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�r�a <br />r�..'� � H <br />ayy <br />y�H <br />K � <br />r7 �7 <br />':1 H i1 <br />y y tg' <br />� O [*1 <br />H C7 <br />��g <br />�] • nqq <br />rHz <br />r-i H <br />8 `� <br />H <br />C] C7 V� <br />��� <br />�-z3 O V� <br />APPLICATi( 'J FOR i.ONST'RUC7 JN PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��T� <br />CEATINGSYST[M: ��JGAS UELECTRIC J_I_'t�J-'_l�Ci'1�----- J <br />E3UILDING DEPARTMENT - <br />259-8810 <br />DEMOLITION COMBINATION �BUILDING MECHANICAL PLUMBING SIGN <br />o�vNEn n�nitnonnr.ss cnr am ruor,�t <br />� �a 7 <br />(�n �mr,r.��r'u�s, �Ilo!'�a�'��.� v� =veNe� Rti�7,o�_ %1 � - 77�% <br />iENANi MAILAO�RE55 I CIIY ZiP PMONE <br />AR:IWECTOR�E5IGNER lAAILAD�RE55 CrtY IiP PMONE <br />/ <br />yt4JEPMCONTflACTOfl AIAILADORE35 CITY ZiP rrvnc a����.����.��- <br />C�Ir.c1e,�C�n, a'obvr3:�� �.�Ice S�evens q82�P, ?�35-770� (�LRcie�o��y�;i <br />IAECHANiCPL CONTRACIOR \UIL 4DDR[55 CItV 2iP P��ONE STATE �IC[NSE � <br />fLU1dBINGCONTRRCTOR AIARAD�RE55 CITV IiP PHONE STAtELICENS[• <br />� a o u S 3� 5� v 35� 1 SN-o - 1C� � <br />C_L/45SOFY PK <br />n NEW AUDITION. ALTERATION REPAIR DEMOLITION WOODSTOVEFRPL INSERT . BUILDING RELOCATION <br />�/�st /� o.� S' ,f G, 3 Z S� - <br />CONiRACT PRiCE OF WORN <br />OESCRIpE WOPN ANO SOt1APE FOOiAGE MVOLYED <br />I'-1 (� p_„g� S�i1 CIC �Nc�Y+� 2 <br />n�oaoseous�oF ioi��e �, �,.i� <br />�LC✓•S/� ..�...nr ., /JI /i�r.kFi.r dGS� <br />ior 3()T :3_� _ e�OCK 7 0�� <br />' ' Ara <br />_��G � � L� Y1L�/�'L_X�'i' <br />�+�o�Ecr nnoers:, <br />PLUMBING <br />NO. TVPE OF FI%7URE OR ITFI <br />�INATERCLOSETITOILET�_ �/ <br />BATHTUB <br />LAVATORY (WASH BASIN� !�� <br />SHOWER !� <br />� KITCHEN SINK 8 DISP ! I <br />OISHWASHER / <br />�AUN�RVTRAY <br />�' �°�' - URINAL <br />DRINKING FOI <br />i `�L ' _- FLOOR DRAIN <br />BACKFLOW PI <br />ROOF DRAIN: <br />— CINN fSPRVIC <br />Q � � <br />`�6'z c. <br />FEE <br />0 <br />SUBTOTAL 5 _2� <br />PERMIT 5 <br />TOTALfEE 5 , <br />FOR OFFICE USE ONLY: <br />rr»ru=;:renr.rc � nenesEmnc� <br />7-�1 ' Zl1 <br />usezon[ �ornnen <br />tH�Ct;fC0111�AL1014A0�C lYPCOlCOlIS1ACILAI <br />�r� _ <br />5'�IE OF pIDG tl0 OF S10RIE5 <br />�740 SFi- <br />yZo Sr ,12 <br />GtLUPAtlGYLO�D <br />—_�I�A <br />n�n;on rons��eu�n�ens <br />I'1P1F11 OY <br />J� <br />REO'� <br />ur <br />I CONTACT PERSON �NO PNONE NO <br />i HEREBV CERTIFV THAT I NAVE READ AND EXAMINED T111S <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. A�L <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE C061PLETED WITH WHETHER SPECIFIED HEREIN O'r7 <br />NOT. THF GRANTING OF � PER�AIT DOES NOT PRESUME TO GIVE <br />AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TP![ <br />?ERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTNORIZEO BV THE <br />OWNER OF THIS PROPERTV (O PERFORM THE WORK FOR VJHICfi <br />APPLICATION IS MADE AND I COP.IPLY WITH THE STATE <br />CONTRACTORS LAW 78 2i FCW AND 29fi200 WAC. <br />�_ �� _��� lGZ <br />�1Gtl`r.Ct�rL � �'-�= <br />% �.:� <br />MECHANICAL <br />N0. TVPE OF EOUIPMENT FEE <br />A C-A HNDLG UNITS-H P. <br />1_ FOF7CED AIR SYSTEGiS-B.TL h7 E.A. __ __ <br />UNITHEATERS-B.T.0 A1 __ <br />� CLOTHES DRYERS // _ _ <br />� VENTILATION FAN _ , _. <br />RANGEHOOD <br />�_ WATER HEATER / _ <br />WOOD STOVE _ <br />- METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP _, <br />FAN <br />SIDCSEIDACN/ PIANCI�ECkl:ii'dLl1+ <br />3 ��.� � � <br />vncarrt srt[ FEES <br />BUILDING <br />o:usa•.t. eocr.^nnor.�.+:s <br />°Pi° � PLUMBING <br />2- <br />OASEA�[Ni MECHANICAL <br />�� ADDITIONALPLANCHECK <br />HEIf.Ni LI'MQITATIQ(J <br />2iV � srn�.[a /-AD.•.J <br />S7�V C EIUILDING SUfiCHARGE <br />CITY OF EVERETT r�um.ic vro��hs <br />LOCALSALES <br />TAX CODE IS 3105 iOTAL <br />FEE <br />�i� n[ceiarr�o <br />3��. G �ii <br />�- <br />r_ <br />;OJ <br />� <br />