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D � x <br />�Ht~n <br />'��z <br />�N41 <br />V7 M <br />��� <br />OM <br />��g <br />�Y �] <br />Cy� <br />HH <br />gy <br />H <br />�� � <br />�t� � <br />Oy <br />w <br />� <br />1 <br />' �� <br />�1 � <br />APPLICATIC 1 FOR CONSTRUCT� 1N PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � T <br />BUILDING DEPARTMENT <br />259-8870 <br />' JEMOLITION COh9BINATION BUILDING xMECHANICAL PWMBING ! SIGN <br />owr�eR �-iaanooness <br />cnr nr r,rout <br />�al��i�4h TIFI- I�L� WA�uur cv�eerf �X Z-S°� 34-os� <br />ilN4Ni MRILApDRE55 Cltt ZiP PNJNE <br />A��C��.i1CCTORUE9Gti[q MAILA�ORE55 <br />CITV <br />PNONE <br />6N�CFAICONiHAG10H IAAILADDRE55 C�tV ZIP PMONE SiATELIGENSE• <br />�u�nA <nas5f� iuc �il2K�l,h W cAilvNds k020 ��S-o<t�)S GUeoPrS �o�ra. <br />L^.C��RI�6:AlGONLRAGiOH MAILR�ORESS QiY ZiP PHO4E S1AiEL�CENSE� � <br />�ILcinNGGONTqRCTOfl MAILADORE55 CIiY 21P PHONE STATEI�LENSE• <br />7 � I <br />C.GRiiACT PPiLE OF WORN <br />� �38D <br />OESCRIBE 4VOi�H RNp SOUARE FOOLAGE INVO � <br />rNST,d�-F%r�N vFc <br />1)UcTUORa � WATrHv4 <br />PROPOSED USE OF B111101NG <br />L[GAL DESCf1iPTtON OF PROPERiY �SNOWN DELO� <br />LOT HLOCN OF <br />�� <br />AiiACl1 TYOCOPI[5� <br />PNRLELiAXID NUN.BER <br />CONsinu: uurv �On0lEN0ER. ADOf1E5S. tELEP110NE NOMBE R <br />PROJE�i��PJ�SG`.�� 1 %/2CLCJ <br />/ �� L <br />PLUMBING <br />NO. TYPE OF FIXTUHE OR ITEM <br />WA7ER CLOSET ITOILETI <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASH <br />URINAL <br />DHINKING FOU� <br />FLOOR DRAIN <br />FOR OFFICE USE ONLY: <br />VROIT SETO�GN �ERR 5[iBACK <br />11;[ ZONE <br />hsl Of LONSf. <br />S V l OF BLDG <br />GCGUPANGYL <br />nCA50N <br />INIAKE OY <br />SU8 TOTAI. S <br />PERMIT 5 <br />TOTAL FEE S <br />� SIDL 5[iPACK <br />IOiAREA <br />NO OG SiORIES <br />FiRE SPl11NKLERS PEOD <br />fIRE ALRlVM RE00 <br />RANSPPPROYLDB•� <br />oniE <br />CONTAf,T PFRSUN AN� vNONE NO <br />i HEREBY CERTIFY TNAT I HAVE READ AND E%AMWED THIS <br />FPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS Of- l.AWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK N'ILL BE COMPLETED WITIi WHETHER SPECIFIE� HER[IN OR <br />NOT. THE GRANTING OF A PERMIT DOES NO7 PRESUME 70 GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER S7ATE OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTFUCTION. TNAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PFiOPERTY TO PERFORM THE WORK FOFi WHICIi <br />APPLtCATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC ORSLAN'1827�96200 WAC. <br />x ,, _!1i • Z `j ' I 3 <br />wn <br />o�.eos���s::��- .. .. - <br />NO. TYPE OF EOUIPMENT <br />A C—A�HNDLG UNITS—H.P. <br />PORCED AIR SVSTEMS—B.T.U. M EA. <br />UNIT HEATERS—E.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />FIREPLACE <br />H[ATPUMP <br />GAS PIPING <br />E%HAUST F/ <br />SUB TO <br />PEFiMIT <br />TOTALF <br />PL4NCNEGNtltIMOER � LEE I �FCEIPL40 <br />\'PCANLSIi[ YtW <br />' �. VES � � NO sui�ou�c <br />ec[unm> � ; a.v:u wvrs -- <br />r,Od" pWId�ING <br />BASEMENi MEGHANICAL <br />C YES NO <br />NEiGHiuMrtanoN ADDIiIONAIPLANCHECK <br />OiHER <br />51ATE 9UILOING SUPCHARGE <br />CITY OF EVERETT ruouc wor�Ks <br />LOCALSALES <br />TAX COOE IS 3105 TOTAL <br />