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��� <br />Hc� <br />�Hf~i� <br />H�� <br />� � � <br />Hy <br />x <br />o�e <br />��g <br />�Y � <br />C"y� <br />HH <br />g� <br />M <br />��y <br />HO� <br />5�`� APPLICATIC'`� FOR CONSTRUCT_�N PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PI.EASE PRINT �� <br />HEATING SYSTEM: � GAS J ELECTRIC iJ _ 1 <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION k BUILDING MECHANICAL PLUMBING SIGN <br />OW-N/EP RIpILA00RE5/5� /CJITV 2�P PHONE <br />�C` 9��i�/ �/'�Yil�2.0 f�Q RESW % �/'%%N'v �C �✓�li�L l� rZ� � �c2��``3 ozs�-yyzJ <br />APCNIiEGTOiVD[$IGNER MAILADORESS GTV ZIP PI'ONh �l✓71���� <br />S� a/�(�rt.r+-�' �.v%�-i�L��I6.(t /i±'2J 3sy'� ii[�S,L� �'v�-!/Y// ��� s.volroc.B/2�.f7V <br />G[NER4LCONTRACTOR hUIL�DDRE55 CILV 2iP PHONE SLALELICENSE♦ <br />I.IECNANiCPLCONTRRCTOR MAR pDDNE55 CITY 21P PMON[ SiATE UCENSE/ <br />PWM0INGCONTf1RCTOfl AUILAO�PE55 CITY ZIP PHONE SLPT[LICENS[• <br />NEW X ADDITION ALTERATION REPAIR DEMOL�TION <br />,.�1.,� _�,U/o5' � � ,.�- .. ov , IcoHr� <br />DESCRIOE W�OR�H ANO SOU/RE FOOT�GE INVOLI'EO <br />%% SS' / / �/ . �� � % �OY.O'z/�U/L_ <br />PBOPOSEO USE OG ppRDiNG �7 <br />G.i.ISI s/1. 9� !�f/I^vIL.Q <br />IEGAL�ESGFIPTIONOFPROPERTY�51 WN�ELOWORATT�CNFO///II���RCOPiE51 <br />LOi'� O/� BLOCK i�/bU OF ��LI//��.L� <br />�0%v �Uo <br />G/ 7 �RO� �/�✓ <br />,�iy�.0 ; c 1,�� <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET�TOILET) <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CIOTHES WASHER — <br />URINAL <br />�RINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREV[NTERS <br />----� <br />ROOF DRAINS—RAINLEADERS <br />/ SINK (SERVICE—BAR, ETC.� — <br />� i . :,✓ <br />SUB TOTAL 5 _�fJ�_ <br />PERMIT 5 <br />TOTAL FEE 5 , <br />FOR OFFICE USE ONLY: <br />FRO�Ni5/Ei0ACK RE�/'7RSETOACH <br />�C./ C., '. <br />IISE'ONE �OTRREA <br />`7 , ` <br />iYPf Oi CONiS AIIOWABIE ttPE 0� LOB51 Ai <br />ir_ —tit <br />NOAF STORiES <br />� <br />FIqE SPRNrclERS RWD <br />�[U <br />REASONFOf15PRINnlERS <br />iNiAH[BV PLANSAPPPOVEO <br />J41 <br />SIUh SEiOPCK <br />/___ <br />WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br />�i.� ��a� 33�/ 7Sy <br />i HEREBY CEHTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF <br />WORK NlILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV[ <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL L�W REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. TNAT 1 AM AUTHORIZED DY THE <br />OWNER OF TFiIS PFiOPERTY TO PERFORM THE WORK FOR WHICFI <br />APPLICATION IS MADE AND I COAIPLY WITH Tl1E STATE <br />CONTRACTORS LAW �8.27 RCW AND 296.200 WAC. <br />Xf%� �7 G/�y <br />��.N.,�,�� �/� �.�� ---�—�— <br />CiIY 11lISiNFSS liC[ NSE NO <br />NO. I TYPE OF EOUIPMENT � FEE <br />FORCED AIR SYSTEh1S—B.T.U. M E.A. <br />UNITHEATERS—B.TU. M <br />CLOTHES DR1'ERS <br />VENTILATION FAN <br />RANGEHOOD <br />1VATER HEATER <br />WOOD STOVE <br />METAL FIPEPLACE ! <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EICHAUST FAN <br />TOTAL <br />PLANCH KNUMG-!1 F[[/ �— <br />�7/ � <br />FFFS VALUATION <br />BUILDING <br />a-m�nva xoo�oxnnaauxrs <br />96'1° PLUM�ING <br />�3 <br />oaSEMENi MECHANICAL <br />IJ — <br />HEIGNTLiMR4110N �DUITIONALPLANCNECK <br />� ..� � <br />SPRINNLER <br />STATE �UILDING SURCHARGE <br />CITY OF EVERETT Pl1BUC WORKS <br />LOCAL SRLES <br />TAX CODE IS 3105 TOTAL <br />5 <br />;s� <br />