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�- <br />; <br />` . APPLICATI�'7 FOR CONSTRUC��JN PERMIT ,�'�� <br />� TO BE COMPLETED IN BLACK INK—PLEASE PRINT �r <br />LHEA�ING SYSTEM: J GAS �}I ELECTRIC J � <br />�p7� <br />p�x <br />>Hv� <br />H�� <br />FC [� <br />H Sv <br />� �"1 � <br />U1 Hrr <br />[s1 O � <br />ON <br />H�g <br />y� v (y <br />t" y � <br />r+ y <br />gy <br />Cdy <br />[�1 � L*1 <br />HOfyi� <br />BUILDING DEPdRTMENT <br />259-6810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />'-T• ONRJER IAARAODRE55 CI1V LP PI�OFE <br />i: G��,.�„M r. �,J��ss g�t7 �iTMalLE ��'v�arT S82.o1 252 9641 <br />�. T[NANT MAILpDDRE55 C11V ?:� PNONE <br />AHCNrtELTOHDESGNER MA'LADDRE55 Giiv ZiP �'�����E <br />GCNERAL LONiPAGtOR M�It PppRE55 CITV ZIP FMONE STATE LICENSE • <br />W000Y s cun)7n++cn�Ya <br />15s21. ISLn� A+c NE A(��uc7-eN g8xz3 �72-7ta3 ���Y�z13m� <br />MECIIAFICALCCYTRACIOR Id41LApDRESS C�TY ZIP �'��ONE SiRTELICEI6E+ <br />ClUA181NGCONiRAGtpR MPI�ADORE55 CI1V lIP PHONE STniEUC[16[• <br />NEW ADDITION ALTERATION x REPAIR <br />�ONiRRGTPliIJEOF140RN � 7 Lu � <br />DESCRIOE WORN hN� SOUASE FOO AG[ IkVOLVEO <br />�fp„„�f Ho�s�cFGAriAcc 325au�r s m rt <br />PROPOSEO USE OP BUIl01NG <br />sr-�- <br />LEGAI DESCRIPiION OF PROPERLV ISMO\VN �[LO\V OH RTiAGI fOUR COPIE51 <br />�o. 23'f2 e�ocK 16'7 oF SviA�wi+�-S yrN <br />SHOWER <br />DISP <br />TOTAL <br />r11T <br />�L FEE <br />FOR OFFICE USE ONLY: <br />� FPONTSEIBACN REARSCTpACN <br />❑5[ 20HE LOT ARPA <br />�.�T04GONiS�LLO'N�fiIE tVPEOlLONSIFGN0. <br />S4E OG BLD6. NO OF SiORIES <br />OCCUFRNCVIO�D ��RESPRNKL[RSR[00 <br />Pur�s nrrnu�co nr <br />FEE <br />DEMOLITION WOODSTOVErFRPL INSERT BUILDING RELOCATION <br />GONLACT PERSON AND PIIONE HO <br />�e-4N K. �%r IsS 3S6•�2j2 DY �S3-81'�'17 tr.vc <br />I HFREGI' CER7IPV THAT I HAVE READ AND EXA1dIIJED THIS <br />APPLICATION AND KNOW THE SAM11E TG BE TRUE AND CORRECT ALL <br />PfiOVI510NS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WItH WHETHER SPEGFIED HEREIN OR <br />NOT. TI1E GRANTING OF A PERMIT DOES NOT PR�SUME TO GIVE <br />�UTHORITY TO VIOLl+TE OF7 GANCFL THE PROVISIONS OF ANY <br />OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFOR1dANCE OF CONS7PUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF Tl115 PROPERTY TO PERFORM THE WORK FOR WNICH <br />APPUCATION IS h1ADE AND I CO�dPLV WITH THE SiA7E <br />CONTRACTORSLAW1827RCW AND2962�OWAC. <br />✓_ / _-"��• ln�l''i�9�- <br />TVPE OF EQUIPMENT <br />A�C—A HNDLG UNITS—H.P. <br />FORCEDAIRSVSTEMS—BS.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTH[S DRVERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLA 8 GHIPANEV <br />FIREP! ACE I ERT <br />HEAT PU <br />GAS P ING <br />E Al1ST FAN <br />TOTAL S <br />�11T 5 <br />1L FEE 5 <br />�ESEI3ACK NUNLMtCnNW Htn <br />� y'L� <br />:�NTS�iE FEES <br />BNLDING <br />uv�Ma wmexi�.u.nv:. — _ <br />"Wv PWMOING <br />SEMENT MECNANICAI <br />iGNt uMilAlION ADDITIONAL PLAN CHECN <br />SPBINNIER <br />STATE BUILOING SURCNARGE <br />CITY OF EVEHETT runuc wonKs <br />LOCALSALES <br />S� <br />TA% COQE IS 3105 TOTAL 6 7', S O I <br />: :k I <br />