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ApPLICATIOrI FOR CONSTRUCT�JN PERMIT �•"`°" <br /> TO E3E COMPLETED IN INK—PLEASE PRINT � ' � <br /> rnr Lrrrg'ern <br /> cirv or . • -- ------—� <br /> eve rett HEATING SYSTEMi �GAS ,ELECTRIC J — -- <br /> BUILDING DEPARTMENT <br /> z59"8g�a pLU.VIBING SIGN <br /> DEkOLITION COMBINATION BUILDING MECHANICAL <br /> ❑LV lIP PNONE <br /> � OIVN[ii MRIIApOR65 � ,y <br /> y . Sf2.7 Scc�...; rw l.:c. F�c..�'�+-51. fJ lc3 �S•-4`uS3 <br /> ���F �Ju_,.e T��vsu;� c. zi�� vHor�e <br /> tcr+nwr unn nooaess <br /> S�I�-Ci� LrtY Pp 1 PMONE / �-ir 1 <br /> APCHIIECiOqOCSiGNEN MAILAOORE55 ,t, \ 1'�il��' � 1CO j� �Ub� � " �- ��C" <br /> C�.ti[.� Ler � pc5lqh. 4>r.s...��."-..�a/ PHONE uceHse. <br /> MAILAD�AE55 �ry Z�P <br /> G[NERAILONTPAGTOR _ <br /> y�� . _ - . . - L�L� <br /> �py Litt 2i� P��ONE tiCENSE• <br /> l•1 C� MECIIANiCAI LONLRPCIOR UAR ApDR[55 <br /> p�H PNONE LICENSE• <br /> �y y ('LUMBING CONiRACiOR MML AD��E55 <br /> CIiY 2�� <br /> �' CLA�SOF WORK �I <br /> �' n '�NEW ADDITION ALTERATION REPAIR DEMOUTION WOODSTOVEIFRPL INSERT BUILDING RELOCATION � <br /> H�A CONi�Li PEPSON AN�PIIONE NO <br /> � H� ? I I <br /> �/1H CONiP�GiPRCEO-WOR / �G �` �G ~1T1� � <br /> � �� ocscnie ion%A/E���PtJ7 rncErtrvo�v�o }- /'72 J' � . . <br /> � .yGr�t-.._ '/ f <br /> ty '0 `° � w ' <br /> i�noros,{ous�oFom�oiHc I HEREBV CERTIPY THAT I HAVE READ AND ExAMINED TH <br /> C1 //� S';�v APPLICA710N AND NNOW THE SAME TO BE 7RUE AND CORNEC7 ALL <br /> O M�h i � <� PROVISIONS OF LAWS AND OR�MANCES GOVERNING THIS NPE OF <br /> G~j�O i.ccn�oesce�ano�+oveeoreerv�s��owHee�owoa,fn�rtacH�ouncovics y,iORK WILL BE COMPLEIED WITH WHETHER SPECIFIED NEREIN OR <br /> � �„� �or � Z� B,«K or 1� ��4 •D � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV 10 VIOLATE OR CANCEL iHE PROVISIONS OF ANV <br /> C" y i S �� OTHER STATE OR LOCAL LAW�FiEGULATING CONSTRUCTION OR THE <br /> ~y l- - �� V� Ci.. �'`' PERFORMANGE OP COIJ3TRUCTION.THAT I AM AUTHORIZED BV THE <br /> g �y OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOfi WHICH <br /> � �� �j ��ro . �G.��C � APPLICATION IS IdADE AND I COMPLY WITH 7NE STATE <br /> CONTRACTORS LAW 1827 RCW AND 29fi.200 WAC. <br /> � yy SiG���*UR[oFCONiPnCWA AIIiHOHIZE�nGENt De1E <br /> y o�n , �J G <br /> s � L� K Q /' /(/ -�r� <br /> —+1- p r � cv �• X ���'�" - <br /> �'�'aE������5� MPLIGAHiS CIi V OU9N[55 UCENSL NO A��D BUS���C.SS Nn6�F <br /> F �e m c-� � (,�.1 cn g �., <br /> PLUMBING MECMANICAL <br /> EE NO. TYPE OF EQUIPMENT FEE <br /> N0. TYPE OF FIXTURE OR ITEM , 0.�C—NHNDLG UNITS—H.P. -. <br /> _� WATER CLOSET(TOILET) �`9 , FORCED AIR S"STEAIS—B.T.U. M E.A. ' ' <br /> � � 7 BATHTUB ' � <br /> I � �;' -- UIJIT HEATERS—B.T.U. M . <br /> �� LAVATORY�WASH BASIN) --T <br /> �� SHOWER CLOTHES DRYERS <br /> � KITGHEN SINK 8 DISP S� �— VENTILATION FAN ,_T-- <br /> ''� � � � RANGE HOOD � <br /> ,� I _� DISHWASHER <br /> — WATER HEATER <br /> LAUNDRYTRAV ' <br /> \YOOD STOVE <br /> CLOTNES WASHER ��__. I <br /> '� �' URINAL <br /> � � PIREPLACE INSERT � <br /> �� DRINKING FOUNTAIN <br /> PLOOR DRAIN HEAT PUMP '�� <br /> — GAS PIPING ' � <br /> � BACKFLOW PREVENTERS ' . <br /> �( I ROOF DRAINS—fiAINLEADERS E%11AU5T FAN � <br /> SINK(SERVICE—BAR.ETQ) � Q;�� � <br /> _ ' J' . <br /> �'� I <br /> SUBTOTAL 5 e� � <br /> � � SUB TOTAL 5 ���__ _ pERM1T 5 � � <br /> !(' — TOTAL FEE 5 TOTAL FEE S � . <br /> FOR OFFICE USE ONLY: nEceiar ra <br /> ' �" rnor+rseience ��cnr�seteacK sioEseiancK aur+cr�ecKHun�oen cee 517. G d' n .S'�'d� <br /> 2a � IUO _5` , �' '"� y s ' � <br /> VALUATI <br /> USE ZONE lOT AREA V�CPNi 9iP FEES � v T <br /> ��� � BUILDING �tl/_O Z'� �� "ry'Y�f—_rb;, <br /> �rri�n ror:is nr.na�aeit ��.i o�coxsi nct�>i «�,�,=ti. x,,aown��ux�,s — uv—�- �� �_ <br /> II '�"'r3 PLUMBING <br /> —���-- �_N <br /> ��C'j(� SF} NO OF�IORi[5 O�SEMENT MEC4IANIC�L � �- " <br /> @}7, if Ca �. ADDITIONALPLANGNEGK * .�� ��-3 <br /> prCUl'ANGVLOAO lIREiPA�+MlERSR[OO HEIGMTLIMITAQi104 ���T � , <br /> .1 I Z V OTH��'�-..� `3O 'r� <br /> �y! <br /> HIASpNfORSPFINNIEHS y � �� <br /> STAT[E3NlUING SURCf��RGE - __ I <br /> - ruq;�rrdow u xr CITY OF EVERETT PUDUG WORKS �p ;o`� <br /> Iq1AMC[IY <br /> LOCALSALES „ i <br /> �� TAX CODE IS 3105 rou� �� -- I <br /> /„'S � . S� <br />