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APPLICATIC 1 FOR CONSTRUCT �N PERMIT � <br /> TO BE COMPLETED IN DLACK iNK—PLEASE PRINT <br /> i HEATING SYSTEM�GAS J ELECTRIC G <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION X BUILDING MECHANICAL PLUMBING SIGN <br /> owNea nmanooaess crtv zir aHoi+e <br /> DD��?Nsr�,�Dcd �c• P.D �8vx a�s3 c��Rc���A �z.z�-o�i c.�oE) �sa-��c i _ <br /> lEN4NT MPILAD�RESS CRV � DP PHONE <br /> �RCHITECTORDESIGNEP IAAILFODRESS CIiV ZiV PHONE <br /> NG��P�a�=r c�nm- ,��srGN Y9.z� io<<,-a s�rs.�a. i��o�a,Z�,��Bv��p (�-0��S�Y-G3o9 <br /> G"cNERALCONTflACTOR 6�AILF�DRE55 CI1V ZiP PHONE STATELICENS[4 <br /> Qi2Y�nl An��s�2t[�Tt��l1—�• �. /�nx .2l�3.�t-`t�E�CT-,��2�a03 -hlh 3 ('zd6lGs.�-�7��/ Ih��2�r��n1.�7D8 <br /> hl[CHANICALCONTPFCTOR MAILAO�RESS Lltt ZiP P��01:E STAT[LIGENS[• <br /> PLUlA�INGCONTRACTOFi AIAILApDRESS QTV ZiP PHON[ STAtELICENSEa <br /> CLASS OF WORK <br /> X' NEW ADDITION ALTERATION P.EPAIR DEMOLITION lh'�ODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CCNTACI P[RSON ANO PPONE N�. / <br /> CONTfiACiPRICEOFWORK �p �Q�JJ7, �(J �_(���� !�5� — �J [� I <br /> �PSCRIBEIVORKANOSOU��iEFOOTAGEINVOLVEO 'ACII SlDc <br /> bU��7D[�n)�In,�s,= u.b a �k = / vv s�.. i=r� _ <br /> aaovoseousEOFauaoiNc Z73 $Lj.rT• EA ' i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> D�jia'�4�AIlIr)(/SC- 1=��: SA�L= APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> �ecaoescnivcor+oF raoaeatt�SNowNoe�owennrTna�Four+cariesi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIPIED HEREIN OR <br /> wr o�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> dfil[ ��L� AUTHORITY TO VIOLATE OR CANCFL THE PROVISIONS OF ANY <br /> �d�-�_' i i <br /> � �«������� ��� PERFORMANCE OFOCONSTRUGTION.THAT I AM AUTHORIZOED BV THE <br /> OWNER OF THIS PROPERTY TCi PEFFORM THE WORK FOR WHICH <br /> — APPLICATION IS MADE ANU I COMPLV WITH THE STATE <br /> �� CONTRACTORS LAW 1827 p W NJD 296.200 WAC. <br /> � ;��z <� �� X : �V�� �\. ������� G,, � l.�� u. <br /> ,_ � � <br /> PBOJEQ�DD9[55 siGr;mm�F i\ Ue�e � <br /> / J I <br /> F' I � ^ L ' OIVfi�I5WC5SLiCrA5fN0 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EQUIPMENT FEE <br /> ATER CI OCP1 iTOILET) �C—A�HNDLG UNITS—H.P. <br /> B THTUB F CED AIR SYST[MS—B.T.J. M E A. <br /> LA TORY iWASH BASIN) UNI EATERS—B.T.U. M <br /> SHO R CLOTH� DRYERS <br /> KITCHE 'CINK 8 DISP _ i VENiILAT N FAN <br /> DISHWAS ER RANGE HO <br /> LAUNDRV T V WATER HEAT <br /> CLOTH[S WA ER WOOD STOVE <br /> URINAL MFTAL FIREPLACE CHIMNEY <br /> DRINKING FOUNTA FIFiEPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PNEVENTE GAS PIPING _ <br /> ROOF DRAINS—RAINLEAD RS � EXHAUST FAN <br /> SINK ISERVICE—BAR,ETQ) <br /> i <br /> --� <br /> �— <br /> SUB 1DTAL 5 SUB TOTAL 5 <br /> PERMIT 5 � PERMIT S <br /> TOTALFEE 5 TOTALFEE $ �— <br /> FGR OFFICE USE ONLY: <br /> FRONTSEiUACK REARSET��CH SIDESEiBACK ' PL4NCNECKNUMf3E(i FEE�� � RECEIi'T`N'0. <br /> 2 � /U� ` s � � S <br /> use:oN-r:i ioranen vacaNtAsre FEES VALUATION FEE <br /> �- J �� 6Q7 /l (3UILOING IL�i��,J� �✓`f� <br /> iSVLOfCONI5ALl01Y0.B1E IYPCOfG. 'SI.AL1UAl OCGu�nM1cr NOO�Dw¢uecu'�as <br /> `'�p° PWMBING � <br /> �'- �al f-3 2 — : <br /> - , <br /> SiZ[OF BLOG NO OF STORiES OASEM[Ni MECHANICAL T^ <br /> Z5� SF 'r 2 U <br /> s �u�a ' <br /> OCCUPANCYIOAD FIRESPRNNLERSREO'D HEIGNiU1.11iAT�ON 4DDIiiONALPLANCHECK T <br /> 35� -��N�R- , l 20 — <br /> i+[nsovr asrniNniEas — — /'/ ; ,._,� <br /> STATE DUILDING SURCHARGE � <br /> iwmneav rini�snrrHov[nov <br /> CITY OF EVERETT PUBLIC WOflKS � >' ' <br /> LOCAL SALES ���- <br /> �a 3�3 5'3 TAX COOE IS 3105 TOTAL �`%� - )�) <br />