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xr� <br />� r`�% r`� <br />ar3c~n <br />H �� <br />K �: <br />H X1 <br />'sJ H "+J <br />y � t' <br />�z <br />H t7 <br />OH <br />��g <br />�y] V �] <br />ay� <br />r r-i H <br />gN <br />cC�, CC C/� <br />� th � <br />H O [yn <br />A�PL.9CAT00� �OR ��sBS'@'E,�UC'i'G��9 ���$@1��'9' �,������� <br />_ V TO BE COMPLETED IN INK—PLEASE PRINT <br />cir� or }{ . <br />�V�reLl � HEATINGSYSTEM• (f]�GAS ❑ELECTRIC ❑ <br />BUII_DING DEPARTMENT , <br />259-8810 � <br />I DEMOLITION � 1 COMBINATION i 1 BUILDING i�� MECHANICAL [! PLUMBING 1 SIGN <br />n�':�:E� I.IAIL ApDRE$5 , f_ CIiY � ZIP PHONE (� l9 L'. <br />TY <br />r71�'�Ci<Lt'1a�_QTn _ r`- 7� -- � �'r ��JcS'- �-.�uicr.�n5 ��;y0},i,'- 77�-LS`79 <br />T N,WT � MRILADORE55 �(� CIiY Z��SN �^C�ib'f PHOkE <br />'\C �� .o�� t5� ti1L3TJ_��Tfl ��/E �'�"/t� hil�ti-it-!'-� f���P = (��V(�'�-M1T;^"' �/��?'�3 <br />ARC�UiEGiOnDE9GNER 1.'AR��DN[55 CIiY ZiP PNOhE <br />/ 1''.Ni'-�.;— <br />% J 1� � <br />GENEMlCO'�IRRCTOfi .. tA/iL/�DDF[$5 GiY ZiP PMOtiE UCENS[� <br />T� kl A- w� T/ � �t%.C� �r_ i _ _ <br />6iECNANiCALCONiRAGTOR �AILR�DR[55 CIfY ZiP PMONC LGENSE <br />�� .. <br />RU'.IDiNGGONiRACTOR AIARAD�RfiSS CI1Y 21P PMONE IIGEH5E1 <br />il.nS50F WORK � <br />, NEW C'. ADDITION �ALTERATION .� REPAIR -�� DEMOLITION �: ��, WOODSTOVE�FRPLINSERT ,�-i BUILDINGRELOCATION <br />\ � N�TACT �PEFSyR4 PND FMONE NO <br />JO�IiRnCTPRICEOFWORK /✓'�'� �--1'J-(—�' I r`� �t�� ( •`� �� �� - � � / �' <br />C[;�nmE wonK nwo souAn[ �oouce mvav[o / . <br />_%. -...., ;l r c i,�J i T t� n i�- l .�' �� XI � l c) l.� l. �vi %�/ �� ���-�-/ <br />r��ovosEous�ovow�owc �I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />���, 7 n� �,�� i APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />iecn�ocsaarnor+ovrnoPear`ur�owr�auowennrucuwur+cories PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COM1IPLETED WITH \NHETHER SPECIFIED HEREIN OH <br />ior o�ocK or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />� AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />'��,, � OTHER STA7E OR LOCAL LAV! REGULATING CONSTRUCTION OR THE <br />—�-=i-�- �'" _ PERFORMANGE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />/ �� 3/ C���'!� eC1 OWNER OF THIS PROPERTV TO PERFORM THE SVORK FOR \4HICH <br />`y- � 't n�� APPLICATION IS IdADE AND I CO�dPIY WITH THE STATE <br />-� — CONTRACTORS LAW 1827 RCW AND 29G200 WAC. <br />:�� � �.,; � �� � � ,icrr,m!+eerea+tanerononaunroa�zeoecer+r onrc <br />--� �, � �r � <br />� 1 C� (J i1 i'�: (. .- n,ts <br />V <br />i�i,o�cct AOonEss ---- <br />I AI'r'L!CAN1iUIT0U51N[SSUCENSENO AtlOIIUvINE55NnAlE <br />�:=zi� ��,,,,�,T�,-,3t��n_C..-r,� <br />TYPE OF FI%TURE OI <br />�VATER CLOS[T (TOILET) <br />pAT!{TUB <br />LAVATORY ( WASH BAS W � <br />SHO�vLR <br />KITCHEN SI�1K R DISP <br />DISH'!lASH[R <br />LAUNDRVTRAY <br />�inTHES WASNER . <br />TOTAL 5 <br />dIT 5 <br />�L FEE 5 <br />FOR OFFICE USE ONLY: <br />�PO��IS[TpALN �FANSEiDACB � <br />v.,vor�c iot nien <br />tiF[ 01 WN75 �IIOWABIf LYPE Of CONSL ACfUAI <br />[ pf �LOG NO.OF Si01UE5 <br />�.�r.iipANGYIOAp Hf1E5PIlNNtCli5RE00 <br />Li �� -0H fOR 5�'��NNlERS <br />�;�n�.cE+�� runserraov�.uor <br />FORCED AIR SYSTEAIS-�. <br />UNIT HEATERS-B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />/ RANGEHOOD <br />� �V�T[R HEATER <br />WO00 S70VE <br />1.1ETAL FIREPLACE 8 CHIh1 <br />FIREPLACEINS[RT., <br />HEAT PUMP <br />i GAS PIPING � <br />i E%HAUSTFAN <br />' � <br />vacnr�r�si�c FF.ES � <br />UUILOING <br />p-cnr...c. noavmwxcuxns <br />�°^^ r�unmiNc <br />065E6�CNT h1ECHANICAI <br />uuGirtuMrtntior+ ADDITIONAIPLANCIIECK <br />OTI{ER <br />STATE OUILOING SURCHARG[ <br />CITY OF EVERETT PII[3LIC WORRS <br />LOCALSALES <br />TAX COOEIS 3105 Torn� <br />F[C <br />F <br />E.A. <br />NU <br />N <br />� <br />tl <br />8 <br />