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�v oC � U IN BLACK INK—PLEASE PRINT ,,,,/�� <br /> � ; <br /> BUILDING DEPARTMENT � HEATWG SYSTEM: J GAS J ELECTRIC �.,J ', <br /> 259$810 — <br /> DEMOLITION COMBINATION 5� BUILDING MECHANICAL <br /> -�""� �.,ni�noer.ess . PLUMBING . � SIGN <br /> �E�1�1 Q a�or:= <br /> � � i�o5 +k;y ,- �-r,�",Cu'��9Y2r� ► zs z 7y :��j <br /> _•,,�' M11AIL AD�FE55 GiTY ZiP FhpNE <br /> .��C,HIiECiOF0E51GNER lAAILAD�RESS qTy _ <br /> ZiP PNONE <br /> E:EFALCOYTqAQOR l.IAILAODflESS CITV Zlp PHONE <br /> Q��Z—�`_ STpTE LICENSE s <br /> �=Q�%�NICALCONTRqGTOR IAAILAOORESS CiTY ��p _ <br /> PHONE STATE LILENSE a <br /> -,U;'BiNGC0111qqCTOR Idqi�qODFESS CITY ZiP PNONE <br /> StATE LICENSE/ <br /> C��9THAGi PR!GE OF VIpRN <br /> ����'ie.E���NG�S1O�U�-ArRrE. FOOTAGE INVOWED __ <br /> �' �V W�+ � LN �UILAI� ^ �� �j X� CONTACTPERSUNANDPHONENO. <br /> i'�v,Z cc�;Gr>�—� S�-�3 vti��72 �U!L'u�� <br /> �.�oros=_ouseoFom�owc i HEREBY CERTIFV THAT I HAVE READ AND EXAMWED THIS <br /> S�A n� L + ������ N �� APPLICATION AND KNOW THE SAME TO BE TRUE AND COPRECT. AL� <br /> ���T�� PROVISIONS OP LAWS AND ORDINANCES GOVERNWG THIS TYPE OF <br /> .:,.n�oescniPno�ioFaaaPearvisNowNee�owoanrTnci�r�ocoPiEsi WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> i,,; I 3 'f I�-I B��K Z Z1 oF ('�-� �[� �-� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE <br /> AUTHORITY TO VIOLATE Oa CANCEL THE PROVISIONS OF ANV <br /> _�-�T I � GN �j �/�;Q(�`� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> — PERFOR6IANCE OF CONSTRUCTION.THAT I qM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> .�� a�nxtonuraeea APPLICATION IS MADE AND I C061PLV WITH THE STATE <br /> '� '� 7 a-^ CONTRACTORS LAW 78.27 RCW AND 2962G0 WAC. <br /> ?�:(D �')_rl O/� [�vJ � <br /> C�'.;�RUCTION IOAN lENOER,FpppE55.TELEPHONE NUAIBER � <br /> g .i' i� (.�i !%5 <br /> PROJECT ADDRESS sic.eiune <br /> d I O S �-I G �T �} � . ��-� � — — <br /> :,1 V pJSNF54 u_[l5�':V <br /> PLUMBING <br /> MECHANICAL — <br /> NO. TYPE OF FIXTURE OR ITEh1 FEE NO. TYPE OF EQUIPMENT FEE <br /> _ _ WATER CLOSET�TOILET) � A�C--AHNDLG UVITS—H.P. <br /> __ BATHTUB POHCED AIR SYSTEMS—B.T.U. M E.q. —�— <br /> _ LAVATORY(WASH BASIN) U^11T HEATERS—B.iU. M 1— <br /> __ SHOWER CLOTHESDRYERS <br /> _ KITCHEN SINK 8 DISP VENTILATION FAN <br /> _ DISHWASHER RANGE HOOD <br /> __ LAUNDRY TRAY WATER HEATER - <br /> _ CLOTHES WASHER WOODSTOVE <br /> _ URINAL METAL FIREPLACE(WOOD BURNING) <br /> _ DRINKING FOUNTAIN FIHEPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING I <br /> ROOF DRA:NS—RAINLEADERS � EXHAUST FAN <br /> _ SINK(SERVICF—BAR,ETC.) <br /> - --�-- <br /> .__ _ SUB TOTAL S SUB?OTAL g <br /> . ____ PERMIT S PERMIT 5 ' <br /> TOTAL FEE 5 TOTAL FEE S �— <br /> FOR OFFICE USE ONLY: <br /> I NONI SEipACK (161R SGiBACK SIOE SEi�ACK PLAN GMEC NUM1I��FJj PEE <br /> neceiaT�;o <br /> ��5.:i� <br /> ��°='O'�E iotaaen vncnr�istre FEES VALUATION FEE <br /> : VES .7 NO � — <br /> 'i C�4016i NOAFS'�ORIES BUILDING J-1 V r <br /> OCCLTANb AUOIO'MLWIGV:][ � �J : ��' <br /> �(J Ga0'JP <br /> „y�� �� � PLUM6ING , <br /> 5:'Fq.Di'pLOG. FIRESPRINKLEPSPEOD BFSEIdENT � - �-- <br /> G S� 0 C YES Ti!Np MECHANICAL — ' <br /> oCCUPaNCviOn� FlaEALARrdp[o� MEIGHTIIAUTATIpN ADOITIONALPLANCHECK � <br /> � a N/� Z ( � OTHER ' <br /> hr,nsor� <br /> STATE�UII.OING SURCM,1RGL f � ��'� <br /> d�,:.:i•e_— vuNsnNPacveuav CITY OF EVERETT -- — 7= <br /> J �� LOCAL SaLES Pueuc woaks <br /> o�rr � �� ��� � i TAX CODE IS 3105 rorn� � �'�D <br /> 1------ <br />