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} APPLICATIO'. .� FOR CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT �T <br />�EATING SYSTEM: ,�AS U ELECTRIC J � <br />A <br />BUILDING DEPARTMEPdT <br />259-6810 <br />DEMOLITION COMBINATION BUILDING .�MECHANICAL PLUMBING SIGN <br />oGNuG/� P/!r7'�"/`� /OoS �NAlV4oRY/Et.1J�yNE s�Fa4EriP �aOs .2 5%'Z-��/% <br />TENRNT MAILRD�qE55 Ut� ZIP N�ptiC <br />ARGMiECTOR0E51GNER MAILADpPE55 CITY iIP PNON[ <br />GENERALCDNTRACiOq MPR�DDFE55 CiTY ZIP PHONE STATELIGENSC♦ <br />MECHANiGnIGONTFACTOR IdAtLGDORE55 Crtv ZiP PHONE STATELIGENS[• <br />TNDMAS qN6A7"iAG,q q�5�� NEi9G sT' u�/N�//1f Z9'Bo7z �6N7'2''d3 TIYONO/1H /�JOB/Y% <br />CUSS OF 1V09K <br />NEW ADDITION <br />DESCRIBE WORK ANp $OUAR[ <br />PPOPOSEO USE OF BUIIDING <br />LW hL DESCPIPiIpN OF PPOPI <br />lOT BLOCH <br />ALTERATION REPAIR <br />.�� � <br />RifACM FW R GOP�ES� <br />_ oF <br />of�o-Oo�-Ol OS <br />PPOJ[GT�pD•�PE55 p <br />�D�J �i0�/4�%��� . <br />PLUt'91NG <br />NO. TVPE C�F FIXTURE <br />WATER CLOSET (TOIIET) <br />BATHTUB <br />LAVATORY ( WASH BAS W � <br />SHOWER <br />KIICHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOF DRAIN <br />BACKfLOW PREVENTERS <br />PERMIT <br />TOTAL F <br />FOR OFFICE USE rONLY: <br />FflONTS[LHACK I tiEAR: <br />IOiAREA <br />NOAf STORIES <br />FEE <br />s <br />DEMOLITION WOODSTOVEiFRPL INSERT <br />I CONiACT VERSON AND PHONE NO <br />BUILDING RELOCATION ' <br />g3 �. <br />i HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAIdE TO BE T9UE AND CORRECT. ALL I <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF I <br />WORK WILL BE COMPLEiED WITH WHETHER SPECIFIED HEREIN OR � <br />NOL THE GRANTING OF A P[RMIT DOES NUT PRESUME TO GWE I <br />AUTHORITY Tn VIOLATE OR CANCEI_ THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW AEGULATING CONSTRUCTION OR 7riE <br />PERFORIdANCE OF CONSTRUCTION. THAT I AN, AUTHORI2ED 8� THE <br />OWNER OF THIS PROPERTV TO PERFORM TNE WORK FO(� 1JHICH <br />APPLICATION IS MADE AND I COIJ�LY WITH THE :iTATE �� <br />CONTRACTORS LAW 1827 RCW AND 29fi2o0 WAC. <br />X ! � �� J 'Co ��� � ��i <br />� wrz <br />--1% �� %S—� <br />. rn.lve�•s��t1rK[ no � <br />MECHANICAL , <br />�O. TVPE OF EQUIPMENT FEF. <br />A�C—A�HNDLG UNITS—H.P. II <br />FORCED AIR SVSTEMS—B.T.U. td E.A. <br />UNIT HEATERS—B.1-.U. M <br />--�' <br />CIOTHES DRYERS <br />VENTILATION FAN ' <br />i <br />RANGEHOOD I <br />WATER HEATER � <br />WOOD STOVE �_ <br />METAL PIREPLACE 8 CHIMNEY � � <br />FIREPLACEINSERT � � <br />HEAT PUMP <br />--:-- <br />� GAS PIPING <br />EXHAUSTFAN . . I <br />S�fJE5f.1�ALK PIANf.116G�U�Oy�. <br />3 �3 <br />VACANT SITE FEES <br />BUILDING <br />wcurexcr xaaowr:uncv�n� --- -- <br />�A�° PLUM�ING <br />eaSEMENT MECHANICAL <br />HEiGHi uMnnnoN ADDITIONAL PU1N CHECK <br />SPRINKLER <br />STATE f3UILUING SURCIIARGE <br />CITY OF EVERETT rueuc woaKs <br />LOCALSALES <br />TAX CODEIS 3105 TOTp� <br />sus rorn� s '� <br />PERMIT S <br />iOTALFEE S . <br />�rt- I nECE�cTNo. <br />e <br />- r� <br />