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l'J i9�ii � <br />/� '.0 r`ri <br />G", H <br />9HCn <br />H�� <br />F'i Ci <br />H �1 <br />"�4 H'TJ <br />fn H <br />Hx <br />oHl7 <br />H�g <br />�] Y ��" <br />7y.H3, <br />t" y x <br />h+ H <br />gy <br />C�d� <br />tj1 � C�1 <br />x H cn <br />H O !n <br />19,PPLICA7IQ�. FOR CONSTRUCTI` N PERMI i °°`'"'" <br />m�•r:.,•��.,��•�� TO BE COMPLETED IN INK—PLEASE PRINT � <br />GITY GF <br />eve�ett HEATING SYSTEM 17,a/G�AS J ELECTRIC J__ _—. _-- � <br />BUILDING DEPARTMENT �` <br />259-8810 <br />DEMOLITION COMBINATION �BUILDING MECHANICAL PLUMBING SIGN <br />O'NNER h1AILADDR[SS CRY 1�P PIIOtlE <br />�/cfi�.SI�D O�E'S�o N 3cL� 3`.�'2.�/p PG stu EVER�Tf' 99=0 3 35S -�Sg3 <br />TEHAM l.1AhA00RE55 Ci1V ZIP PHONE <br />SAirl E ,�}5 fl� ✓� <br />FFLHIiEGTORDESiGN[f� IANLApORESS Citv 2iP PHONE <br />DCyVf}CI� E. �0�/,IJSELL �Bj� �cI3 �7✓c , cV�''ai'ET/" 9B.ao/ a5� - //// <br />f,EHERRLCONiRACiOH fAPILAppRE55 / GITV Z�P CHG. � LICENSEa <br />�,C�pii�f. s,i� ' J ,' ? ° '' .1_'_i�.�J <br />�� Ji —� �:' ! 'P�J'� `�d lC✓�= =/. �;?'� �7 i �i% � �_-��l�n i' . <br />..�..�.....,... �...�.e.�..,o unii ennAF�c CIiY ZIP PHONE LICENSE P <br />Pl111A0R1G CONTPNCtOR <br />C1A550F WORH� � <br />NEW X ADC <br />raice oF <br />aooaess <br />ALTERATION <br />S <br />GRY <br />REPAIR DEIdOLIT10N <br />_ � 12 � �o�,. j: <br />� � <br />asF��3 ' <br />PRG G`Lrl15EGFpWLpINIi - "" ' - -' - " <br />�.FS/l.��tJc� <br />� ecni oesegairnor+oF racrearv �,s�+o��•n+ ee�.c:v on nnnc�� roun eavies�, <br />�or J o�a�K _ S or .��� <br />PHONE <br />s <br />WGODSTOV6FRPL It.SERT _ . BUILDID.3 RELOCATION <br />P'ID PNONE NO <br />a,�:�, , 3v�-��'�9� <br />I HEREBv CC(7TiFV THAT I HAVE READ AND EXP.MINED THIS <br />APPLIC4TION AND KNOW THE SNfdE TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDIN�NCE$ GOVERNI�G I HIS T(f E OF <br />WORK WILL BE C01dPLETED VlITH WHETHER SPEGFIEO HEREIN OR <br />NOT. THE GRANTING OF A PERMIT �OES NOT PHESUME TO GIVE <br />AUTHORITY TO VIOLATE O'1 CANCEL THE PROVIS�JNS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORIdANCE OF CONSTRUCTION. THAT I AM AUTHORRED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COtdPIY WITH THE STATE <br />CONTRACTORS LAW 1827 FCW AND 296200 WAC. <br />5'G'lAiu4GOfCOUTRACiOROB/.UIMORREOAGENi DAiE <br />-�?!1.'�. $.'��tLP��-�1_� ��� �3 —I X �,�-a'��'w i �����s �.t , <br />PROJ[LiAO�P[55 �-- - <br />a�'PL'�CA4TS Clir 9u5! :FSS UGEt15E Np ANp �OSINE55 NAI.!E <br />NO. TYPE OF FIXTURE OR I" <br />/ NlATER CLOSET (TOILET� <br />BATHTUB <br />_L LAVATORV(WASH B�SIN� <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />GLOTHES WASHCH <br />UFiINAL <br />DRI�lKING FOUNTAIN <br />FLOOR DRAIN <br />BAGKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK ISERVICE—BAR, ETC.) <br />SU�TOTAL S <br />PERh11T 5 <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FRONTSEiO�CN� HFnq5E1HnCH <br />z5 _�-2s �- <br />US[ZONF 101AB[/. <br />�2-S Z��v <br />iVPEOf C�IlIG AlIU:1FALF IVP[ 01 COqSi AGIUAI <br />�L-,.� �-�✓ <br />SIZ[ OF E3LDG NO O� Si0lUES <br />64o sF ( <br />OCCUPANCV IOnD FIqE SPRIIKtEfiS RE <br />a/��I {�k� <br />NEASOt11�OR SPHiNKlEPS <br />INIANF.flY PL4NS�PPROV[�oY <br />�d 3�,6 <br />TYPE OF EOU�PMENT <br />A:C—A:HNDLG UNITS—H.P. <br />FORCED AIR SYSTcMS—B.T.U. M E.A. <br />UNITHEAiERS—B.TL�. M <br />CIOTHES DRYERS <br />VENTIL�TION FAN <br />RANGEHOOD <br />WATER HFATER <br />WOOD S10VE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE WSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTfAN <br />SI�LSF.IDACY�---"� �����C -GHI �dEiER <br />7S / L �= <br />vnci,ut srtc / FEES <br />N� <br />BUILDiNG <br />�.o..aur., r,no�exw.�.�.u•i��s - —___ <br />�_� PLUMBING <br />F�ASGfdE��i 67ECHANICAL <br />y�s �J[c�; . G,ti--� �K=o' <br />N[if,fR lrtdlinil�t� "��ITIONAL PLAN GHECH <br />(_D __ OTHEfi <br />STATE �UILDING SURCHARGE <br />CITY OF EVERETT runuc wonKs <br />LOCAL SALES — <br />TAX CODEIS 3105 rora� <br />�,� <br />SUB T0 <br />PERPd1T <br />TOTALF <br />5 i S �e J <br />S <br />S /.� ' O <br />R[CLIi'f NO <br />4�sC�� <br />FEE <br />��� <br />— �G �:LlQ <br />- � 1 �1 �r� <br />�c r <br />5�1, � ( _ _ <br />