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APPLICATIC �� FOR CONSTRUC7 _JN PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT � <br /> HEATING SYSTEM: U GAS i ELECTPIC U __� <br /> BUILDING U[PARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION � BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER I.IAIIAD�R[SS LITY 11P PHONE <br /> � q .rENT /-�•✓4/1.ClE6h P� lpl�r ev��err ys ��� z s z - 8 i� � <br /> iE�1ANT MAILAO�RE55 CIIY IIP PMONE <br /> o � oa yaa K�Kay ✓en-f�i✓ <br /> � � � ARCRRECTOB�@SIGNEP MAR�DDPESS LitY 2iP PIION[ <br /> ,. f,.roe5 .9Rca, rccr✓' f�Grr�rr 7�7u,r s.r8 • 64 � � <br /> r1 f� GLNLNALCONtPACTOR Mr11�q0�PE55 /� CITV 21P PHONE STRi[LICENSE� <br /> p� y0 /✓' . � c G � ?' " (/ <br /> N M i,i[�HANiU�CONTRRCTOR AUItADORE55 CILY ZiP PNONE SLAIEIICENSE� <br /> � � � PW6101NGGONLRACTOF AiRILAODRESS CIIV ZIP N��ONE $TAiCLICEN$[• <br /> � � <br /> C1 • CLnSS Of WOPK <br /> � H NEW . ADDITION �CALTERATION PEPAIR DEMO�I�TTONrensorvnNoO�roNeoo6FRPLINSEPT BUILDINGRELOCATION <br /> N �d aoo �.rAf� PE>BR�i✓ �J'B • 6 !7/ _ <br /> H CONTPACTPPIGEOFWORK I <br /> O N OESCRIB[\YORKANDSOUAREFOOT�1GEiYVOI\'ED <br /> a � .cen+ooFc porr 7'en�.v�vT <br /> � y PFOPOSEDUSEOfBU�IOMG i HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br /> ,QDDlt'✓�r��� � CI�LC EXy APPLICATION�ND KNOW THF SAM11E TO BE TflUE AND CORRECT.ALL <br /> �Eca�oEscairTioNOFPeovenrrisNowHee�owoan*ma�rouacoPies PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> � �D If or EVCR�1T1� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OH <br /> iot W��� � a�ocK NOT. THE GRANTING OF A PERMIT DOES N07-PAESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL TyE"PROVISIONS OF ANY <br /> N� 1 L Ol�t k C�EU Oi �✓�M'E�T�T OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTPUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV T�-PEflFORM THE WOFK FOR WHICH <br /> APPLICATION IS MADE �Nil, I COMPLY WIT}I 7HE STATE <br /> CONTPACTORS U1qJ 1027.R�AND2962D0 WAC/ <br /> / � <br /> � <br /> X �� � � ✓�__-� 9'� fr0�. <br /> Vi1:�tVl:C / O�IC <br /> PROJECTADORESS ���,� �``yu / �ry <br /> � � ���Q � � cnvor�s^.FssirrrsEno <br /> � C�� � PLUMBING . MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 1 - - WATER CLOSET(TOILET) A%C-A�HNDLG UNITS-H,P. <br /> BATHTUB FORCED AIR SYSTEAIS-PS.U. Id E.A. <br /> �� UNIT HEATERS-B.T.U. M <br /> Ll.VATORY(WASH OASW) <br /> � '��1 SHOYJER CLOTHES DRYERS <br /> � ' KITCHEN SINK 8 DISP VENTILATION FAN __r__ <br /> � OISHWASHER RANGE HOOD <br /> '�� WATER HEATER <br /> iLAUNDRY TRAY — '�— <br /> �� CLOTHES WASHER WOOD STOVE <br /> � URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> � FLOOR DRAIN HEAT PUMP --�_ <br /> i !1 1 BACKPLOW PREVENTERS GAS PIPING �_ <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE-BAR,ETC.1 �- <br /> � ' — <br /> �' � <br /> I <br /> � <br /> SUB TOTAL S S'JB TOTAL 5 <br /> I ��I. PERMIT 5 __ PERA9IT 5 <br /> �� TOTALFEE 5 TOTALFEE S �- <br /> FOR OFFICE USE ONLY: 7 �� <br /> iRONTSETBACN—' �EPHSETUACK Si�ESEtO>CR v�pt.ICH[CKN111.10[R FEE BEC[IPTN c� <br /> � �a� 3'I�� '�ln.O� `� / / <br /> USEZQNE LUiARf:A VALANTSiiE FEES VALUATION FEE <br /> .� iA O �'- ) ') <br /> BUILDING �• / �i` 'V� <br /> lYPEOiCON1� IVPEOi[aN9.ACIpAI aLq�rn r,oqcxtu�..p�•.:r - ---- <br /> �n� .-�� �f � PLUMOING _ _, <br /> .]1.7�1 .1N <br /> 52E OF fiLDG. HO.OF STORiES IlASEIAENT IdLCHAN�CAL <br /> 13'h'a �f T�, Z ti'd ---- — <br /> OCGUPRNCYLORO FIRESPRNNLENSnEO'D NEIGMilndrtnTlON ADOITIOYALF'LANCIIECK �/ � ]L� <br /> 7� TI ON(i ti0T'RT "Mk� TlME srniNKien _ � <br /> HF.ASON FOq SPRi1lRLERS <br /> ���NA���� S1�T[BUILDING SURCHARGE `� <br /> INiANE BV PL�N54PPPOVC�OY CITY OF EVERETT PUBLIC WORKS — - <br /> LOCALSALES <br /> � ��✓ �M TAX COUE IS 3105 TOTA� J� IQQ <br />