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xC� <br />L�f C7 <br />,��x <br />ay� <br />H�� <br />� r�i � <br />'+j H �1 <br />V1 H <br />Hx :" <br />t+7 O � <br />Hq <br />OH <br />H�g <br />�i]Y (�] <br />zH� <br />['� ~, `l'+ <br />Hy <br />g`� <br />H <br />C] C7 V� <br />��� <br />zym <br />H O cn <br />APPLICATI��'J F�f; CONSTRUC7�� JN PERMIT � <br />TO BE COI,!NLETED IN BLACK INK—PLEASE PRINT <br />� HEATING SYSTEA��AS J ELECTRIC • J <br />6UILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING �ECHANICAL PLUMBING SIGN i <br />O\"'ER AIAiLAD�9[SS CrtV 2iP PHLNE <br />�busT ��� S/33 � ���D �o�✓T Ls9- �7 <br />iENANT MAiIqD�RE55 CifY ?iP P�'.ONE <br />ARCHrtECTO�i�E51GNEP MRIIRDDRE55 ��TY Z�" P����� � <br />GENERALCONiRACTOP MARAODRE55 CITY ZiP PMONE StATELIGENSE• <br />�dECN4NiCR� CONTR4CTOB MRIL RDORE55 LITY ZiP PNONE STATE LICENSE � <br />5� Z - <br />PWIdpR1GCONLP4GTOFl MRILApDRE55 CItY 21P PMONE SiRTEI�CENSE• <br />CL155 UF WORK <br />NEW ADDIT10�! �hLTERATION FEPAIR DEMOLITION VlOODSTOVFiFRPL INSEiiT BUIL�ING 9ELOCATION <br />CONtAC� PEi150N AA � PNOYE NO <br />� <br />SOUARE FOOIDG[ <br />aaoroseo use oF au�ioirvc <br />.SF.e <br />IEGA� DESCFIPLiON OF PROPERTY �SHO\YN BEIOY <br />Lpi _ BtOCN OF <br />ar+aecrnoer�es�?� , / P/�i <br />�V <br />PLUMBING <br />NO. TYPE OF FI7(TURE OI <br />WATER CIOSET �TOIIET� <br />BAIN.UB <br />LAVATORY(WASH BASIN) <br />Sr!OWER <br />KITCHEN SINK & DISP <br />DISNWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOF DRAIN <br />BACKFLOW PREVENTERS <br />ROOF ORAWS—RAINLEADE <br />SINK ISERVICE—BAR, ETC.) <br />FOR OFFICE USE ONLY: <br />FRONTSEIBRCN �EAPSEiBRCN <br />USE20NE <br />SRE OF BLOG. <br />(3Y <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />�PPLICATION AND KNOW THE 5��+1E TO BE TRUE AIJD CORREC?. ALL <br />FDURCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFI[D HEREIN .'JR <br />NOT. THE GRANTING OF A PERh11T DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR i.ANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL lAW REGULATING COIJSTRUCTION OR THE <br />PERFOR6IANGE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THF <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND � C0�.1PLV WITH ?HE ST�T[ <br />CONTRACTORS LAW 18 27 RCW �ND 296200 WAC. <br />— � — 'y0 fi'�L <br />— s�.�..,..— c,n <br />. ✓l _ — <br />SUB TOTAL 5 <br />PERtdIT 5 <br />TOTALFEE S <br />rrve or eoxsi acmu <br />NO.OF STOFIES <br />FlNESPPNKlER5RE0 <br />PI ANS RPPROVf D kiY <br />TYPE OF EOUIPMENT FEE <br />A�C—A HNDLG UNITS—H.P. <br />FORCED AIR SYSTEAa—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATEii <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />GAS <br />FAN <br />SIDESLipACH PLRNOICCMNN.ILEN <br />% (�Cs / <br />J <br />VRGANT SITE FEES <br />BUILDING <br />xc�r.w. rmacaru�•a�•.•s --- <br />LPD11° � PLUMOING <br />oaSEMENT MECHANICAL <br />HEiGMT uMrtnnON �ODITIONAL PLAN CHECK <br />SPRINNLEH <br />ST%TE BWLDMG SUNCHnI7G[ <br />CITY OF EVERETT FUf3LIC WORNS <br />LOCALSALES <br />TAX CODEIS 3105 TOTAL <br />SU8 TOTAL 5 <br />PERMIT 5 � <br />FE[ � R[CEiPLNO <br />� <br />� <br />� <br />