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APPLICATIOK�=UR Cc3NSTI3UC1�1�.�:! PERMIT �'��'«'" <br /> ,,,,�,,,,,,�,�:,, TO BE COMPLETED IN INK—PLEASE PRIN7 � <br /> r,nvo!� <br /> eve rett HEATING SVSTEM GAS J ELEGTRIC J � <br /> BUILDING DEPARTMENT I � --__—__ --- <br /> 259-8810 <br /> DEMOLIfION COMBINATION BUILDING yMi=CHi.NICAL PLUMBING ,�,iGN <br /> � ;rd.R MnitnDOnC55 (m � :n � r��.pVE <br /> � i !! ,'�r'1�)�SFi�I �C' ''i .�� f/iz �1'� �;�':�GG i�J1-/-5 �;:_- <br /> ��`'ytl �/ M�R�DDRESS ciiv� ZiP F��ONE <br /> n�anat[CTORDESiGNEN M��L�DDRE55 CItY ZiP PqpNE <br /> OI:(�ALGOHiR4Gi0R M�ILADDRES$ CITV Zlp PH@JE LICENSE� <br /> VEC1i4NiCpLGONfRAC10R MAiL�0�RE55 CIiY jlP PHONE IIGENSEI <br /> � �� �`-�/,:Ii•-�,�/�"o�iixi 1rK 33� �i'.S�r�'r,�S r-1�(�-:,2 r- �'�-S�i�� �(�l-E,-s/.�?GS��f�._) <br /> ��Wr.�i3MGCOAiRACTON nILAD�RE55 GiV ZIP PNONE �ICENSE• <br /> �y C1A550f WORK �/ <br /> � y y NEW ADDITION y ALTERATION REPAIR DEMOLITION WOODSTOVEiFRPL INSEFT BUILDING RELOCATION <br /> �.�y � �t/� c�n*ncrrensor+nr�ow��r�o <br /> 1'3 �M CONiR4CTPR�LEOFWORK L/� 1 � �� �� <br /> �'y� OLSCRiBEW09rtRND50tIn�EfppTAGEMVOIV[D , -` ^ /, � ,`•„ 7r � �.�J� // � <br /> �' /%.:��� <br /> O �G O �/ �'� •��f- ������' <br /> �a H�a L�� ��� ii�r i�/f��� b�fl ��J <br /> y y M ���oPosEouSc-a/ew�oiNc �— I HERE�V CEPTIFV THAT 1 HAVE READ AND EXAMINED THIS <br /> S 'L'� I (��CC F/" ) (�G� APPLICATION AND KNOW THE SAME TO BE TRUE ANU CORRECL ALL <br /> P10� ie,niocscnianoeoFvaovearr�sHownoE�owoanrucNvouecqoies� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> y WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � ~ ��� a��� �F NOT. THE GRANTING OF A PERh11T DOES NOi PRESUME TO GIVE <br /> � AUTHORITV TO VIOLATE OR CANCEL 7HE PROVISIONS OF ANV <br /> O <br /> 'n`� n lZX ����1� -F������- '�� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> FI <br /> .`L' N PERFORMANCE OF CONSTRl1CTION.THAT I A1.1 AUTHORIZED BV THE <br /> ,�y y OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> p.� y APPLICATION IS MADE AND I COMPLV 1YITH THE STATE <br /> l7 V1 CONTR4CTORS LAW 7827 RCW AND 29G200 WAC. <br /> ��y s:cvntu��[ovcorrtnrctoaaanutHoaizconceHr �aie <br /> � � � r-r+o�ecrnooae�; / /,� I/j �<:=/� �. . �/��/ .� � � <br /> -1 �L � �" _ f , <br /> `�(/p�� ��Z�([.�t:,_' nvnu�iscirvF�us� �sucemsc�nn��onus�nes rnne <br /> PLUMBING MECHANICAL <br /> � N0. TYPE O� XTURE OR ITEM FEE NO. TYPE OF EOUIFMENT FEE <br /> _ 1'JrtER CLOSE7�TOIl6T) _ p�C-A HNDLG UNI75-H.P. <br /> � _ OMHTUB FORCEDAIRSYSTFIdS-B.TU. M E.A. <br /> � LAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M � <br /> SHOWER CLOTHES JFYERS --'— <br /> �� KITCHEH SINK 8 DISP VEVTILATION FAN <br /> DISHWASHEF RANGE HOOD —�— <br /> � LAUNDRVTRAV WATER HEATER <br /> CLCTHES WASHER WOOD STOVE <br /> �i �� URINAL _ 1dE7AL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN HEAT PUMP --T <br /> � '�� _ BACKFLOW PREVENTERS ' � GAS PIPING <br /> . �,� _ ROOF Of1AIN5-RAINLEADERS —r EXHAUST FAN <br /> SINK(SERVICE-BAR.ETC.) — <br /> �� _- - —� <br /> �1� _ <br /> S118 TOTAL 5 SUB TOTAL $ <br /> ��� PERMI7 S PERMIT $ <br /> �. TOTAL FEE 5 TOiAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> �RONTS(iBACK fIGqS[TdACK SiD[ti6i�3pCN CIANpI[f,NNl1AI CR <br /> �C@ R[LEIviNO <br /> � �I/ <br /> usezor+[ iotnaen vacnnrsrtE FEES VALUATION FEE <br /> BUIL�ING � <br /> ivPFO�tONi5�LL0Y.'>BIE tY140fCON51RC711AI acm�vcr xnwbniu�o;di�;s _ <br /> cnouv P�UMBING <br /> SiZEOFBLDG. NO.OFSTORIES BPSEMENI �— <br /> MECHANICAL <br /> OCCUPANCYLO�O FlRESPpNNIERSREO'� NEIGHTLIMITpT10N �1DDITIONALPLANCHECK <br /> REASON FOq SPqIHNLER$ ��i�R <br /> _—��— <br /> 6iATL BUILOING SURGHARGE <br /> u�IDH[f1Y PlANS APPqOVC01lY CITY OF EVERETT PUBLIC WOFKS <br /> LOCAL SALES <br /> TAX CODE IS 3105 Torn� <br />