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APP�•-ICATIC-'Y FOR CONSTRUCT'1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM GAS EL <br />BUILDING DEPARTMENT J �9 ECTRIC J <br />259-8810 <br />DEMOLITION COMBINATION j� BUILDING MECHANICAL PLUMBING SIGN <br />'J�Y���R ldNL �DDRE55 GRY ZiP PHON[ <br />—Ll.� �✓e���� �SC�a_��•r , faP�oG •ors� 339• 3o Q'S <br />TEN/NT �_J�Cca DRESS �IiV 21P PHONE <br />-��—�h�aa/ "� r� /v ��;c��_� •�s. y�o� Rmr� f�u�� .��,�na.� l.�JA 9�9� U3 �-Sd FY 9 <br />����,�rE�, <br />Gt fERAL WNiRM1CiOR ' l.tAlL��pfiGSS � <br />� .. �� . <br />�../1LL�'�'- -II �:7 n �! �- � i <br />IAECN4NICALCONiqACtOR h1AILApURLSS L� <br />Gni �ni- o�i1-�.- <br />PLUtdBINGCONTR4LTOR MNLAODRE55 C <br />CONTRnCi VRICE OF WORK <br />DESCRI�E WORK AND SOUFRE FOOiAGE INVOWED <br />PROPp�S.ELD USE OF �WLDING � <br />--S.9L�µ�r <br />L[GAL DFSCRIPTION OF PROVER7Y ISIIOWN BELOW OR AT74CM T1Y0 COPIESI <br />�or�'LiJ7'�� o�ocr.�� oF ���'�+G� <br />�`Aqi Ill lA% I D NUblpEfi <br />_y;y�-��o'0/7-Dl�S <br />LiRJ£tRUCT10NLOANLEN�6R.ADDRE55.iELEPHONE NUMB[F <br />(_�.�...-r T,_1 r'� -r_ %� /i :'�. �l . <br />PLUMBING <br />N0. TYPE OF FI%TURE OR ITEM <br />WATEH CLOSET (TOILET) <br />BATHTUB <br />LAVATORV (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISIiWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK ISERVICE—BAR. ETC.1 <br />SUB TpTAL S <br />PERMIT ^� <br />TOTALF[E § <br />FOR OFFICE USE ONLY: <br />FROHiSEi��CK REAflS[TB4CK <br />G, <br />USE 20NE LOT AtiEA <br />l�l-Z. G-Z <br />�7Y�ff Of COII� NO OF STORIES <br />V'N � <br />SIZ[ OF BLDG i1RE SPRINKLEflS REO'D <br />0 D �4,''I, NO <br />OCCIIP�NCYLOAG FIREALMIdF[OD <br />�� <br />RGSON <br />ORu�M9•,,c� <br />INTAKEBY PLl�J;nPPROVEDBY <br />7 J � ) <br />� <br />� <br />��r� z�� <br />//�J i <br />CIT� Y �+12G �G <br />. � <br />.)�_'�J.�,�.; \ .. <br />CI:� <br />TCIiV ZIP <br />FEE <br />� <br />PHON[ <br />I�.Y/_Y..G_aii <br />PIIONE <br />:, ' , <br />PNONE /' <br />6 <br />PHONE <br />CONTFGT P[RSON �NO PMONE NO. <br />5.�7.-��%r� /.9ya4 - �/.3s <br />STryT%LICENS[ 4 <br />�TE LICENSE e <br />SiFTE LIGENS[> <br />i HER[BY CERTIFY 7HAT I HAVE READ AND EXAMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETE:� WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A f`ERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE CA CANCEL TFIE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERPORAIANCE OF Cf.NSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS ^ROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION iS MADE AND I COMPLV WITH Tht STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X� AL ��7 — <br />:Yvsiuni . o�r[ <br />CiIVH'S:, i i;lN�I NJ <br />MECMANICAL <br />JO. I TYPE OF EOUIPMENT FEE <br />� A�C—A:HNDLG UNITS—H.P. , <br />-- ��-�� <br />—� /�,� /��Qh � f' _n�, r���. %, <br />_T ,...-� <br />—i <br />—T �. .� n � !�' �'�Xl� �'% <br />� ` - r� <br />= / . , � �/ -�G/�i <br />�- ,/jt'(GG��<,. �� i/ <br />�- ���Ul:.� !✓� �/l�.:,� <br />r / / <br />.. - �'��� � P/��- �'/� ��� <br />,. / <br />PERMIT <br />TOTALFEE <br />i <br />� � � �7��,,,,, e__ ��C.'(�� �1 <br />PL.NC��F., NI BER �EE <br />��53/ <br />vncanr siie FEES <br />YES - � NO BUILDING <br />�.�:,.�, . ,::.�,���;�:�,: <br />� �3 PWMBING <br />BnSEMENT IAECHANICAL <br />YES �O <br />HEic��iuAlRrnON� A�DITIONALPLANCHECK <br />� �� OTHER <br />STA7E AUILDING SURCHAqGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 Tora� <br />7Z <br />�---- <br />� <br />� �, (�� <br />�. � �)�.� <br />