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� � <br />C�H <br />�Hrn <br />� � � <br />oH A1 <br />'il �'� <br />�� <br />O�d <br />��g <br />�r n <br />t"y� <br />My <br />g� <br />O5by <br />l'l <br />H� <br />HO[n <br />�� APPLICATIQ":"' FOR CONSTRUCTC`�N PERMIT <br />�� � � <br />� TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />—� <br />BUILDING DEPARTMENT � <br />259-6810 <br />DEMOLITION COMBINATION <br />OIYNER AIAIL AD�RES$ <br />Y}�/�i2K k' Silc; .i;c��1 <br />��,,.�,r n+naaooeess <br />HEATING SYSTEM: ]A GAS U ELECTRIC U <br />BUILDING <br />f,ItV <br />i%F'kf.c/7- <br />CIiV <br />MECHANICAL <br />21P PNONE <br />'7 '7 � <br />�v_; _5 5�> <br />21P PHONE <br />PLUMBING SIGN <br />SS OF 1YOFN <br />NEW � ADDITION ALTEFATION REPAIR DEMOLIiION WOODSTOV6FRPLINSERT 6UILDINGRELOC <br />P ns..N �C U!i ICONiACTPERSONANDPHONENO �..n.ir -T+:iJ :7C:�.L/77 <br />i — <br />.1 � � <br />IEGALDESC' <br />LOT <br />OF PPOFERtt iSMOWN OEIOW OP <br />p�OCK _ Of _ <br />r��r1� <br />TRAY <br />SUB TOTAL <br />— PERMIT <br />TOTALFEE <br />FOR OFFICE USE ONLY: <br />FRONTSETBlGh REAR 5[T�ACK <br />, , <br />usezo� ���AnEA <br />—'—S � 3 Z �� <br />tmE or coxts nuownatE tv�� ar corvsr acww_ <br />SIZEzF1� NOOFSTORIES <br />�� s G Z <br />nca�i�+ntrv�GLYLOAD FiPESPRNkLER5RE0�� <br />pEA50N YON SPeirvucno <br />INTANE 9Y PlANS APPROVED Bv <br />J+� �. <br />u <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMIN[D <br />1�G�1..'C%�L E APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE OF <br />WORK W�LL BE COMPLETED WITH WHETHER Sr'ECIFIED 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 />% I OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. IHAT I AM AUTHORIZED BY THE <br />� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COt.1PLV WITH THE STATE <br />�...� � -{ CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />i � <br />; � X a��:�/�/> �- 9� <br />^ l <br />.,..<,�.�i. �.+�' n���. <br />I `�,"�/(��.' lIIVPt:iy�.SSi�:,IN�.iN:1 _ <br />NO. TYPE OF EOUIPMErv i <br />h�C—A:HNDLG UM1S—H.P. <br />FORCED AIR SVSTEMS—B T.U. M <br />UNIT HEATERS—B T.U. M _ <br />�_ 1 CI.OTHES DRYERS <br />— WOOD STOVE <br />METAL FIREPLACE 8 <br />FIREPLACEINSERT <br />HEAT PUh1P <br />/ GAS PIPING <br />L! ExHAUSTFAN <br />Si�[SLioPLN� PIANCHECKNtIA1BER <br />�,� .� c <br />vnc��+r srte FEES <br />/�' `�� Aui�o�Nc <br />eccur.vc. eamnwuumav,��s <br />c�ouv p�UM01NG <br />BAS[MENT �dECHANICAI <br />NEIGNT LIMuAtjp�+� ADDITIONAL PLAH CHECK � <br />� SPRINKLER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUOLIC WOflKS <br />LOCALSAIES <br />TAX CODEIS 3105 TOTAI <br />r <br />_ —� <br />SUB TOTAL $ rY'� <br />F[E <br />�f t�i . G '% <br />