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��y� <br />�O `.0 x <br />> H fn <br />1 <br />H � 3'. <br />1� ~ (i <br />H x1 <br />oxo <br />"i1 H 'il <br />HyC <br />�z <br />Ht7 <br />OH <br />��g <br />L�. Oq <br />9Htj1 <br />Y <br />t HH <br />gy <br />n d � <br />� � � <br />HOtNi� <br />�� <br />� <br />�'�_ <br />� �� <br />1� <br />APPLICATIO... �OR CONS3RUCT1.►N PERMIT �'`�'"'" <br />TO BE COMPLETED IN IIJK—NLEASE PRINT � <br />. �� Lca�9rn n <br />GITY OF <br />everett <br />BUILDING DEPARTMENT <br />255-8810 <br />HEATING SY;iTEM: j1 GAS ❑ ELECTRIC '..I <br />DE OLITION COMBINATION BUILDING >CMECHANICAL PLUMBING SIGN <br />�` �� MRitnDOa[55 _ Crtv 1:P PUONE <br />i � ��`���(�1����_��(,j l. <br />., c � I tii� �� L���.� I- ��� � <br />TENANt MRILAD�RE55 QiV ZIP PHONE <br />•RCHrtEGTOR0E5iGNER MAILADORE55 CitY ZiP PHONE <br />GENER�LCONTNACTOR M�IIRDORE55 GIT' 21P PNONE LiChNSE� <br />�f[CMnNiG�LGONTFACTOF MAIL�DDRE55 CiTV 2iP VHONE IiCENSE� <br />% ' - I�C_ <br />PLUM�MGCONTR�GTOR MMLnpDRE55 �iT�' ZiP PHONE UGENSE� <br />NEW �,.� ADDITION X ALTERATION �. � REPAIR <br />/ CONT AGT P� OF WORN <br />OESCRIBE WORK �ND SOU4PE FOOiRG[ IMVOIVED <br />1� <br />J _ i �i <br />LEGAL �ESCRIPiION U' � AOPE <br />LOT BLOCK <br />��2 <br />HITCHEN SINK 8 DISf <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DtiINKING FOUNTAIN <br />SINK <br />FOR OFFICE USE ONLY: <br />fPOM SEIBAGn n[nR: <br />ivPEOiCONiS AIIOW�BIE <br />SREOFBLDG. <br />OCCOPANGYLOAD <br />R[�SONfORSPP:NXLERS <br />vanx�nv - __ .— <br />or <br />ITEM <br />SUB <br />LOLhRE� <br />1VPE Of CONSL RCiOAL <br />NOAF STOPIES <br />FiRE SPRNKLERSRE <br />PLANSAPPROVEDO <br />Si�E SET�nCn <br />DEMOLITION . WOODSTOVE/FRPLINSEFT - BUILDINGRELOCATION <br />LONiACT PERSON AND PNONE NO <br />I HEREBV CERTIFY iHAT I HAVE tiEAO AND EXAMINED THIS <br />APPLICATION AND KNOW TF'E SAME TO BE TqUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS 7YPE �JF <br />WORK WILL BE COMPLETED WITH N'HETHER SPECIFIED HEREIN JF <br />NOT. THE GRANTING OF A PER�d1T DOES NOT PRESUME TO GIVE <br />AUiHORITV TO VIOLATE OR CANCEL THF PROVISIONS OF ANY <br />OTHER STATE OR LOCAL lAW REGULATING CONSTHUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />O\NNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE .4ND I COMPLV WITH ThIE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />SIGNPTUREOFCONiflAGiOflORAOTNORIZEO�GENi OPiE <br />� ��'�� ��, G�,L ��. ���� <br />AFPLICANiSCILVBUSM[SSIICCM1�ENO ANDBUSMESSNAM� � <br />NO. TYPE OF EOUIPMENT <br />NC—A'HNDLG UNITS—H.P. <br />I FORCED AIR SYSTEfdS—B.T.U. <br />VENTILA710N <br />RANGEHOC[ <br />WATtFI1EAT <br />WOOD STOVI <br />METAL FIREP <br />FIR@PLACE II <br />HEAT PUA1P <br />GAS PIPING <br />8 <br />OUILUING <br />ouuwxn xowo+muxcuens <br />caav p�UMBING <br />B�SEMENT MECHPNIGAL <br />HE�GMiIiMrtAnON ADDITIONALPLANCNECK <br />_ OiHEfi <br />STATE BUILDING SUFLHARGE <br />CITY OF EVEHETT PUBUC WORNS <br />LOCRLSALES <br />TAX COOE IS 3105 TOTAL <br />SUBTOTAL S `�'Q',' <br />PERMIT S ' � <br />TOTALFEE S J`�� <br />GEE FECEIPiNO. <br />VALUATION FEE <br />� <br />.�� �., <br />s– _., <br />