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APPLICATIC^ 1 FOR CONSTRUCT-�N ��I�I� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT DEC - 7 �ySa-�`� <br />H A G SYSTEM• U GAS ❑ ELECTRIC ❑ "" � vr tvtKET�' <br />BUILDING DEPARTMENT ���oo� s Dept. <br />259-8810 Fi�E slittNKl�- <br />I 1 DEMOLITION f 1 COMBINATION I! BUILDING i✓MECHANICAL I l PLUMBING I I SIGN <br />ILADORE55 CITy� Z�P �Pj'ONE <br />owrae% . _ 1 / - - — ..,iz., � � �%� Q/e /. ) �, un . �fd.�v . �S/v"� .3� _ <br />AflGNCEC70RDE51GNEF MRILAODRE55 CITY ur •����•. <br />GENERALCONiRRCTOR MAILAO�AE55 GITY 21P PIIONE STRIELICENSE• <br />—�, . 2t`tv� 3f3Y4� +��E W PX'16i� UJA 9r�� 35�-243� <br />PNONE ST�TELICENSEt <br />MECHANICAL�ONTR�CTOR MAILADORESS LITY Z�P C���71-EJ�E <br />�C �1� r��A� �Ri7� r._ G MC1Y�/A�L� RD•_ «�ARU�1L1 1�.� C�C�p� ��-�--r�P <br />v��.�n �w�� r�v.. . <br />��T� Z�p PHONE SiRTELICEN5E1 <br />PWMBINGCONTRAGiOR MAll�00RE55 <br />�CU SOFWORK <br />NEW 11 ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FHPL INSERT I I BUILDING REL <br />�'f CONT:,.CT^PEP�SO,1N �ND PHONE N0. 2? 1_�� � <br />CONiRACTPRICE0FW0� `�" 4O�_^ IFWGL M�� C��� <br />PROPOSED USE OF BUILOING <br />��L� �F�� <br />LEG�L DESCRIPTION OF PROPEI <br />l0T BLOCN <br />S.w.�/q, S�G� <br />OF <br />T.Zf <br />PROJECTAODRE55 <br />51od 5.2ND �5� <br />WATER <br />FLOOR DRF <br />BACKFLOW <br />ROOF DRAI <br />SINK (SERV <br />FOR OFFICE USE ONLY: <br />FRONTSEIB�CN R[ARSEIOnCK <br />USE20NE IOTAREA <br />7VPL O�F CONt <br />�N <br />SRE OF Bl <br />INTANE BY <br />PERMIT <br />TOIALf <br />' G(O�N,SC' AGiUA� <br />�11 V <br />�y <br />� Nic�2 sr.:�-+ <br />GOPIES� <br />WM <br />i HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO G�V[ <br />AUTHORITY i0 VIOL�TE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHi::hi <br />APPLICATION IS MADE �ND I COMPLY WITH THE STATC <br />r.nNiaAGTORS LAW 18.27 RCW AND 296200 WAC. <br />„ , �����/'l//�� iz/z/� <br />���2� 70� o�,E �� <br />cnvousrtsssuccHseuo <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />A/C—AIHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />METAL <br />FIREPL <br />HEATF <br />GAS PI <br />IydJ <br />ea <br />SUB TUTAL $ <br />PERMIT $ <br />SIDESCIDALK PL4Nf,11 CY.NUMOfAf fEE <br />c%lr yo,s � v <br />VACFNf51TE FEES �A� <br />BUILDING <br />amrexcr uoaowcwNeuxns — <br />�^�^ ' 1 PLUM�WG <br />BTSEMENT MECIIANICAL <br />ioD NEiGHT�nTnnaN ADDITION�IPLANCHHCK <br />SPRINNLER <br />rj,br ,p�� �� STAiEBUILDINGSURCHARGE _ <br />N4'G (iY <br />�� CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES — <br />.... TAX CODE IS 3105 TOTAL <br />J <br />T <br />