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�9 M <br />IV � <br />H <br />pc. M <br />� H y <br />K � n <br />O C O <br />T M �V <br />�] y M <br />d' 2 <br />ro <br />o .+ 5� <br />n :° ?S <br />H <br />t' y <br />N y <br />f+ <br />O N <br />� �y [r9 <br />i O N <br />� _i <br />APPLICR►T10�� FOR CONSTRUCTION PERMIT ''`"`'"'" <br />TO BE COMPLETED IN INK—PLEASE PRINT �Vl/�/E_C . � <br />.: ,..�.. �,�ly.:�—T�"''.�"""n'- ` <br />-�, .. -...,. , . <br />_ �, �- ,.' ." . r. ��. � <br />,ev�erett , . ___ _ . --- - - : ,. _t-� <br />. I HEATING SYSTEM: 'J GAS si"ELECTRIC ❑�_,�� _ <br />BUILDING DEPARTMENT -- <br />259-8810 <br />�D� EMOLITION rc COM8INATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNfR F'AILGDOHfS$ ���� 11P PMDNE <br />Lnw�ENc-Y H �'I I�Y� JLArNE �/✓r}�-G'�i�rq G✓tl�F7T 9 d�"i --ti' �-� 4S� --- <br />if N�NI <br />MAIL ADORE55 CITY 2� ������� <br />�.,.;iu1CC10RDC5F�NER MRILRD�41E55 <br />N��� C�rsl' <br />��NtnnIGONiRAGTOR M�iLRDDPE55 <br />�/���(ln�yr�H�T LI;i H/G�; <br />eic:�innicn�wr�iAacton uniinooREss <br />LITY <br />=�p PHONE IICCNSE � <br />�`�ilA� 11 L � �VSC N�i��%� <br />�ip PIIONL UGENSE • <br />Pi.U1.�0�tlGGON1PAGIUR I.INLAUDRCSS CIIY ZIP PIIONE LICENSE• <br />�nvh /�C�tiri 3Yli I�i=oHr� tvtT"�Tf `J�w� L���_L�iE� <br />cuss or woan <br />NEW - ADDITION ALTERATION YC F7EPAIR DEMOLITION . WOODSTOV6FPPL INSERT � BUILDING RELOCATI <br />CONTRCT PERSON AND PMONE NO <br />o�;cwoe wo�� <br />S 1 ItjC Av <br />I+np, JSEO US[ <br />/� 6'c SIOI <br />ior <br />S <br />�$ �� U/ �e;r�� — <br />iWt�GE �NVO��[� <br />EHo.:tt (7a� <br />DING <br />PROPEBiY�SHOWN <br />o�ocK _ <br />�'��OJE.ri ADDRE55 <br />Z50L wA�/' <br />PLUMBING <br />N , TYPE OF <br />VJA7EF CLOSET <br />BATHTU� <br />LAVATORV�WAS <br />� SHOWER <br />I KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRVTRAV <br />/ CL0T41ES WASH <br />URINAL <br />DRINKING FOU� <br />FLOOH DRAIN <br />OACKFLOW PRE <br />ROOF DRAINS— <br />SINK ISERVICE- <br />FOR OFFICE USE ONLY: <br />FRONTS[TOALN REAHSEipA( <br />USE20NF LOTAREA <br />MROfCONiS.PLLOWAB�[ ttPE01CONSi <br />�iZE� NOAF STOR <br />� SF o <br />OLGUPANLYLOAD FlRESPRNNL <br />u /n ti� <br />1 HEREBY CERTIFV THA1 I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREGT. ALL <br />iawo�nnncHFouaCoaiEs PROVISIONS OF LAWS AND ORDINANCES GGVERNING THIS TVPE OF <br />WORK WILL 8E COMPLETED WiTH WHET�{ER SPECIFIED HERE�N OR <br />ov NOL THE GRANTING OF A PERId1T DOES NOT PRESUME TO GIVE <br />;.UTHORITY TO VIOLAiE OR CANCEL THE PROVISIONS OF ANY <br />OiHER STATE OR LOCAL LAW RLGU! `TING CONSTR; ICTION OR THE <br />PERFORIdANCE OF CONSTRUCTION. TF!AT I AM AUTH.�RIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORtd THE WOR.( FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTqACTORS LAW 1827 RGW AND 29fi200 WAC <br />SI,NAIDPEOFGONiRnCTOROHFUiHORIZEOAGENi MiL /� ��y —�J� <br />X _�� ���/�� �" � Y, 3 3 <br />�� -- <br />APP IGANi50ivPUS�CEN5EN0 PWOBUSINESSNPME <br />FEE <br />T <br />G ' <br />/O � � <br />TOTAL FEE b � yf � <br />N S��E 5[iOACN <br />VPG�NL S�TE <br />ALIORI flLtuvµcv M100lf*M1R�'�NSC..". <br />PLANS APi�iiO� <br />9�` <br />REO'D <br />LIMITAiION <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />FORCED AIR 5`.'STEh1S—B.T.U. M <br />UNIT HEA7ERS—B.T.LL M <br />CLOTHES DRYcPS <br />VENTILATION FAN <br />RANGEHOOD <br />WATEF HEATER <br />WOOD STOVE <br />1.1ETAL FIR[PLAC[ 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXNAUSTFAN <br />SUB TOTAL 5 � G a �— <br />PFRMIT 5 � <br />� TOTAL FEE 5 � �� ' —� <br />a/.P 73 <br />Plnv;HECK1:IlldHER � fCE ����� �EC[IPTNO��^/ <br />l <br />�7cj-S!1 f°%•. � ° <br />fEES VALUATION FEE <br />ouaoiNc $ z7 �iy _ 33C• IS-° <br />PLUMf31NG y S ��Oc <br />MECIIANICAL 6 �� � � �" <br />ADDI710NAL PLAN CHECK 33 � '�/ <br />OTMER <br />-� <br />STATE UUIIDING SURCIIARGE y�� S O <br />PU�LIC WORNS <br />.orn� y'7 `� � �� <br />