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_�„� <br /> , <br /> � <br /> r APPLICATIOrI �OR CONSTRUCT uN PERMIT °� `, <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � f� <br /> CHEATING SYSTEM: GAS U ELECTRIC lJ <br /> BUILDING DEPARTMENT <br /> 259�8810 <br /> DEMOLITION I � COMBINATION BUILDING �I I MECHANICAL I I PLUMBING I I SIGN ,. <br /> owr�en unanoonEss nrv zm rr�or+e ; <br /> �v�z�r fki.s��✓� A���uP�� 2�. Pv��a2 ST Eba��T �'87v� �8' t�zzZ <br /> � � � TEN�NI A!AIL40011E55 CIIV 21P PMONE <br /> � y RRCNIIECTORDESIGHER �.���IP�ORE55 CIIY ZIP P��ONE <br /> � o�e 1��',Cetl�,✓ �kJirecr5 i4�2 ��wT � cr� �YS�r'� Cv.1 ��zo/ a5'F 3/6/ <br /> GENER�LGONLMCTOR MML4DDR[SS LItY 21P PI1pNE SUIEIICENSE� <br /> o � S ao /�e, r�o�' �-- <br /> MECN�NILMCONtRAGtOP �A�ILADDrlE55 CIiY ZIP ��IONE ST�IEUCENSE� <br /> ~J N M�y <br /> i � � PIUMBINGCONIRAGiO(1 MNl�OD0E55 Cltt ZIP PNG6E STQELICENSE� <br /> Q n f� cuss or wonK / <br /> R ea �j � I NEW I I ADDIT�ON I I ALTERATION (/ REPAIFi I I DEMOUTION I I WOODSiOVE/FRPL INSERT I I BUILDING RELOCATION <br /> � � n cor+ucr renson n virorv��+o. <br /> � M GON�RACTPPIGEOFWORK � o� Ooo po0 T �,S5�t� _ a'SS• 3/G�I <br /> � DESGI110E WORKl1N0 SOl1ARE FOOtAGE�NVOLV[D <br /> S o~a /� ¢ flo�a:.✓4 U�i5 — A.Qrac.Uc�L�, <br /> PROPOSEOUSEOFBl11L01NG / / I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � � , LO(�! /.✓LO�c� /tq 5/N�i APPLICATION AND KNOW THE SAME TO BE TRUE AND CORPECT.ALL <br /> lEG4LDE5CRIPTIONOFPRd'EflTY�5110W110ELUYOf1�li�CNrWOt014Cfi� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> -- WORK WILL BE COMPLETED WITH WHETHER SPEGFIED FIEREIN OR <br /> �or a�ocK oF NOT. THE GRANIING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> . AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TNE <br /> PERFORM�NCE OF GONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> _ APPL�ION IS MADE AND I COMPLY WITH THE STATE <br /> GON A ORS LAW 27�200 WAC. <br /> 4� orn �.,o✓ i _ e,,..,�..c<<s x litn,.�.. �- 3 •F� <br /> , PROJECI ADDRE55 SKenM�[ ��� <br /> i3a7- 39'- 3/- .7.3- .�l �7 f/Eshtac,c rr. ���.a�ms��ti��n�� <br /> . � PLUMBING MECHANICRL <br /> ���i N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> ` WATER CLOSET(TOILET) � NC—AMNDLG UNITS—H.P. � <br /> �� BATHTUB ' � FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � LAVATORY(WASH BASIN) i UNIi HEAIERS—B.T.U. M i <br /> ,__. SHOWER � CIOTHESDRYERS i <br /> `� KITCHEN SINK�DISP i VEN7ILATION FAN <br /> � DISHWASHER RANGE HOOD � <br /> I , LAUNDRV TRAY � WATER HEATER ' <br /> I �� �, CLOTHES WASHER � WOOD STOVE � <br /> � I ��1 URINAL ' METALFIREPLACEBCHIMNEY � <br /> � DRINKING FOUNTAIN i FIpEPLACE INSERT i <br /> �� I FLOOR DRAIN HEAT PUMP � <br /> �� �� BACKFIOW PREVENtERS � GAS PIPING i <br /> I �I�� ; ROOF DFAINS—RAINLEADEFS � E%HAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; <br /> � <br /> t ' ' <br /> _ � � � � <br /> � , � <br /> � <br /> � i _ SUBTOiAI E SUBTOTAL E ' <br /> � , PERMIT S � PERMIT S i <br /> � <br /> TOTAL FEE E ' TOTAL FEE E ' <br /> FOR OFFICE USE ONLY: a� <br /> ' f0pNi5ETB�GN REAq5EI0�GN SIDGSElOnf.H Pl�ANC�11CC,_N�N�ulA0E11 � f[F �ECEIPiNO. <br /> . �\ � l�� ��� � �� i <br /> p u5e za+F lor nnen V�C�Ni Sllf. FEES VALUATON FEE <br /> ' � BUILDING � <br /> IYIYOff.ONl5�ll11WABlE iYf`fOfCUNSt�CIWI apx�nxcr m�n✓mNwGun�S i <br /> ' ,-` � /,i' �"' /' PLUM9ING i <br /> IW (r� w <br /> 512EOPBL00. NO.r,FSTORieS BaSEMENt MECHANICAL � <br /> i <br /> � D ADDITIONALPLANCNECK ' <br /> � , �y O�CCUPANCYlW�O FIRESPRNKIyERySR�EOD 11EIGNIIIMIt�110N � <br /> Ml �pT '�I� � SPRINKLER ' <br /> i <br /> ��� RE�SONfdiSPPINNLEf15 <br /> �l�'N��'/j StATE OUILDING SURCNAPGE i <br /> � <br /> . MT�ICE BY PUNS��P�OVED BV CITY OF EVERETT PUBLIC WORK$ � <br /> ` : LOCAL SALES <br /> : Z ��(/� TAX CODE IS 3105 roT�� ; ,' <br /> :� ; <br />