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� <br /> �PPLICATIO.J FOR CONSTRIJC7'..yid P,ERMi'� �� <br /> ��C� �� TO BE COMPLETED IN BLACK INK—PLEASE PRINT ;.�Ti � <br /> �\ SEP 1 ;; �., y _ <br /> HEATING SYSTEM: iJ GAS I.J EIECTRIC ❑ �+�rv �r":: ",� <br /> BUILDING DEPARTMENT o " <br /> 259-8810 Public Vdorl;s D.pt,r <br /> DEMOLITION COMBINATION BUILDING MECHANICAL �'�LUMBWG SIGN �3= <br /> U:R:eR IAAILAOORE55 QiY ZiP PHONE � <br /> Onu.�/ /-�o,nES,Sac. 3Yd0 6tsYusee A� e �aoo �-rrce 9giod. 32g• 3�70 � <br /> ieIL1NT MFILADDFE55 CITV ,IP PHONE � <br /> � <br /> niiCryiECTOROESIGNER IdAILA�ORE56 CITv TIP PHONE � <br /> .�C^LRnLGONTRACTOR M41lA��RE55 CITY 21P PMONE STFTELICENSEa � <br /> !'CQi4NICALCONiRACTOP MAILA�ORESS CIiY ZIP PHONE STATELICENSEb j <br /> y <br /> i'LUr!3INGCONiRACTOR MAILADDRE55 CITY ZIP PMONE STFTELICENSEa . <br /> Qnc.iF�C., a� F�uMe,✓6 , �k. P.o. C?,����.�4 [�o.�rvtatE 940X8 N8; ,zcaS P�,��,a,r�vc�, � <br /> CLASS OF WORK � <br /> ✓NEW � ADDITION ' . ALTERATION . REPAIR � DEMOLI i ION . WOODSTOVEiFRPL INSERT BUILDING RELOCA�� � - <br /> — t <br /> CONTACT PERSOK qND PMONE NO. } <br /> CCNiH�CT PfiICE OF WORK � <br /> D[SCFiIBE WORK AND SOUARE FOOTAGE INVOLVED - <br /> : <br /> PROPOSEOUSECFOUILOING I HEREBY CERTIFY THAT I HAVE READ ANC EXAMINED �i'� � `� <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC i � <br /> lCr.'d.DESCPI�TIONOFPROPERTY�SHOWNBELOWORATTACHFOORCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVEPNINGTHISTY�i- I <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HER[i:'- � B] <br /> icr e�ocK oF NOT. THE GRANTING OF A P=RMIT DOES NOT PRESUME TO t;l�.�,. �' <br /> AUTHORITY TO VIOLATE OR CANCEL THE PfiOVISIONS OF :,P:�� <br /> OTHEF STATE OH LOCAL lAW REGULATING CONSTAUCTION OR I���1_ <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BV Tl�F � <br /> OWN[F OF THIS PROPERTV TO PERFORM THE WORK FOR !V!�I�.;!�. <br /> -- APPLICATION IS MADE AND I COMPU' ':.'llll TI-IE SL\l[ <br /> CONiRACTORS LAW 18.27 RCW AND 296.200�VAC. <br /> — X �F7.�.(/ �(__�` - _ _ —__ <br /> ����c�eornooness sm� ine ., , <br /> sr o _s��a_ <br /> $09 ��� �GA�E C—�IERET'T �.DY� SiFI'oZ3 cirvei�s��;;ssi.�r,rr.,cr�o —_ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMEhT FEF. <br /> 3 WATER CLOSET(TOILET) A'C—AiHNDLG UNITS—H.P. <br /> � BATHTUB FOrICED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) 3Si UNIT HEATERS—B.T.U. M <br /> / SHOWER CLOTHESDRYERS <br /> / KITCHEN SINK 8 DISP i VENTILATION�AN <br /> / DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY ; WATERHEATEfl � <br /> / CLOTHES WASHER WOODSTOVE i <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLAr,E INSERT <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLON!PREVENTERS GAS PIPING � <br /> ROOF DRAINS—RA W LEADERS EXHAUST FAN ' I <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � <br /> SUB TOTAL S 9g ; SUB TOTAL $ <br /> PERMIT 5 ,p� PER�AIT S <br /> TOTAL FEE $ TOTAL FEE $ �I <br /> FOR OFFICE USE ONLY: � <br /> � FRONTSETBACN REAFSET�ACK SIOESETBACH PL�NCHECKNUMBEfl FEE RECEIPTNO � <br /> � 5 <br /> usezorve LOTAREA V�CANTSITE FEES VALUATION FEE <br /> BUILDING � <br /> tYPEOFWNiS.AtLOWABIE iYPEOFGONSiAG�OAL atuPautY nooFotvFLLrt.Gm;tS — <br /> cnauv pLUMBING <br /> 5¢EOFBIDG. NO.OFSTORIES BASEMENT MECHANICAL <br /> OCCOPANCVLOAD FIRESPRNKLEPSiiEOU MEIGHTLIMITATION ADDITiUNALPLANCHECK i <br /> SPRINKLEFl � I <br /> REASONFORSPRINKLERS — � <br /> SiATE BUILDING SUACHARGE <br /> INTqNE BY P�.ANSAPPROVe�BY CITY OF EVERETT PUBLIC WORKS � <br /> LOCAL SALES <br /> TRX COOE IS 3105 Tora� <br /> � <br /> i <br />