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uhV FOR ��NSY'I�1 1 •SP1 PEFMIT <br /> � ('.ITY(X i <br /> everett <br /> BUILDING DEPARTMI NT <br /> 259-8810 TO DE COMPLETED IN INK—PL'-ASE PRINT <br /> I I DEMOLITION COMBINATION ?L <br /> �.q— - _ -__ BUILDING X MECHANICAL x <br /> NA4 AOORr55 --�— PLUABI <br /> -Selea" Bomes- T, <br /> Tc_ Zv7 <br /> IINANI huaATmnEss EMILSt- EMIB118kk•-WA-98203_]9 <br /> rro mro�2ll.6=258-]5-03 <br /> AIOf,IRiF.Ct dillE91°NF—AII AOCIIE59 r <br /> CITY PHONE <br /> y OENFRAI.CONMACron MAl AnU+Es9 <br /> Select BOmeO `Iry ZIP PHONE <br /> C.. zinc. 237 Elm Street Everett WA 98203 206 258-1503 ELECIITI <br /> ARf,HANIGht CONfRACTOq MAA-AOORr55 <br /> y Clry r+n PNDNE <br /> lK 1I:EI <br /> y ,HZPLUMDP/OCONTRACTOR MAIL AOURESS <br /> CITY rro 1'11(M'r - <br /> O D Ilcrn•r.i <br /> 1G-A.49 d LW <br /> d H11( <br /> '>d H NEW I I AOOITK)N I ALTERATION ' <br /> ttNAM MMI <br /> OVEMEN1 On MTERgR REMODEL ONLY I_I REPAIR f7 DEMOLITION I 1 WOODSTOVEIFgPL INSERT 11 �I NNO W <br /> QQ CLYHRAC7 PRICE Cr WOIIM; CON+ACT PERSON AND PHONE NO <br /> l7yd IXSGnIDEM�LN..°�t�ANO6WAnEFCOTACEINVOLVED '���� [?andy Clark,. 34_P-1320 <br /> ,C 3 PnMOs- E8p OSE pF�ullnMO CFiI M _ <br /> I— h 1 <br /> 1 I HEREBY CERTIFY THAT I IIAVF. REAO rR <br /> Y, r•I l --B 1Ej1'a Fpm T eS TeIICe APPLICATION ANG KNOW THE SAME RBCTII 1VAM11111, <br /> T n�ul rn tmr•rxW rOr PPt> AT Tu.I°W°n ArACH rolti, ,,SI ANIOr(jmo, <br /> ��Q PROVISIONS OF LAWS AND ORDINANCES Gt.11 tNINQ THI!7 T'. <br /> I h� 1n1-=rT�-- nl Of.K CF yanaht-nQiy 1 WORK WILL BE COMPLETED WITH WHETHCH <br /> (� t° <br /> O N NOT. THE GRANTING OF A PERMIT DOES N, "Try Rn <br /> AUTHORITY TO VIOLATE OR CANCEL THI �r.L <br /> OTHER STATE OR LOCAL LAW RrGIN ATINn,I , 1 i f is 1 <br /> PERFORMANCE OF CONSIHUI•,TION. THAT I Al. Hp)rU/II . <br /> OWNER OF THIS PROPEGTI' 10 PERFORM IIT WORK Fns• '♦ <br /> 0 C "- APPLICATION IS MADE AND 1 COMPLhv1T1I 7111 <br /> CONTRACTORS LAW 18.27 RCW AND 298.200'.'•' <br /> SKONANFIE Or RACTOR On AUTNOA <br /> ySele t OMesr Inc°A°E"T <br /> i'TKUT C,9 AAIN111E S9 <br /> 111 ----- <br /> I JG A RYJ•B 9INE59lCEN NNtbV ANO RUS1Hr9L NA1 <br /> PLUMBING -- <br /> N0. TYPE OF FIXTURE OR ITEM MECHANICAL -- <br /> WATER CLOSET(TOILET) FEE N0. TYPE OF EQUIPMENT <br /> BATHTUB 'J A/C-AMNDLO UNITS-H.P, <br /> LAVA TORY(WASH BASIN( FORCED AIR SYSTEMS—B.T.U. M E.A <br /> ATw _ <br /> wSHOWER '� UNIT HEATERS—B.T.U.—M�— <br /> KITCHEN SINK a DISP CLOTHES DRYERS <br /> 1 f -,�) DISHWASHER VENTILATION FAN <br /> "LINORY TRAY ' RANGE HOOD --" <br /> _I CLOTHES WASHER WATER HEATER - <br /> URINAL ' WOOD STOVE <br /> DRINKING FOUNTAIN METAL FIREPLACE a CHIMNEY- " <br /> ' FLOOR DRAIN ' FIREPLACE INSERT <br /> BACKFLOW PREVENTERS HEAT PUMP <br /> IA <br /> I S PIPING I`ROOF DRAINSOA <br /> -RAINLEADER9 I ;j <br /> SINK(SERVICE-BAR,ETC.! EXHAUSTFAN, ! <br /> (0 <br /> I <br /> �` -- SUBTOTAL S <br /> �"1 <br /> PERMIT - _$ SUB TOTAL <br /> I PERMIT .Q H <br /> TOTAL FEE E <br /> rrlp+T SF TRACH REAn SETRACn <br /> SIDE SETBACK � II rrr TO fAML FEE <br /> 20 — <br /> 14 <br /> 01 <br /> I5rO1LE LorFA� LE <br /> I'1_1PIIA_1 `te"nV' 1�i'� <br /> VACANT Siff. <br /> Z X)t VES I I NO FEES VALUATION FEE <br /> �- TM lit MST Al10WANF Tm Cr C S1 ArfUAL Itti BUILDING <br /> AA aRKTAn <br /> ( PLUMBING �11Att <br /> 51 Or7NpO NO MsfllTlS!i TMSFIti G/1 <br /> 1 55/• f MECHANICAL <br /> X'CUPANLYIOAD - I I VES -NO _OT <br /> FINE 6PRNKlLR9 REOU IS;InM IMITATION OTHER <br /> �R11 �..1L//+� <br /> I IVES X NO ,�y� <br /> Z "V <br /> ASON FOR SPRNIILFR9 STATE BUILDING SURCHARGE "V <br /> ""PULATgN ACL AY PLAN9 APPnOV[D RY STATE ENERGY SUR CHARGE <br /> — _�0 <br /> CITY OF EVERETT PUPLIC woRKS - <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL <br />