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m�x <br />9 H fA <br />y �H <br />fC f] <br />H xl <br />'��7 N'31 <br />V1 H <br />H <br />�� <br />H C7 <br />�ng <br />�1] V �% <br />� H� <br />i-+ H <br />g �' H <br />n �� <br />� � Cs1 <br />zym <br />�0� <br />APPLICATION �OR CONSTRU�Tr J�N PEEiM1Y `'�<«��' <br />n�� n-erg�ee� TO BE COMPLETED IN INK—PLEASE PRINT � <br />cnvoF <br />everett HEATINGSYSTEM: UGAS �fELECTRIC U___—_--� <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION �C BUILDING MECHANICAL %�PLUMBING SIGN <br />OWNEP l.IAILADDRE55 CITY ZIP PHOtJE <br />! <br />WILL /�� ��('o.ViKa�e 7Z7 �].3R�.STS4J tue.-�tf 9�L�3 353-zoi.3 <br />TENANT MAiL 4D�RE55 CiTY ZIP PHONE <br />L�ARAOORE55 CrtV ZIP PIIO��E <br />G[NERALLONTRN.;TOfi MNIADDRE55 CITV Zla PHOtlE LiCENSEe <br />=UE't2�+i i �1�� DERs !NC S60L �VfRGRECNWFy £VE2E? �4zoT jSJ-7/L/ �(/-2�?-�Q+r30/ P/}. <br />AIeCNANIC�ICONiRAGiO�V �•����/�DPE55 CITY l�P PMON[ UCENSEa <br />SS OF WORY. <br />NEW X ADDITION <br />OESCRI�E �90PK �ND SOU��F. FOOTAGE i <br />ADo V7 Z 7q L/ �/�-' o T <br />PROPOSED USE OF 9WLOIHG <br />a�g. /J6�w-a e <br />ALTERATION <br />�qy Tip PHONE LIGENSE• <br />REPAIR � GEMOLITION WOODSTOVEiFRPL I�JSERT BUILDING REIOCATiON <br />CONtACiPER50r1ANDPHONEl:O <br />��GF ,�D-vEs 35-3-7/G / <br />e 4.= r cicfi w- ,> r <br />ICGAL DESCRi�ti0�10� pROPERTV 4���W�� �«�%'•YO/a n�iIACN GOU�+CG-:CS" <br />�or�_O�ocH o0� oF COR.[�!-/C�� � <br />io�Ecrnooaess <br />; � � � �3�� ��. s�J <br />PLUMBING <br />NO. TYPE OF FIXTURE (�R ITEM <br />� WATER CLOSET (TOILET� _ <br />1 BATHTUD <br />LAVA'.ORVIWASFIBASIN) <br />SHOWER <br />HITCHEN SINK 8 DISP <br />� UISHWASHER <br />LAL'WDRY TRAY <br />i CLOTHES W�SHER <br />URINAL <br />DRMKING FOUNTARJ <br />FLOOR CRAIN <br />BACKFLOW PREVENTERS <br />RGOF JRAINS—RAWLEADE <br />�IN�: ;SERVICE—BAR, ETC.) <br />SUB TOTAL 5 <br />PERMIT 5 <br />FOR OFFICE USE ONLY: <br />f N01li v[TBACK RE4R SEiOACK <br />71>' 2G' <br />U511 ZONE LOi ABFR�/y'� <br />- �- S 7�=/ <br />rrrf ar Goms aurnvicetE iva[or cori5r aCma� <br />�=1J__ — <br />9Z[ OF BLOG NO OF SIORI[5 <br />n�a SF Q��� f . <br />FIR[ SPR11Hl[RS <br />N� <br />r�rnK[m v�nnsnrrnoveoov <br />�� �'�! 5��� <br />FEE <br />C <br />0 <br />SIIJI35ETfinCH .--_...— <br />5� <br />VAGANf $IIE <br />�.�„�� ,��n«,,.�,;��.. <br />1�4911' I <br />NFIGMi LIIAIiAiION <br />2�� <br />CITY OF EVERETT <br />I.00RL SAI.ES <br />TAX CODE IS 3105 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THf_ SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COIdPL'eTEU VJITH WHETHER SPECIFlED HEREIN OR <br />NOT. THE GRANTING OP A PERMIT DOES NOT PRESUNE TO GIVE <br />AUTHOHITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STFTE OR LOCAL LAW REGULATING CONSTRUGTION OR THE <br />PERFORMANCE UF CONS�AUCTIOIJ. THAT I AM AUTHORIZED BY THE <br />OWNER QP THIS PROPEFlTV TO PERFORM T�+E WORK FOR WHICH <br />APPLICATION IS IdADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 182;' FCW AND 296.20D WAC. <br />,IGtlAiUnEOFG01liNACiCRORAUI��ORRE�AGENi D/iE <br />�� <br />X <br />� �, <br />pPPUU� �. Qiv �i��F.55liCEv9F�+U AUUFlU51'IESSNa�dE <br />NO. I T'!PE OF f=OUIPMENT � FEE <br />FORCEUAIRSYSTENS—B.T.U. M EA. <br />UNIT HEATEPS—�.T.U. P.1 <br />F�N <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 (:IiIMNFY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXIIAUST FAN <br />SUBTOTAI S" <br />PEiiM1T S <br />iOTAL FEE S <br />PL1NC11lI 1l111dP(.R fEE NECEIPLnNO <br />�� �',��6�j<// 1—1 �..P �� % �-I �0� <br />FEES VAIUAIIUrv r�c <br />BWLDIIJGdS��SG �P37 <br />--C,=P1o�8—�L1— �?��90 — S n ' n <br />PWMBING 3 a � c� <br />ldECHAKICAL ' S�G <br />ADDITIONAL PLAN CHECK � <br />OTH[fi <br />— - --- ----T <br />srnTr: oui�cinc su�c�;nH�r- � �$� <br />PU�LIC WORHS '�� <br />TOTAL �C(�j � <br />