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APPLlCATIOI FOR CONSTRUCTI` N PERMIT �'`�''°" <br /> „F.,:.,,,,, TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cirv or <br /> everett HEATING SYSTEM: U GAS ❑ELECTRIC J _ --- <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING ,�MECHANICAL PLUMBING SIGN <br /> 01VNlR MAllAOD�[SS UTY ]IP �MONE <br /> �cNr�¢n �crso,✓ K�//� 6 K�?✓IEv� � Evr 9�203 3S�-DB��/� <br /> �E��qry{ MPILADDRESS CIfV ZIP PNONE <br /> ARClIITECTORpE51GNEN MRIIADDRE55 Ci1v I�P �NON[ <br /> cR�ERnLCONLRPC)OR MAaP�DFE55 CiIV 21P PHONE LiCENSE• <br /> /t/p/ G✓Nf�'r /�iirc� 3�l� Hrcc r: �vr �/C2o r 2S9-S33! �eIN v�f /o32*Z <br /> y �.�y� IdECHANI�ALCONLRPLiOP MAILRDORE55 CIiY 2iP PIIONE LCENSC <br /> C� �� <br /> s[�, y CRY 2iP P��ONE IiCENS[� <br /> A rY x PWMBINGCONiRnLTOR M�It�0�RE55 <br /> C.' M <br /> 9 H(/� <br /> N � CLn550i WORN <br /> y N NEW `�'1DITION AL?ERATION . REPAI(i D[MOLITION VdOODSTOVE�PRPL INSERT BUILDING REIOCATION <br /> CONtALi FERSON PND PIIONE NO <br /> y� N � CO L ACTI'RCEOFWORM�/ S �v�' - <br /> fA H ULSCRIpE WORN AN�SOUI.R[�OOIFGE INVOLVEO <br /> �x� SN517r�L ��YS .i'c'v7LC ' �✓'NL"� — <br /> O � vnoaoseous�oFo�i�ort+c I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINFD THIS <br /> �N . �` APPLICATION AND KNOW THE SAME TO BE TRUE AND CCRRECT.ALL <br /> H �g ieon�oescaianoHovcaocFA*vismwnee�owoanrucHrovacovies PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE Of <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �"�` n ior eiocK oF NOT. T11E G(iANTING OF A PERMIT DUES NOT PRESUME TO GIVE <br /> AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> A H x OTHER STATE OR LOCAI LAW REGULATING CONSTHUGTION OR THE <br /> C �„� y PEHfORMANCE OF CONSTRUCTION,THAT I AM AUTHORIZED BY THE <br /> �y y OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> O M APPLICATION IS MADE AND I COMPLV WITFi THE STATE <br /> ��� CONTRACTORS LAW tB.27 RCW AND 295200 WAC. <br /> � SGNAiUR[OF CONiqACLOR OR AUiMORIZED AG V!1 0/?II <br /> � v�,, X Z <br /> � — --- � - -� <br /> rnaeer�ooaess <br /> ���0 � �✓,EK ,� / qPPUC4 'G1V p5M65lI�fNS�.�G >NDOUS',NCStiqpMC <br /> W <br /> PLUMB�NG MECHANICAL <br /> i <br /> � NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT E <br /> � WATERCLOSET�TOILETi _ _ AC—AHNDLGUNITS—H.P. <br /> C� BATHTUB _ � FORCEDAIRS`'STE�1S—BTU M EA. <br /> LAVATORV(WASH BASIN� UNIi HEAiERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> _ r <br /> ,_� DISHWASHER R4N�EHOOD <br /> I ` LAUNDRV TRAV � WA7ER HEATER <br /> CLOTHES WASHER WOOD S20VE <br /> URINAL METAL FIfiEPLACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> I �1�' FLOOR DRAIN HEAT PUMP <br /> BACKFLOWPFEVENTERS Z GASPIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> ,� _ SINK ISERVICE—�AA.ETC.) _ <br /> � - <br /> 7_ � <br /> �' I SUB TOTAL S SUB TOTAL 5 �/n ; <br /> PERMIT 5 PERMIT S --��� <br /> TOTALFEE $ TO7ALFEE 5 � <br /> FOR Of FICE USE ONLY: <br /> �RO4TSEIBACN PFARSETflALN SIDESETOAGN PLANCHECNNUMB[R fE[ �ECEIPi110 <br /> useiorve �ornnEn vecnNrstte FEES �ALUATION FEE <br /> 6111LDING <br /> IYPFOiLOHfSRlOWABtF tYPEOfGONSf.AL10Al OCwN� xomCnuotcuh^s -- <br /> LPOp° PLUMDING <br /> SREOFBLDG NOOFStORIES BASEMENT MECIIANICAL �S' <br /> OCCUMNGV LOND RRE SPPNNLEPS REO'D NEN'iNi UMITATION ADDITIONAL PLAN CHECK <br /> OTMER <br /> — — —� <br /> PERSON fOR SPPINMlERS <br /> STATE 9UIL�IN6 SUFiGHARGG <br /> INiPKE�Y GLANS APPROVEfI llv CITY OF EVERETT PUBLIC WORH$ <br /> LOCALSALES <br /> TAX COUE IS 3105 rorn� S� ; - <br />