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���� <br /> APPLICATIG 7 FOR CONSTRUCT_ �N PERMIT � <br /> � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��"/+�T <br /> �7 �C�,,,�-+ BUILDING DEPARTMENT HEATING SYSTEM: J GAS J ELEC7RIC J <br /> �i tn 259-8810 <br /> A � x DEMOLITION COMBINATION x BUILDING MECHANICAL PLUMBING SIGN <br /> �y y pp;gq NnR ADOaE% ❑tt Ziv PXONE <br /> H�a (f-il ,,, •1 �S`I��r= ���ti. U �c�o�c Pv�c,- [�f�:�rr —z5y-i&3� <br /> 1-3 H iENANi MAILAOORE55 OTV IIP PIIONE <br /> �H� �/�i�/1��i1 L+rJ7" - <br /> nRCHITECTOP�ESiGNER 1AAILA��RE55 GTY ZiP T�OHE <br /> � y H Nn��P��> Gc,�sr ti I3i N�<-l+r.r.-a �r� ��it<n- 9 2ur i,;ti�7os� NAV1RGIf L30oL/ <br /> �O � GtNENALCONTPtLTOR MAIIRDDRESS CRY ZiP PHONE STATELICENSE/ <br /> C�7 <br /> H t7 - <br /> O H �j MECHRNICRLCONTRAGTOF MARADDRESS CITY ZiP PHONE STATELILENSE• <br /> NCi7C� — <br /> 'n� �' PWI.IB�NGCONiPALTOB MAiLADDRE55 QTV ZiP cMONE STFTEtIf.ENS[• <br /> zy� <br /> CLn550f 140PK <br /> � ~ y K NEW ADDITION �LTERATION REPAIR DEMOLITION WOODSTCVEiFRPL INSERT BUILDING RELOCATION <br /> �� I-i r n CONiACi CERSON AND P1104E NO <br /> Cy corvtancrvA�ceovwon� '���7c' Sl �c�d�dC7 <br /> � �ly � CC;'�CRIBE WORN P^ID SOV0.RE FOOTAGE INVOIVED <br /> LHtn <br /> HOcn ��QP�cTANn ORi�Wey <br /> aR01'W[Ot15EOFBUILDiNG I HEREBV CEPTIFY THAT I HAVE READ AND El(AMINED THIS <br /> C�'�R PO/�� �� R�-n"�'`'L ' APPLICATION AND KNOW THE SAME TO BE THUE AND CORFECT.ALL <br /> iEc<ioescamrioNOFaaocearv�snowneeiowonarTncHvouacoa�es� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS7VPEOF <br /> W(4 WORK WILL BE COMPLETED WITH WNETHER SPECIFlED HEREIN CR <br /> ior j �(W �1�- eiocK � oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL lHE PROVISIONS OF ANY <br /> �L'f10 Y (/�'�� C e S � -'� � p�. OTHER SiA7E OR LOCAL LAW REGULATING CONSTRUCTION OR TH[ <br /> PERFOFMANCE OF CONSTRUCTION.THAT I AFd�UTHORIZEO BY iHE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOHK FOR IVHICH <br /> APPLICATION IS MADE AND I COMPLV WITH TH[ ti7AT[ <br /> CONTRACTORSLAW1827RCW AND296200WAC. <br /> 1 <br /> _ X �/���/L �� 7 G 3.� <br /> vr�oxcrnooncss . ... . .. /✓yi�{,qCu Lcr�� ��( -1-t --7i <br /> z s�L vl uro.p P��<-F -- <br /> � � PLUMBING MECHANICAL � <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE UF E�UIPME��T FEE <br /> 1�I WAiER CLOSET ITOILET) P C—�:HNDLG UNITS—H.P. __ <br /> BA7HTU8 FORCED AIR SVSTEAIS—B.T,U. M EA. <br /> f 1 LAVATORY�WASH BASM) UNIiHEATER�—BT.U. M <br /> SHOWER CLOTHESD�9VEFS <br /> '�I KITCHEN SINK 8 DISP VENTILA7;ON PAN <br /> DISHWASHER RANGE HOOD <br /> ! ' LAUNDRYTRAY _ WATERHEATF.R _ <br /> CLOTHcS WASHER WOODSTOVE <br /> ��' URINAL METAL FIREPLACE 8 CNIMNEV <br /> '�1 DRINKING FOUNTAW FIREPLACE INSERT _ <br /> FLOOR DFAIN HEAT PUMP <br /> t � BACKFLOW PREVENTERS _ GAS PIPING <br /> � ROOF L7RAINS—RAINLEADERS EXHAUST FAN <br /> �' SINK�SERVICE—BAR.FTG) _ <br /> O — — <br /> f�, SUB TOTAL 5 SUB TOTAL 5 _ <br /> ' PERMIT 5 PFRMI7 S <br /> '� TOTALFEE S �— <br /> TOTAL F':E 5 <br /> FOR OFFICE USE ONLY: <br /> fRON�CACH q[�RS[I�ACH / SIpE�AC�j PLANCH[CNNUAIOER iEE �[CFIP�1;0 <br /> .• / � 3�ri� 35. i o 7U>s�. <br /> usemmt �oranen VACANi51iE FEES VALUATION FEE <br /> /�L BUILOING �Z�SU � ;GU <br /> ivP[OiLONtSPIIOWABI[ iM[a�CON5tAL1UIL aNrR,cr Ma�cnuL'.;u::s - — <br /> —�("' 'l 49�p° �. PWM�ING _ . <br /> �L_� `I��A� "I-1 <br /> SiZEOF9LDG N�OFSTORiES BASEMENT MECHANICAL <br /> � � S o <br /> pCCUPnNCvlOrl� FIRESPR':✓lEa5iiE0D HEIGHiLiMit�tioN AD�ITIONALPLANCHECK <br /> �/ Q �J'J Z� SPRINKLER ' <br /> —T_- <br /> R[ASON ORSPPMKLERS ! <br /> STATE BUII DING SURGHARG[ �J L� <br /> iHrn�c ov rini�snr�noveoev CITY OF EVERETT vu�uc�vot�rs •— <br /> J�` LOCALSALES <br /> G.�26`%' TAX CODE IS 3105 TOTAL �� j $Z <br />