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yC�H <br />x r -� <br />[= n <br />ay <br />r��x <br />r r�L � <br />H 93 <br />yzH <br />� F? .`U <br />O SO <br />'� ��'�1 <br />CA H <br />zz� <br />r� o n <br />� N d <br />n <br />H �T; <br />n� o <br />H <br />7 1--I <br />ay• <br />r z <br />Hy <br />pyH <br />nd� <br />�i �r� <br />Z r3 V1 <br />H O cn <br />♦ <br />APPLlCA°�iid�l F�JR C�PI�"C�aJC", Ot�i PERQV9IT ,,���" <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />. „e��r.e���..� <br />LRYOF _ —� <br />everett HEATINGSYSTEM: ❑GAS ❑ELECTFIC J _-- — -- —_] <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION �� COMBINATION <br />�,�.����E�� IAFILAOV�ESS <br />A/ n r . /d . i. c �� ./ G. -�=I <br />MAIL A�LRE55 <br />BUILDING <br />GIiY <br />_� ��—� <br />, GP <br />MECHANICAL <br />2iP �PH/OjNE <br />G^�-�> 7 _' <br />Z�p PHONE <br />PLUM8ING SIGN <br />� ��n, r�p PNONE LICENSF. a <br />�AECHANICIICONiFNCTOR MRILfDORE55 <br />I'.UTABV�GGONTflAGiOR MqILiDCRE55 CITV ZIP PMONE LICENSE� <br />' i L.- �, r� woan � <br />�;�W � ADDITION %C ALTERATION X REPAIF DEMOLITION �'�'OODSTOVE/FRPL INSERT BUILDING RELOCATION <br />-- — CGNTFCT PERSON AN� PNONE NO <br />�.;n.nCiPR�CEOFWORK �Q ?-.00.lO <br />�� �.,,:�v:5CWORKI.ND50UAR�EFOOTAGEINJ0�VE0� <br />FL�ii /ai✓ fC:l .. 4=- <br />Y CERTIFY THA7 I HAVE READ AND EXAMINED THIS <br />;�:�:;c: pCSCflIPiIONOfPqO�ERiV15MOW��tltLUw�nniin�n�w�.....•...� <br />i/ �- ZZ 6LOCN -�r�/ oF �io r nF i/F�'f <br />=%'c��i' L 3 �%�i 5' ✓.�c', , �J7. <br />�l�L ��/ <br />. � i�.�[Ci ADDRE55 <br />PLUMBING <br />N0. TVPE OF FIXTUAE OR ITEM FEE <br />WATER CLOSET (TOILETI <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />� (�- " HITCHEN SINK 8 DISP <br />DISHW�SHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL _ <br />DAINKING FOUNTAIN <br />FLOOR DRAIN _. <br />BACKFLOVJPREVENTERS <br />ROOF DRAINS—RAMLEADEPS <br />SINK ISERVICE—BAR. ETC.) <br />SU� TOT/1l 5 <br />� � � TOTALFEE <br />FOR OFFICE USE ONLY: <br />.i ,�� ;tipRCe _'� R[MISEiBTCK �� <br />. �p��t LOTAPEA <br />.�.; CONIS PILOWABI( LYI'E Of COH51 �CLWL <br />: i OI- BLOG NOAf STORI[5 <br />ro�'pNCVLOA� FiRESPP.NRICRSPWD <br />� '� n�-pN FOR $PRINMIE(15 <br />.,,..rnr rinnsnri�Ro:�co�ar_---- <br />� <br />I HEREB <br />,4PPl.ICATION AND KP'OW THE SAME TO BE `flUE AND CORRECT ALL <br />F'ROVISIONS OF LAWS AN� OROINANCES GOVERNING THIS TYPE OF <br />VJOHK WILL BE COMPLETED WITH WHETHER SPEGFIED 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 OF LOCAL LAW REGULATING :ONSTRUCTION OR THE <br />PERFORMANGE OF CONSTRUCTIOiJ. THAT I AtA AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFOFM T:ie WORK FOR VJHICH <br />APPLICATION IS MADE AND I COMPLY V✓ITH THE STATE <br />CONTRACTORS LAW 18 27 RCW AND 296.200 WAC. <br />S�GN4TUREOF�CONTRACIOR UinpPRED/GiNi D�TE <br />/ /� <br />— ���/�Y � ���!ls�L_+ �/-/'� %d <br />APPIIGAHiS f,liV �USME55 LICENSE NO. n11D B1151NE55 NAIdE <br />A�C—!� HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS-8. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />vFNTIlA710N FAN <br />WATER HEATtM <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP _ <br />GAS PIPWG <br />M E.A. <br />PERMIT <br />TOTALF <br />SIDC.RpICK PIANCHEf.0.NUA10LR ILt <br />vncnr�rsirE FEES VALUATION <br />BUILDING � f S�rO_� <br />xmn�cv xoaw.xwvo::vas �--- <br />Ci°�° PLUMBING <br />BASEMEYi MECHANICAL <br />HEiGMTIiMI*�nON AD�ITIJNALPLANCHEGK <br />_____'_" OTHGR <br />STATE �L1ILDING SURCHARGf. <br />CITY OF EVERET� PUBI IC WORNS <br />LOCALSALES <br />TAX COOEIS 3105 TOTAL <br />FEE <br />� <br />�5 <br />RFC[IPi NO <br />FEE <br />/9 SZ �o. <br />0 7 I �� <br />