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��� <br />H <br />>HC~i� <br />Y <br />K � n <br />'R1 H'� <br />Hy <br />x <br />o�d <br />��g <br />�Y (] <br />t"y� <br />HH <br />g �' <br />C]C(�/� <br />��+ <br />�Hf�ii <br />HO�n <br />APPLIGATIO�. FOR CONSTRUCTIiN PERMIT �`'�«''� <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />fhe Evcrgmrn <br />CITV OF <br />everett HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOUTION COMBINATION <br />' O\�"��/IEP j M4iLA00R[SS / <br />Yi... I C..r.GJ/'� ZIICf i//%U��lJA <br />I,IpiL AO�RESS <br />GENER/LCONTRALiOR <br />MECNANICRL yO�YT� AGtyP I.IAILAD�RE55 <br />/.yl. �i�fr-�C.c�.Jv �w 3l10 - � <br />PlUM01NGCONiRAGTOR MMLADDRE55 <br />CLASS OF WORK <br />� <br />PROPOSEO USF OF <br />ti� <br />IEOALD SCR!PTIO <br />ior <br />RPa <br />BUILDING MECHANICAL <br />CITY 21P PHONE <br />� �> ��j ��s'- Z!G G <br />CITV 2iP PNONE <br />CITV 21P PHONE <br />CITV ZIP PHONE <br />l:u� <br />i/� ��� <br />ADDITION . ALTERATION <br />.a <br />F 1VORN 7OO � <br />IU SOURRC FOOIDGE INVOLVE� <br />PLUMBING SIGN <br />• <br />21P PHO•.' UGtner • <br />i 2fS-�'��i /L�r4�.G �a�,ez <br />ZIP PHONE IICENSEI <br />REPAIR .. DEMOLITION . WOODSTOVE/FRPL INSERT . BUILDING RELOCATION <br />� CON7ACiPEF50NANpP1/0NEN0. <br />���c I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />„�(' APPLICATION AND KNOW THE S.�ME TO BE TRUE AND CORRECT. ALL <br />PPOYERTV ISHO\YN �EIOW ORRTTACM FOURCOPIESI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETeD WITfI WHETHER SPECIFIED HEREIN OR <br />B�cxK oF NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE A�JD I COMPLV WITH THE STATE <br />CONTR�CTORS LAW 1027 RCW AND 296200 WAC. <br />SIGNFiUREOFCONTRACiOROR�UtNORREORGENT DAiE <br />X �'�G-N-N--1 / _ <br />��.� l�_ �{- 1„Jl APPIiCANTSGiYBt15ME5 iCENSENO.RNOBU51NE55NAA�E <br />WATERCLOSET <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRVTRAY <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADEFS <br />SINK �SERVICE—BAR, ETC.) <br />PERMIT <br />TOTALFEE <br />FOR OFFICE USE ONLY: <br />FB�YTSETBRCK RERRSEiBACK <br />❑5[20NE LOTRR[A <br />I1+i0itOHfSAIIOWABIE iYPEOFCONSi.ACtUAI <br />SIZEOP6LDG NO.OFSTORiES <br />OCCUPANGYLOAD FIRESPRNKLEPSPEC <br />nensow ron sanu:K�ers <br />INiAKEUY PLANS��CPOVEO�Y <br />NO. TYPE OF <br />A/C—AMNDLG UNI� <br />J FORCED AIR SYSTI <br />UNIT HEATERS—B. <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE <br />FIREPLACEINSERI <br />HEAT PUMP <br />GAS PIPING <br />EXHAl1ST FAN <br />3 <br />SIDE SETBRCN <br />BUILDWG <br />OLN4ANCY NO C10W[l1�NGUV115 <br />�P0°P PLUM6ING <br />BRSEMENi MECHANICAL <br />HEiGHTUMrtnnoN �DDITIONALPLANCHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES -- <br />TAX COOE IS 3105 TaTA� <br />�B.T.U. M E.A. <br />M <br />P[CEIPi NO. <br />