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_. <br /> ` � ,-�P P l.'�!1 ■ I O� ���\a evPrett <br /> '°"'°„°,°°° C O N ST'R l)�T 1 C� f� <br /> <�„ �F � <br /> everett _ PERh� IT <br /> I:UILDING DEPARTMENT � - <br /> ; ,��.gp�Q TO BE COMPLETED IN INK • PLEASE PRINT' <br /> DEMOLITIGN ❑ COMBINATION MSBUILDING x� MECYANICAL h13 PLUMBING ❑ SIGN <br /> , , „ MAIIPLDPE55 ��1' Z�P PMON(Z�6 338-0335 <br /> RC CONSTRUCTION COMPANY 2722 i00th St SE. , Gveret-t , Washinqton 98208 <br /> � i i I(n�V:SW:lFN MAI.FDDR[$L CIiY 21P VYONf. <br /> i —�,, �u,��+�,:�or� rA.i.<ouae�;s cirv nv 206 338'�"0'335 �'��"-gS��N <br /> P.0 CONSTHUCTION CCt9P�NY 2722 lOQr���SE. Everett . Washinc�ton 987.028 <br /> . /.a� CON:H>GtOq M�ILRObRESS CILY ZIP 1910NE I.iCENSf • � <br /> - .:q..••".: N11R4LIOF MAllP0�RE55 Ci�V 2iP R1DNF L�CLbSt � <br /> . .� 'NOPY. — -- <br /> r i ri[W ❑ nDDI710N ❑ ALTEtiATION ❑ REPAIR ❑ DEMOLITIGN ❑ WOODSTOVE/FRPL.INSERT ❑ �UILDING RELOCAiIOta ' <br /> . �s,H�p��V/O/Rr�COS101l.1FilRIAL5PlU5LA90R1 "� <br /> J1 .( 4 l � `_o • <br /> �,:V :'JPrt <br /> ronst-rurtion <br /> ��)��Pr� � <br /> m.mnwG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS �I'� � <br /> � familv rocirianre — _ PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> ,-�.�,���cu�auounroao�e r�sNowr�ae�owcrnrracnFouacoriesi PROVISIONSOFLAWSANDORDIN^MCESGOVERNINGTHISTI'P[ �' <br /> D GF WORK WII.L BECOMPLETED W�i H WHETHER SPECIFIED HERE '. <br /> �_iaicc.._oi�� arcr�❑ P�rk Ilivicinn � WGRNOT.THEGRANTINGCFAPERMITDOESNOTPR[SUMETO <br /> GIVE AUTHOHITY TO VIOLATE OR CANCEI THE PROVISIOMS OP �'� <br /> ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIGN '� <br /> ---�` OR THE PERFGRMANCE OF CONSTRUCTION. '� <br /> -- SIGNATURER�cCUNSr'1'�U�'1'lULVEI.UMYANYGniL i <br /> X � <br /> �� _ ' �1������ti� <br /> I I L� � C/ APPLIGNNTSCII pU51ryE5SLiCFN5hN0 , <br /> IO'7I1 �o �� <br /> _�r�ff, L�JA q$ZOk �(��� � �L� �1��, 019678 <br /> PLUMBING MECHANICAL <br /> ��0. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMFH7 FEE � <br /> ��� WnTEfl CLOSET�TOILET� � A/C—A/NNOLG lJN1T5—M P _ <br /> � �A7"HTUO f� — REFRIGERATIONUPFPS�—HP EA. <br /> ,��' LAVAfORYIWASHBASIN� � BOILERS—d.TUiMP <br /> I SHJWER — GASFIREDl�C.UNITS—BTU <br /> � KITCHEN SINN 8 OISP � FORCED AIR SYSTEMS—87 U. M EA. � J <br /> � DISHWASHER WFLL HEATERS—BS U. M , <br /> LAUNDFV TRAV UNIT MEATERS—B.T U M � <br /> � CLOThES WASNER F � EVAPORaTIVE COOLEFS ' <br /> � � Uf�INAL CLOTHES DR1'ERS � � � <br /> URINNING fOUNTAIN VENTILATION FAN � 1 <br /> FLOOR DRAIN RANGE HOOD �j <br /> 3ACKFLOW PREVENTERS WATER HEATEfl <br /> ROOP DRFINS—PAINLEAOcPS WOOD STOVE <br /> SINK iSERVICE—�AF.ETC) METAL FIREPLACE d CHIMNEV <br /> FIREPLACEINS[RT <br /> MEATPUMP <br /> GAS PIPING <br /> E%HAUSTFAN <br /> SUB TOTAL S � SUB TOTAL r - ' <br /> PERMIT f PERMIT - <br /> r. <br /> I TOTAL FEE f _�' TOTAL FEE �� ) <br /> -� .� ium .. i�enq se runcK SiDE SEtenGK n�N�HECK nIUF1dEF I FEE ,� RECEIPT NO � <br /> � �� ' � ' _ ���/���9G9 <br /> ip�nr�tn vncnr�rsrt[ FEES VALUATION FEE <br /> � I _ O�V ❑YES LlNO <br /> � i�961 UCCUppNGYGiIOUP NOOFOWfLLMGUN1i5 dUILDINCa g� ��� [.��.����� <br /> PlUM81NG r���, <br /> .� <br /> . Ni Illi NO 0{ SIOHIE$ Mh% OGG .OND — .:_�� <br /> MECHANICAL <br /> OTHER <br /> � � i_.�'qINKLLRS RLOUIRED 17 YES ❑ NO STATE BUILDING SURCHARGE , � � <br /> _ STA7E ENERGv SURCHAHGE I '�l��n <br /> i•.I� 11. Vi_drvSCrrtCnED BY APPR FUF ISSUnNCE BY / <br /> PUBUC WORKS � <br /> \��/�V � /�f/ ��. TOTAL (.P�� � 1 � <br /> v�' <br /> PROPF.RTY OWNERS ARE RESPONSI�LE FOFi DE(EH611NING ALL <br /> FFiOPERTV LINE LOCATIONS nND RELAT[D FAS[h1ENTS <br />