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� y <br />C�N <br />��� <br />�x� <br />H <br />Hy <br />x <br />O�d <br />��8 <br />Hy � <br />t"H� <br />MH <br />8y <br />f]�N <br />�H[�i� <br />H O fn <br />a <br />APPLICATI(.�� FOR CONSTRUC7.JN PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��T <br />� HEATING SYSTEM: � GAS �:'.] ELECTRIC ❑ _ I <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING �MECHANICAL PLUMBING SIGN <br />t R+nNT <br />GENEPAL <br />lOT <br />MNLADDRESS <br />AODITION ALTERATION PEPAIR <br />EocwonK� ��.�� <br />,,�.�:o�u�n=_ f n4GE iNVOIVEg.�_`� \ ��`� t ( <br />-1 l, <br />OFDy+��(y+G� O <br />� � `-' <br />fION OF PqOPERTV �SHOYM PELOW OR ATTDCN FOUR COPIE51 <br />_ BIOCK OF <br />BATIiTUB <br />LAVATORY�WASH 6A5 <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLO7HES VJASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT <br />ROOF DFAINS—RAINI <br />SINK ISERVICE—BAR <br />� ��V <br />E OR ITEM <br />sue <br />FOR OFFICE USE ONLY: <br />FRONiSETOACK RE�NSETPRCN <br />USEZON[ LOiAqEA <br />lYP[OFLONiS.AIIOWABIE 1YPE OfCONSi.ACiUAI <br />Si2[OFOLUO. NOAFSTORIES <br />UCCUPANCVLOAO FIpESPRNKL[RSF[ <br />1'1iANE DV <br />BY <br />FEE <br />�IiV / �P� �. PMON�p <br />(�i(lf'Y - ��, �1.��- �Oc�l�� <br />CITY 2iP PIIONE <br />pTY ZIP PHDNE <br />arv r.v aHor+E <br />��T�C��- Z 1��-01 P�����—� <br />��Jy ZIP PHONE <br />s�meucervse� <br />3���.�n,�v ��h���lo3� <br />STATE UCENSE � <br />CC( ( <br />DEMOLITION WOODSTOVEiFRPL INSEflT .� BUILDING RELOCATION <br />� GONTALT PEli50N FN� PHOhE NO. <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OROINANCES GOVERNIN6 THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAYJ REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV T4E <br />OWNER OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICN <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />�, ���r�� <br />Xnwr�nc o�•E <br />NO. I TYPE OF <br />AIR <br />VE�JTILATION FAN <br />RA�'GE HOOD <br />WATER HE�TER <br />WOO�STOVE <br />METAL FIREPLACE <br />FIREPLACE INSEF <br />HEAT PUh1f' <br />GAS PIPING <br />EXH�USTFAN <br />Si�E5Et6AGK PLFNCNECKNOMOER/.� FEE <br />�%%7D <br />VACANT SITE FEES <br />OUILDItJG <br />aaM�,cr r�oormvuoncuv�rs ' <br />r.nouv p�Uh1BING <br />o!�EMENT MECNANICAL <br />HEIGHTLIMITRION AD�ITANALPIANCHECK <br />SPFINKLER <br />STATE BUILOING SURCMARGE <br />CITY OF EVERETT auouc woAKs <br />LOCAL SALES <br />TAX CO�EIS 3105 TOTA� <br />M <br />M E.A. <br />TOTAL S <br />MIT 5 <br />>L FEE S <br />fiECEiPi N0. <br />