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<- <br />< ,� � -; /�J �. ..; <br />APPLICATIQ"�' FOR CONSTRUCT �N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT �— <br />259 6810 <br />DEMOLITION i COMBINATION <br />OW//NER /� 1 AUR�DDRESS <br />/`-���� C�'ClY.'1 �� Bf�Y �'9- <br />TENANi MlILADDR[SS <br />AqCM/I�IECTO/RD�ESIGN�ER /� IAAIL�DDRESS <br />�/ D��� /--C� V�Dv L/C�l l7vlc�2 �l.L� � Z <br />HEATING SYSTEM: !] GAS <br />I BUILDING <br />CRV <br />�.,� �i- <br />G7Y <br />CIiY <br />iJ <br />� MECHANICAL � PLUMBING SIGN <br />21P <br />ZIP <br />-> > z=� <br />PMONE <br />PHONE <br />WNT,/fiAFT PRICE OF WORK <br />/—� -lr-���dt- � <br />I�� <br />UESCRIBE IVORN AND SOUARE FOpTpGE INVOLVE� COhiACT PEii50N FND PHONE NO. <br />T��� �'z �� /C� �l�L /�'�!�C1/lr/� — C �V� C �i �� <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAM�N�D THIS <br />PFOPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />LEGALDESGRIPTIONOFPROP@RTV�SHOIYNBELOIYORATTACNTWpCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�or� o�ocK � oF ��• �"<< fo2 i'�1 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />I�I AT o� �Nw I-� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />—r— PERFOR�7ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />anHce�Tnzio.NUMeer+ APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />I" S _ p _ O' ' W' l <br />CONTRACTORS LA 18.27 RCW AND 296200 WAC. <br />�ONSiRLCTIONLOANLENDER,ADDRE55 TELE HON NUMBER I {� <br />�on �enr �nne�no _ i�i____L� ��� � � / � � <br />PLUMBING ' <br />NO. TYPE OF FIXTURE OR <br />� WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) r <br />SHOWER <br />KITCHEN SINK 8 OISP / �/ <br />DISHWASHER !!! <br />LAUNDRYTHAY <br />ORINKING FOUNTAIN <br />FLOOR ORAIPI <br />BACKFLOW FREVFNI <br />SINK <br />SU8 <br />FOR OFFICE USE ONLY: <br />FRONTSETB4CN PE�ASET�ACK <br />� , � , <br />USE ZONE LOT ARpEA� ,,,l <br />^ 5�73.Sw <br />iV EO�LONSi NO OFSTOqIF.S <br />� �� y3(j FIRESPRINNLERSFEOp <br />�Jlt N� <br />e <br />JCCUPANCVLOAD FIREALARMRE00 <br />INi�KE�V PLqNSAPPROV[D�V <br />� JM <br />I onTe ir���il.i <br />FEE NO. TYPE OF E�UIPMEN' <br />�- <br />� A�C—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. <br />� UNITHEATERS—B.T.U. M <br />j CLOTHES DRYERS /ll <br />� VENTILATION FAN <br />� RANGE HOOD /� <br />WATER HEATER � <br />WOODSTOVE <br />_ METAL FIREPLACE (WOOD BUF <br />� FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />. EXHAUSTFAN /�!I I) <br />i $ <br />FEE $ <br />SIDE SET�ACN PL4N CH �CH"N�lyl ,1BER <br />S �_"�6 3 <br />VACFNTSRE FEES <br />.�- YES � NO BUILDING <br />OLC�ICP4LY N00'OWRLIryGUH:S — <br />�`'f � PLUMBING <br />BnSEM[NT MECHANICAL <br />�VES NO <br />1EIGMt uMI7AnoN ADDITIONAI PLAN CHGCK <br />��! <br />OTHER <br />STA7E �UILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WOHKS <br />LOCAL SALES <br />TAX CODE I' 3105 TOTAL <br />aun iviH� a U� - <br />PERMIT S <br />TOTALFEE S <br />FEE FECEIPTIJO. <br />59S �1v p�.� c7 <br />VALUATION FEE <br />rqC� 3� D, zo __� "�.5 0 <br />GG�, <br />l.L_1� <br />��� <br />�Q i <br />—�— <br />8�U <br />2U � <br />_ ; �l D 7 �_� <br />