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yS C'=] <br />�ay <br />��x <br />C H <br />9Hf/� <br />rx <br />H>3 <br />H zH <br />�C f] <br />'�J H '�J <br />V] H <br />C��7 O � <br />O hy-i�y <br />� C��7 O <br />G] . C� <br />zy� <br />r z <br />HH <br />O�� <br />sr�-r <br />C7 CT7 <br />z y cn <br />H O V� <br />r"' �►' <br />"..� <br />w �, <br />� '� <br />_ ._ - - - - -- _ <br />�� HEAiIIJG SYSTE�:1: �(1 GAS J ELECTRIC J __ _. _. � <br />BUILDING DEPARTPAENT <br />259-8810 <br />DEMOLITION COMBINATION � BUILDING I! MECHANICAL f1 PLUMBING SIGN <br />6NILnC�riE55 CIiV ZIP PMONE <br />��(1•�� �o�SEH 3 i l 2 S6'''-` Si. St�J �;urecrr 4�;�:a3 348 - 39�9- <br />�...;rr rananoor+ess ciri zir vNor+e <br />;,r��tit[Ci0R0E5iG1lEF MAiLRODPE55 GIiV JP PMGrvt <br />�Eck�,c,y CoNSitzl,r7loJ �7zS S��'��-n�, m�zYs�;uu wR. `tb',��o GJ�i- 31�6 <br />c�:![RALCONTRACTOR 6idILA�OFE55 CItY ZiP PH09E SiAtELICENS[e <br />i�cK-�cx �eNSTru/cTtur.� 5/-1-m� Y EC.lt* ll9 � 7- <br />:.'F.GHANICALGONiPACiOF IAAiLA0DRE55 CIiY ZiP PHOt1E 5'AiELiCENSEa <br />GI.Ui'3iNGCONiqALiOR UAiLADDPe55 CITv Zi? PHONE STATEUCENSEa <br />CO'liPALT PRICE OF WORN � /�� <br />�-t �;r ��u r� °Y` i� <br />'�CSCRif1E WOP ANp 50UAfiE FOOTAGE �NYOLPED <br />f�% IZO S4� FT. OF �i(i+Piv� �i.vinil- iO�YiE' <br />'y� /N5�7Xi /✓�� C/'�flnnc'7S <br />F�OPOSEO USE OF BNL�INu^ <br />,�-f0 /yE OF OWN�� <br />�. ECAL OESCiiIPTION Of PROPEBTV iSHOC/t! BCLUIV CH AiIFCH TWD COPiE51 <br />�, � i zv � 3 �.�>:K __I_� oF G�''p �' �w _ <br />�011 Dh7 <br />=.:a �c� rar, i o. r.ur.+aEn <br />r*`t58�-137- o�Z-ooc�8 <br />,.,r:;rr�ucii�a �cnn i EucCP neLr.�s; 1ELEne:rF r:Lv� en <br />PRJJECT ADDRESS <br />-��� �„y7 r�uF r��s.ecrr. wA. <br />TYPE OF fl%TURE OH ITEM <br />VJATER CLOSET ITOILETi <br />LAVATORY I�VASH BASIN) <br />KITCHEN SINK & <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKIMG FOUNTAIN <br />FLOOR DRAIN <br />ROOF <br />AhD P��O'+E NO <br />i HERF:�' CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APFi.;JqTION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />P'iOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />vVORK WILL B° COPdPLETED WITH WHETHER SPECIFIED NEREIN OR <br />NOT. THE GRAN7ING OF A PERMIT DOES N0T PRESU.'viE TO GIV; <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF AfJY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPLRTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS !.1ADE Af:D I COMPLY WITH THE STATE <br />CONTRACTORS LAW 7E27 RCW AND 256200 WAC. <br />l /' / <br />x l�`� �i�Y� __ . <br />�—�� — °„` - <br />..,.F ,:o <br />RIECHANICAL <br />NO. TYPE OF EOUIPtdENT <br />A C—��HNDLG UNITS—H.P. <br />FORCED fdq SYSTEMS—B.T.U. M E.A. <br />� U^liT HE0.TERS—B.T.U. M <br />CLOTHFSDRYERS <br />VENTILATION FAN <br />RANGE IIOOD <br />WJ.T=R HEATER <br />WO.�D STOVE <br />MGTAL FIREPLACI <br />FIREPLACE INSEF <br />4EAT PUMP <br />�,� � SUBTOTAL S ' _' SUBTOTAL 5 <br />PERMIT S —� PERMIT $ <br />TOTALFEE 5 —I TOTALFEE S <br />' FOR OFFICE USE ONLY: S1�1JK `L 0�.7��7��5 �t v iKGO �Z � o U 3� <br />FqONTSEiBAf,K HF.MS[��ACK IOF.SET�ACK NLRlCHEC&NlIl1CHi F[E n�) R[ <br />5 <br />/ � <br />�,-, � �� 5 � .�'�=/ �1�� �_- <br />USEZ�ONE LOT <br />—J�I— � <br />ttCEOFCOH51. NO.� <br />SIZE OF OI�G. <br />REASON <br />rn nKe ov <br />FlRE SPRINHI [RS fiEO'D <br />neo 0 <br />P�nNs naapoyeo or <br />J t-+ <br />ont� !e %. ,i'. <br />vncnr�t sire FE[S <br />i� �� YES �NO puiLUWG <br />ou�:draucv raoFmvrui�;cuv:; --- <br />�mbv pL�M61NG <br />OASEIA[Nt <br />'iR YES -.I NO MECHANICAL _ <br />HEIGHTLI1AIinTIOPo ADDITIONAL PIAN CHECK <br />����� � OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUf3LIC WORKS <br />LOCALSALES <br />TAX COUE IS 31�5 ��Tp� <br />FEE <br />� <br />