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DEMOLITION COMBINP,-fION <br />Crv���(�q -� ldAIL�A7D�RE55 /� <br />lir'.-�_�CC�/! /�� lIVV� <br />TE:JRNT IA/ILAppRESS <br />AfGi:iELTOROEFIGNER tAAILpDOqESS <br />LPlERALCONTRACtOfl IAA'�FD�RE55 <br />I.tEGNANICALGONTflAGTOR IdPILApDRESS <br />�r'ei' /✓�+,-cas �r� ?�xsn3G� <br />PLNdpINGWNiRACTOR 1AAILAJpflE55 <br />CCtITRACT PRICE OF YlORK ^'�� <br />'�l��L J <br />DESCniBE WORK ANf: SOUaRE FOOTPGE INVOLVED <br />i�%; / �� I�LJ-S \ nNv�Ksid. <br />PROPOSED UeE OF BUIIDING <br />S�- � <br />L[G4L DESCFIPTION OF PROPERTY ISNOLYN BELO W OR ATfAGH TWO COPIES� <br />LOi BLOCK OF <br />PpRCEL TA%ID.NU1dBEF <br />�pN51RUCTION LOAN LENOER. FODRESS, TELEPHONE NUTABER <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SlflK 8 DISP <br />DISHWASHtR <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLJW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />CrtY <br />CITY <br />CITV <br />CITY <br />� <br />CITV <br />Zla <br />ZIP <br />ZIP <br />2i? <br />�IP <br />PhONE <br />� s a-9� <br />PHON'c <br />�:ONTACT PERSGN AN� PNONE NO <br />PHOIJE <br />�S� <br />_L <br />PHON� <br />STATE UGENSE9 <br />SiATE LICENSE e <br />V �Ql./�C <br />STATE LICENSE a <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHECT. ALL <br />PROVISIONS UF LAWS A�'D ORDINANCES GOVERNING i HIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERA4IT DOES N0T PRESUM1IE TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE Or CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AM1D I COMPLV WITH THE STATE <br />CONTRACTORS LA1V 1827 RCN/ AND 296200 WAC. <br />�'��,��1� �o� — �'1 �"-i'`/ <br />?cj..cnr i o:.ic <br />A%C—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />� CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />� FIREPLACE INSERT <br />i_ <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />I SUBTOTAL 3 — <br />—� PERMIT S <br />� TOTALFEE S <br />FOR OFFICE USE ONLY: <br />PROt1T5ET0ACN R[FRSEiB�CK SI�ESETBACK PLANCH[CKNUl:.BEii FE`_ <br />USEZONE LOTAREA VACANTSITE FEES <br />- YES ❑ NO BUILUING <br />t1Fi0FCON5T NO.OFSTORIES o[cu�a';[r nOo�OwRu�icu•�.A <br />eeour PLUM11BING <br />SREOFBLDG. FIFESPFINKLEPSREO'D P45EMENT h1ECHANICAL <br />C; YES �: � NO <br />CCCJPANGYLOAD FIPEAIAHMREO� HGIGHTLIldITATION �DDITIONALPLANCHECK <br />OTHER <br />R'ASON <br />STATE BUILOING SUR(;NAFGE <br />INTAVEDY P1�N54PPROVEDOY CITl' OF EVERETT PUBLIC WOFKS <br />LOCALSALES <br />on,e TAX CODE IS 3105 rorn� <br />_._. ._____.,.__....__._,.�,� ,.,..�,.... <br />.:_.. .�. ��- _,-..�_� . ,:_. _ :�.�-.• . . .::.::� ..... � .. _..-_,..,�s�:zs�r,nc . ..:.. . <br />_ _... _._.� . . . : : . �� . �. <br />..; :. _ . .. . .., . .. _ . .� . _ ,_,.. �r . � <br />FEE <br />TOTAL S ; <br />,dIT S <br />�L PEE 5 <br />RECEIPTNO. <br />IATION FEE <br />R <br />� <br />