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e <br />�ti . <br />� APPLICATIOI�OR CONSTRUCTIG�J PERMIT�,�i <br />Tb BE COMPLETED IN BLACK INK—PLEASE PRINT ��J,... <br />��_., <br />BUILDING DEPARTMENT H�TING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ � <br />259-8810 <br />❑ DEMOLI710N I� C011ABINATION f�' BUILDIN(i IJ MECHANICAL <br />owr�n µ����E� �m, ❑ PLUMBING Cl $KiN <br />. nr �� <br />._._�_..�.... cm zia - ' P� . <br />� ARCNIIECTORDESIfY1ER � <br />MIIILADD11ES5 CITV ZIP PHONE � <br />GENEMLCONTMOTON IMILADDRE&9 Cm• , <br />ZIP PMONE ST�TEL�CEN4E� � <br />fdw//� iR�� 19• Il..c•�• <br />r.�cww�cawiw�c7ua ;—� L� c��� 9 p.:8� �=' S�C2n <br />►uti�noness �m �:.�_� Y/ecsas..ae�ri <br />ZIP . RiONE STATE IICENSE � ! <br />PLUMBNOC�NTMCTOR MAILADDRESS �Ry .. <br />ZIP PMFIE ST�TE I�CEN8E � . <br />❑ NEW ❑ ADDITION L 1 ALTERATION <br />G��. <br />LOT 9�� _ � <br />I / � <br />FOR o�ce use oN�r: <br />FnoHrsEte�ac �,< <br />TVPF Of CONIS. <br />.C'T:!'. <br />TOTAL <br />REPAIR L I DEMOLITION L7 WOpDSTOVE/FRPL INSERT ❑ BUILDINp RELOCATION � <br />CONTACT PERSON wND PNONE NO. I <br />, __gey_y�� � <br />e'~ y%�O yi� � <br />1 HEREBV CERTIFV THAT I HAVE REAG AND EXAMINED THIS � <br />APPLICATION AND KNOW THE SAME TO BE TqUE AND COpRECT. ALL '� <br />cov�s� PROVISIONS OF LAW S AND OpDINAN0E3 OONEpNM1G TMIS TYPE OF <br />�MORK WILL BE CAMpLETED WITFI WHETHEq SPECIflED HEREIN OF � <br />NOT. THE OqANTINO OF A PEqM�r ppES NOT PqE8UME TO OIVE <br />AUTH091TV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY i <br />OTHEq STATE OR LOCAL UW REt3UlATRp CONgTqt�� pq TME <br />PERFOAMANCE OF CONSTRUCTKMI. THAT 1 MA AUTHOpRED BV THE � <br />OYVNER OF THIS PROPERN TO I�ERFOpM THE WOqK FOR WHICN <br />APPLICATION IS MADE AND I COMPLY WITH THE S7ATE � <br />CONTRACTORS LAW 1827 RCW AKD 2g82pp yyAC. <br />t <br />, <br />X �� r Be�.i� � <br />�„� - �,� �/�1�� ; <br />cm ws�css �ceraE Ho i <br />MEClMNICAL <br />� N0. TYPE OF EG111P11ElIT � i <br />' NC—NHNDL(i UNITS—H.P. � �� <br />� FORCED AIR SVSTEMS--B.T.U. M E.A. � <br />� UNIT HEATERS--B.T.U. M � <br />' CLOTHES DRYERS T— i <br />� VENTILATION FAN � � <br />' RANOE FIOOD � <br />� WATER HEATER , <br />� WOOD STOVE � �. <br />' METAI. FIREPLACE 8 CHIMN , <br />� FIREPLACE INSERT � , <br />6AS PIPINCi / —T , , <br />ewu�err�u 7 � T� . <br />EGKNUMBEfl FEE <br />L9ay <br />BUILDIN6 <br />lYPEOiCOqSTACNK ocavwtv rroammuNGunTs <br />_� GRW> <br />' PLUMeINc3 <br />NO.OFSTORIES BASEMENT <br />ND MECHANICAL <br />nI�A <br />s� <br />HEqNTLIMIT�TqN � PUN CHECK <br />SPRINKIER <br />STATE BUILDINO SURCHAR6E <br />CITY OF EVERETT PUBUC VYORNS <br />LOCAL =ALE8 <br />TAX CODE IS 9105 roru <br />SUB TOTAL S <br />r <br />� <br />