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I <br /> APPLICATIC Y F�Ji� CO�ISTRI:C�JN PERMIT �� <br /> TO BE COMP�ETED IN BLACK INK—PLEASE PRINT rcrr <br /> � � BUILDING DEPARTMENT �HEATING SYSTEM: �1 GAS �J ELECTRIC J _ � <br /> p �Y' . 259-8810 <br /> y y�, ' DEMOLITION COMBINATION BUILDING MECHANICAL pLUMBING SIGN <br /> C� OWNER M1IAiLA0DNE55 �iTv ZiP PHONE <br /> ��� t�'� l;�� f'e: Sl-rn� � .7�? 7 � /����.� ��- �6 � �-��-'� Y a S� <br /> TENANT MAILADpfl�SS CITV $IP PHONE <br /> '+tl H �tl <br /> y(n�..� ARCIIITECT OR DESIGNER MAi�60DRE55 pltV Zin PHONE <br /> O�i <br /> O � GENENRLGONTRACTOR IAALLqDORE55 CiTV ZIP PHONE STATELiCENSE• <br /> H <br /> � � �[ hIELHqNICALCONTPACTOR MRILRDDRESS CItV ZiP FHONE STAiELICENSEv <br /> V <br /> �r n <br /> ~ y� LU�191NGCONTRACiOR MAILRDDRESS CITV ZIP PHONE STATEIICENS[t <br /> � <br /> F <br /> M f] ClAS50F WORK <br /> y NEN' . ADDITION ALTERATION REPAIF DEMOLIiION WOODSTOVEiFRPLINSERT BWLDINGRELOCATION <br /> C] CJ VJ <br /> G � CON tpCT P[�i50N AND PHON[NO <br /> WNTPACi PInCF.OF WORK ��� ��J� <br /> y(A DESCRIPF/N'/OPNAVDSOVAPEFOOTAG//W}',•)LVE� ry� --- <br /> H O CA /05 O � /.i �,.!/�-� � <br /> aaoroseouseoFow�o�r+c i h�EREBV CERTIFY THAT I HAVE READ AND EXAWINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC2 ALL <br /> LEGAtD'cSCRIPTIOVJFPROPERLVISHOWNBELO1VOnpTiAC�iFOURGOPIES� PROVISIONSOFLAWSANDORC!NANCESGOVERNINGTHISTVPEOF <br /> WOAK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot__ e�ocK oF NOl THE GRANTING OP A PERMIT DO[S NOT PRESUME TO GIVE <br /> AI�TiORITY TO VIOLATE OR CANCEL THE PROVIS!CNS OF AIJV <br /> . 0T4[R STATE OR LOC4L LAW REGULATING CONSTHUCTION OR�NE <br /> G �a 7 PEAFORMANCE OF CONSTRUCTION THAT I AM AU fHORIZED BV THE <br /> Cj 1����- ��� OWNCR OF THI� PROPERTY TO PERFORAI THE WORK FOR \'VHICH <br /> 6 `l J �\PPL CATION IS MADE AND I COP.IPLV WITH THE STATE <br /> G"JNTHACTORS LAW iB27 RCW AND 2A6200 WAC. <br /> aeo�ecrno�uEss .�,.:..�,::�Tl�—t�?7`_'�' / /w—�3�� . <br /> � � � <br /> �n nos•��•�u;:n:sr no <br /> PLUMBING MECHANICAL <br /> '_� NO. TVPE OF FIXTURE OR ITEM FLE NO. TVPE OF EOUIPMENT FEE <br /> _ WATERCLOSET�TOILET) A:C-A�HNDlGUN175-H.P <br /> '.+1 BATHTUB FOFCED AIR SYSTEMS-B.T.U. M E.l�. <br /> LAVATORV�WASH BASIN) UNIT HEATERS-B.TU. M ' <br /> ' ' _ SHOWER CLO'NES DRVERS �- <br /> � KI i CNEN SINK&DISP VEN1lLATION FAN <br /> � DISHWASHt'n_ ; RANGE HOOD _ <br /> LAUNDRY TRAY WATER HEA7ER <br /> ' CLOTHES WASHER �_ WOODSTPVE <br /> URINAL NETAI. FIREPLACE 8 CHIh1NEY —T— <br /> � DRINNING FOUNTAiN <br /> FIREPiACE INSERT <br /> f'1 FLOOR DRAIIJ Hhni f`U^AP <br /> � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> ' � _ SINK�SERVICE-BAfl.ETC.) _ —�— <br /> f T <br /> -� -- —�— <br /> ' SU6 TOT?L 5 ; SUB TOTAL 5 <br /> PERMIT $ �- PERMIT 5 <br /> � TOTAL FEE S TOTAL PEE S �— <br /> FOR OFFICE USE ONLY: <br /> FB09i5EiG�GH REARSRBTCH SIOESETBALK PLI�.NCH�C 1�)(!,[µ �[E NCCEIPTNO . <br /> J /7 <br /> usezo�u[ LOiAR[q vacnruTSiTe FEES VALUATIDN FEE <br /> BWLDING / <br /> /� i �j2 <br /> i�PE Oi GONiS.AIIaVUBIE IYPE 0!L01151.ALTUAI o[tu>�ucv m o�n'n�..c;.0 is L ` � ---l.L==J-i_- <br /> enow P�UMBING <br /> SIZ[OFBIDG NOAFSTORIES BASF4fENT MECHANICAL <br /> OCCUPANCYLOAD FIRESPRNNLERSREO'D NEiGHiL�MrtFiION ADDITIONAL?LANCHECK <br /> . SPRINKLER <br /> PEASON FOR SPFMKLERS _ <br /> STATE�UILDING SURCHAfiGE '�� <br /> VlIAK[[IY PLANSAPPqOV[D�\ 1 CITY OF EVERETT PUOLIC WORN$ _ <br /> � LOCALSALES <br /> TAX CODE IS 3105 rurn� <br />