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/�Pp�.ICA�'9�tsa� �fD� CONS7�IlIC� ���! PEF�@IAlT <br /> , ����E;� <br /> I"vL��l�"i�':I � � � <br /> r,nv or <br /> everett <br /> BUILDING DEPARTti1ENT TO�E COMPLETED IN INK—PLEASE PFiINT <br /> 259�i810 <br /> i�DEMOLITION 1:7 COMBINATION � i BUILDING I I MECHANICAL I I PLUMBING I J SIGN <br /> o:;uen Mu��onness arv zia P�io�+e <br /> �/jL{g-ty1,,v. C_aniS)� 2�"l ! -� ILST £t L=v��� i"'z& T-o,Y =: � 7=7 /53 <br /> �� � H TENANi MA!LApORESS GIiY PMONE <br /> i �irray <br /> ARCIIIiELIOflDE51�NEfl IA�ILADDRESS CITY ZiP PH':NE <br /> ID � x >�vr� 'L <br /> �:, H - <br /> � H IA GENEflALLONTBACT00 MAIIp�OflE55 CIIY ZIP PHONE IICENSE/ <br /> y � H (�ri��ol� _ <br /> IAECIIANtCALCONTPRdTOH MAII�ODRE55 QTY ZIP PIICIlE IICEHSE� <br /> � H� <br /> � H � FLUTAOINGCONTflRCTOR MALLA�OflE55 CRY 21P PMG11E LICENSE/ <br /> CA Hr <br /> x 2 3 anssoFwoa� <br /> L�7 y d I.l NEW C7 ADDITION ❑ ALTERATION ! 1 REPAIR f-f"II�MOLffION f 1 WOODSTOVElFRPL INSERT f� BUILDING FiELOCATION <br /> TENMlT IUPqOVEAIENT Ofl INTERIOq NEMODEL ONLY CONiAGT PERSON NND PHON(E/1��10� 2 Z, l/ 7 <br /> �� � CONiRAGTPflICEOFWORK:_ ���fZLDPIC . / ✓/ - 7L�-7 <br /> �.y � pE5f3).9EWORKAND50UPFLFOOTRGErtIVOLV[I9\ <br /> yy I-\'.��t1(Y�I�� 5114��I�cMtu,r�, lPt,�Ql�_�(i,_ _ <br /> t� H y PfiOPO5EDU5EOPt1UILDING �— I HERF.BY CE:iTIFV THP.T I HAVE READ AND EXAMINED THIS <br /> APPLICATION AIJD KNOW�fHE SAME TO BE TRUE AND CORHECT.ALL <br /> � F"� LEG0.LDESCpIPtIONOFPpOPERTY�5110WNB�:D'i�ORATTACIIFOLRCOMIES� PROVISIONSOFLAWSANDORDINANCESGOVEflNINGTHISTYPEOF <br />� n d� WORK WILL BE COMPLETED WITH WHETHER SP[CIFIED HERFIN OR <br /> �or etocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �� [r�1 AUTHORITY TO VIOLATc OR CANCEL THE PROVISIONS OF ANY <br /> � H y OTHEfl STATE OR LOCAL'.AW REGULATING CONSTRUCTIC'iN OR THE <br /> ' C � PERFORMANCE DF CONS"i RUCTION.THAT I AM AUTHGRI7ED BY THE <br /> � OWNER OF TfiIS PROPERTY TO PERFORM THE WORK �^9 WHICH <br /> APPLICATIOW IS MADE AND I COMPLY WITH Th�E STATE <br /> � CONTRACTOFlS LAW 1827 RCW AN�296.200 WAC. <br /> $IGIlAfIIREOFC(d1iRACTO(IOIIAU1110RI2EOAGENT OAT[ <br />( �� C;�� r/.� <br /> I PROJLCTADDh[SS <br /> I � �, n APPLICAf�15CItY0USIfiE55UC[I!S .NNDOl151NE5S1lAME <br /> O�Ci <br />� PLUMBING MECHANICAL <br /> �� .A r, . NO. TYPE OF FIRTURE OR ITEM FEE NO. TYPE OF EQIJIPMENT FEE <br /> , 1,_�� _ WATERCLOSE-�TOILET) �� _ A/C—A/HN�LGUNITS—H.P. � <br /> . � BATHTUB FORCED AIR SYST[Id5—B.T.U. M E.H. � <br /> 1 ' LAVATORY(WASH BASItJ) ' UNIT HEATERS—B.T.U. M ; — <br /> ,� SHOWER CLOTHES DHYERS �T-- <br /> I ��O KITCHEN SINK 8 DISP i VENTILATION FAN <br /> I i �� DISHWASHER _ RANGEHOOD �— <br />� i _ LAUNDRYTRAI' — ; WATERHEATER ' <br /> CLOTHES WASHER T— WOODSTOVE I <br />� ' I � ' I _ UflINAL � METAL FIREPLACE&CHIMNEV —� <br /> �� DRINKWG FOUNTAIN i FIREPLACE INSERT _� <br /> , FLOOR DRAIN HEAT PUMP <br /> �. , BACKFLOW FFEVENTEflS GAS PIPING <br /> ROOF DRAINS�—RAINLEADERS EXHAUST FAN <br /> li _� SINK(SERVICE---BAR,ETC.) ' <br /> �—— <br /> i <br /> ---� <br /> i_ _ <br /> j � � � _ I <br /> ���� � � <br /> SUBTOTAL 5 ; Sl1BTOTAL S ' <br /> PEFifAll' $ —�— PERMIT 5 � <br /> f ,�' TOTAI_FEE $ TOTAL FEE 3 <br /> FflONTSET�ACK REARS[TURCN SIDES[IDACH PIANCHEGKNI11AOGP F[E RECEIPiNO. <br /> usez �ornnEa VACANTSRE FEES VALUATION FEE <br /> ��� I I YES I I NO �— <br /> (3UILDING i <br /> lYPE0FC0115i.ALlOW0.BtE lYPE0iL0115I.AGIUAt acuvux� uao�owum.tiams — i — <br /> LIIGOY <br /> rwraoirac ' <br /> SREOFOL�G. NO.OFSTOfiIES BASEMENT MECf1ANiCAL � <br /> I.IYES I ( NO � <br /> OCCUPN�CYLOAD FIRESPflNKLER5flE0'0 IIEiGMTLIMRATIOH OTIIER i <br /> CI YES I�I NO STATE BUILDING SURCHqqGE � <br /> i <br /> flEA50N FOfl SPNINKIEfl� '�— <br /> STATCENEHGYSURCHARGE i � <br /> narucnrroi�,�cc.or r�nusnPrr,oveoor CITYOFEIIERETT ruoucwor�Ks <br /> LOCALSRLES , <br /> TAX COOE IS 3105 Tora� <br /> �)� '1R'S <br /> I <br />