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��� <br /> APPLICATIOh f�O�; CONSTRUCTI(..� PERMIT �� <br /> TO BE COMPLETEG IN BLACK INK—PLEASE PRINT �h� <br /> I HE.4TING SYSTEM1I: J GAS '�.]ELECTRIC __i L(' �-�- ' � � <br /> BUILDING DEPARTP,IENT ' -- -- - <br /> 259-6870 <br /> ���'j DEMOLITION COMBINATIQN_ �BUILDING MECHANICAL PLUMBIA� SIGN <br /> y p1Y.fR �.1MLA�OFLSS Gi1V ZIP V9�ONE <br /> �o m (�I`(�T `I F r�E�l] UIEiA� - E�C�C-i7 RYIv� 2St7-545 3 <br /> �y�j �[NANi �AAiLADDRE55 Cliv I�P 44�oNE <br /> r.� �t U 1.�rli� <br /> F] N /�9::��RECTOR�ESIGNER MAILADDRE55 CItV ZIP PMONE <br /> k y� ���., <br /> �H � id.ni.nALCCNiRACiOR MAILPDOR:SS QiY 2iP FHONE S1AiElICENS[• <br /> V1 H ��� <br /> x �iic'�mN:CnLCO9Ni�f1PL10R MFiIA�OFE55 CIIY 2iP PHONE SiRiEIiCENSE• �r� <br /> Q Fi ��y PLV!'.fI:N(:CON1iR C C'� MAILADDRESS CIIY �IP CI�CN[ STATEUCENS[• r � <br /> � t��l O (aAil`I[�-- " <br /> ��� n G1A550V\VORK <br /> FI C <br /> �j y� �NEW AD01710N ALTERATION REPAIR DEMOLITION \VOODSTOVE�FRPL INSERT BUILDING RELOCATION <br /> �.�y S'Jt. �L y /6 ' �L CONiACiP[[SONANDTPHO�NE�N�O" � <br /> �J Hy CON�IIACiPR�CEOFWORI( � /j .7/� r 'I�]�yyuEl� ����3 <br /> Ov,H �fSCRil�EIVOPK�ND500AFEPOOtnGEM\O6'E� � <br /> o�t7" w _C.�2/+G(_ 2 24 �-��-+�-�P <br /> �•�r�+tl aw;:•oscous[oFouaoc�, I HEFiEBV CEfiTIFV THAT I HAVE READ AND E%AMWED THIS <br /> �M� 7 .GL S F'� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> 2 H VJ la'�r'f{�� h'/� `/.�' <br /> y �y �eani.oescamprior+oFvnoaea*viSNownnE�owounitacnrouncoaicsi PROVISIONSOPLAWSANDORDINANCESGOVEFNINGTHISIYPEOF <br /> �r D �(� �RI'E 1'I�JGfrS /,��'I� WORK WILL BE C01dPLEiED WITH WHETIiER SPEGFIED HEREIN OR <br /> ior eioce oc � t�h� NOT. THE GRANTRJG OF A PERIdIT DOGS NOT PRESUME TO GNE <br /> AUTHORITY TO VIOLATE OR GANCEL THF. PROVISIONS OF ANV <br /> (J�- ���� OTHEn S7ATE OR LOCAL LAW REGIJLATING CONSTRUCTION OR THE <br /> PERFJRh1A1JCE OF CONSTRUCTION.THAT I AM AUTHORIZED�V THE <br /> OWNER OF THIS PROPERTV TO PERFORId THE WOFK FOP IVHI(;H <br /> — APPLICATION IS MADE AND I C01dPLV WITH THE STATE � <br /> CONTRACTORS LAW 78 27 RCW AND 296200 WAC � <br /> __ x_�1��i.y, �l6 !L <br /> VPOJECi ADDR—FI55 " ��� <br /> � � I C(1414L� <br /> FLUMBING MECHANICAL <br /> ��� NO. TYPE OF FI%TURE OR ITEM — FEE — NO. TVPE OF EOUIPMENT— — FEE <br /> � WATER CLOSET rTOILET� � AC—A HNDLG UNITS—H.P ' � <br /> �, � BATHTUB FORGEDAIRSVSTEIdS—B.T.U. M E.A. _ <br /> 1 ' LAVATORV IW�SH BASIN) _ UNIT HEATERS—B TU M �_ <br /> �� SHOWER CLOTHESDRYERS <br /> � KITCHEN SINK 8 DISP i � VENTILAI ION FAN <br /> � - --� <br /> DISHWASHEFi FANGE HOOD <br /> LAUNDRVTRAV W�TER HEATEA <br /> CLOTHES WASHFR / WOOD STOVE <br /> i o� URWAL METAL FlREPLACE&CHIMNEY —T— <br /> ORINKING FOUNTTIN � FIREPLACE INSERT , <br /> FLOOR DRAIN HEAT PUIdP / �— <br /> BACKFLOW PREV[NTC.`15 GAS PIPING � <br /> I ' ' ROOF DRAINS-�(��INLEAD_RS E%HAUST FAN <br /> � SINK(SERVICE—BAR,ETC..) � <br /> ' ��1 _. — — T- <br /> , ; <br /> � � SUB TOTAL 5 SU�TOiAL 5 <br /> � PERMIT S —� PERMIT S <br /> �� TOTALFEc S TOTALFEE 5 �— <br /> �� � _ _-- <br /> FOR OFFICE USE ONLY: <br /> �PONTSETpACN RE4RSE10AGK SI�ESEidACN� PLANCHLCKNNAI1�q 114 NICFIPINO , <br /> 2d ' o � S ��: ,r- � �; ;,�: o s- e:�,. z z <br /> usez • ioinn[n vncnrvrsrte FEES VALUATION PEE � <br /> � <br /> - Z. t'c0 � nuuoiNc --- �RZ I.(o ---/-��-'���- <br /> ix�ar eans naownoi[ ttr[or or�s newni o����. �.o��6��!e.,���+�„� -- - - --�- - — <br /> �' J i+--/� _ ���1 X� _ viw.nartac, -- — <br /> si]coro�Dc. HOOFstoi�i[s naSemErvr MECHANICAL <br /> UC UPnNCYIOR� �iRESPFNK�E415N[oD NEiGlnLrtdiiqyON AGDITIONALPLANCHECK <br /> � q NQ ZI ypqINKLEfl I <br /> � <br /> � <br /> — -- - -- — --—-- ----�- <br /> qFASONFORSPPINKLERS —"--- -- <br /> SiAi[BWLf)ItJGSUHCHAHGE i j7J <br /> nnn.c ov v�nr�s nrrr�ov[om CITY OF EVEflETT Puf3i.iC woRK � <br /> --�—__- I <br /> LOCALSALES I <br /> J F3 ��3 TAX COOE IS 3105 TOTA� � / j 3.i <br />