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ARPLICATIC'1 FOR CONSTRUCT' 1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />_ — -- - -- --- --- ----1 <br />HEATING SYSTEb'� i�I GAS J ELECTRIC J __ _. ____ - I <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />o�vnt n i.un nnn��rss : <br />� ������t��,��r,�- �,�• - �'!��i — <br />�IRANI M41lADDRE55 <br />nnr'�u1ECT OR DESIfiNER <br />GfNCRAI. fOrytR4CTOR <br />lI[tHPNIC4l GONfRqCiOq <br />CONINAGTPFREOF <br />ocsr,�aoe wo�rc nNr <br />M�II <br />61AIL <br />unn nooness <br />BUILDING MECHANICAL PLUMBING <br />rirv n�' — �r�or,r <br />� _ � . %� i",! / - l <br />cirr zir rHONe <br />CIiV ZIP PIIONE <br />CItV <br />CIIV <br />Cil�� <br />ZIV <br />7ir <br />SIGN <br />PHONE S7AtE UC[NSE � <br />PHONE E.JIICENSE � <br />�G _��/ �( � — <br />Pr�011[ Sin��IiCEN5E1 <br />�:��� <<��,�r�a � l���r� �'�.�-��' /� <br />�rr���va��a �.��� � �anncr rensoN nHo aHor�e Ho � <br />�/ J F <br />'L ' <br />n�onoseouseoceJ��oiNc ��/a��l/�, �1�,���� <br />lE �MOFSCRIP(�ONOiPROPERtViSNOWNOEIOWOARITALHiYIOCOP0.5� <br />tOi--- BLOCN — OF <br />—�-��,��a��� <br />PARCElTA1fIG NIlM9ER �� <br />CONSLRUCTi0Hl0ANLENDGR �DORESS TELFPHONENU" ' <br />PROJECT ADDA E �� � ,- � <br />/d"/� /rJ/ �' ,� _c= <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATEN CLOSET (TOILt I I <br />EfATHTUB <br />LAVATORV (WASH BASINI <br />SHOWER <br />KITCH[N SINK 8 DISP <br />DISHWASHC-R <br />LAUNDRVTRAV <br />CLOTHES WASHER _ <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />9AGKFLOW PREVENTERS <br />POOF DRAINS—RAINLEADI <br />SINK (SERVICE—BAR. ETC. <br />SUB TO <br />PERMIT <br />POR OFFICE USE ONLY: <br />rno���snnncn ---- -�rnns[rnnce-�---� <br />usf IUNf --�_ —lol ORF.� <br />ivr� �p GON57 NO OF SipRIES <br />�Cf' Of BIDG �'�RE SPR�NRlCNS REO'D <br />�,��.i.i�vnNcviono nneunnuneoo <br />i�l ASON —"—"'� � <br />,������ �� rina �r,ovrnnr <br />nnrr G _ � �j <br />FEE <br />—� <br />i HEREflV CCRTIFV THAT I NAVE READ AND E%AMINED TH S <br />APPLICATICN AND KNOW THE SAME TO BE 7RUE AND CORRECT. A_l <br />PROVISION9 OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH N'IIETHER SPECIFIED HEREM pR <br />NOT. THE (;RANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORIT+' TO VIOLATE OR C�NCEL iHE PFOVISIONS OF �I�IV <br />OTHFR STPTE OR LOCAL LAW REGULATING CONSTRUCiION OR THE <br />PERFURMANCE OF CONSTHUCTI(1N. THAT I AM AUTHORIZED BY THE <br />OWNER Of THIS PRQPERTV f0 PERFOFM THE YlORH FOR WHICH <br />APPLICAT'ON 1$,�'AADE 4ND I COMPLV WITH THE STA`E <br />COtliRACT� 3 W 1�27 RCW AND 296?00 WAC <br />���� T�, �'�(ZC�� -�G � �� <br />) <br />.xnun n���� — <br />�,,. �,,, ,,,� s., � r,,.,— � — — <br />MECHANIC4L _ <br />�O. TYPE OF EOUIPMENT FEE <br />Z A C—A N'JDLG UNITS--H.P. <br />FORCEUt�IRSVSTENS—B.T.U. M E.A. <br />% UNI1 HEATERS—B.T.U. M _ _ <br />xse nvvooc � <br />VENTILATION FAN <br />RANGEHOOD <br />WATER NEAiEH <br />WOOD S�fOVE . <br />METAL F��RCPLACE (WOOD BURNING� _ <br />FIREPLACE INSER— ___ <br />HEAT PUMP <br />G�5 PIPING <br />�'— 'Z. EXHAUST FAN _ <br />9DESFtSnr,n rinr�oqc���yrdaFq it� <br /><�i i !/,') <br />i <br />vnceNi sire FEES <br />� VES NC aun.owc <br />(Y[pC�el. ���.u..Al.l i��hl- __ <br />r' " PLUM9IN � <br />B�SCMFNf M[CNANICAL <br />VES NO - �--- --- -----.. <br />NEIGN1;iMlintiON �OUIiIONAI PIANCHECN _ <br />— — <br />--- _ .. - - - --- omrn _— . <br />51�71 PUIIDINGSURf,11ARf�l� _ <br />CITY OF EVERETT rum ic woaKs <br />LOCAL SALES <br />TAX CODE IS 3105 rora� <br />SUB TOTAL S � �_ <br />PERh11T $ `� <br />TOV�L FEE S � � <br />n[ceirinn <br />VALUATION FEE <br />_'___�- <br />