE UCENSE• <br /> C1A55 OF WORR <br /> ❑ NEW ❑ P.DO�TION ❑ AL7ERATION ❑ REPAIR ❑ DEMOlIT10N ❑ WOODSTOVE/FRPL.INSERT ❑ BUILD;NG REIOCAiION <br /> VRLU�TION OF WOHH ICOSi OF IAAIERIp�S P W^�RBORI <br /> OESCRiBE WORK <br /> Demolish & remeve house on ro ert <br /> USE OF BUILDINO � <br /> I HEREBY CERTIfY THAT I h1AVE READ AND EX�MINEO THIS AP• <br /> PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT.ALL <br /> tEGRL0E5CRIPiIONOFO(10PERtVI5110WNBElOWORAiTACNFOUPCOVIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> 13 795 Everett Ldnd Co 1St �FWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br /> ior__e�oc�or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME Tp <br /> Add t0 5veret t GIVE AUTHORITY TO VI9LATE OR CANCEL THE PROVISIONS OF <br /> ANYOTHERSTATEORLOCALLAly REGULATINGCONSTRUCTIUN <br /> OR THE PERFORMANCE OF C09(STRUCTION. <br /> SIONAT REOFCONTRAGTORORA RREDAOENT DAIE <br /> ��'.�� ' <br /> r u��Lf.._—.�-,�—�� <br /> PPOJECT�DORE55 qPPLICANTS CITY BUSINESS LI(ENSF.N0. <br /> 3_3 ��r La,-,s�z� AdE, E�E2c �T' <br /> PLUMBING MECHANICAL <br /> NO. rYPE OF FIXTUflE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE77 AIR f;OND. UNITS-H.P.EA <br /> _ BAiHTUtl REFRIGERATION UNITS-N.P.EA <br /> LAVAI'ORVIN'ASH BASIN� 001LEfi5-H.P.EA. <br /> SHOIVER GAS FIRED 0.C.UNITS-10NNAGE EA <br /> KITCNEN SINK 8 DISP. FORCED AIR SYSTEMS-B.T.U. M EA. <br /> QISNWASHER WALLHEATERS-B.T.U. M <br /> �AUNORYtRAY UNITHEAIEF5-B.T.U. M <br /> CLOTHES WASHER EVAPOFiATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINt.L VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DHAIN AIF HAN�LING UNIT- C.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF ORAINS-RAINLEADERS METAI FILiEPLAC�8 CHIMNEY <br /> SINK SERVICE-BAR,ETC.1 WOODS70VE/FIREPLACEINSERT <br /> SUBTOTAL SUBTOTAL S <br /> PEHMIT f PERMIT S <br /> _ TOTALFEE S TOTALFEE S <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �RONISEIDnCK REARSEiBACN $IpESEiBRCN Plr1NCHECNNUMOER ALr1NCNECNIEE <br /> FEE RECEIPi NJ. <br /> USE 10NE �pi qfiER yqL�Ni StTE <br /> f]YES pN0 FEES VAIU�TION FEE <br /> TYPEOFCONST Of.LUPqNCYGROUP NO.OFOWELLINOUNRS <br /> � BUIL6ING 5 <br /> SIZE OF BLDG NO�OF SIORIE9 MAX.OGL.IORD <br /> PLUMBING <br /> MECHANICAL <br /> �IRE SPRIt�KLERS REOUIRED O YES ❑ NO <br /> OTHER <br /> PENALTY <br /> APPLICAIIONPCC OY PLANSCHECNEDBY APPR.FOBISSU�NGEBY _ <br /> TOTAL <br />