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' APPLICATIC�1 FOR CONSTRUCT' 1N PERMIT �✓� <br />TO BE COMPLETED IN BLACK INK–PLEASE PRINT <br />I_ HEATING SYSTEM: J GAS �L[CTRIC J ____ _ . 1 <br />BUILn�NG DEPARTMENT <br />259-3810 <br />DEMOLITION COh1BINATION BUILDING MECHANICAL ,J(PLUMBING SIGN <br />ntiwrtn --- innn nnnnas --- i:irv --. _—.�i;—_— _— runrir — _ <br />Micl�ae,l Ft��htmors Il'i�5�✓'St.'S.uJ. �EvtcE.�(._�t6Lo3 Czo4� z9� �Sy9_(_ <br />,�„�,�, ..,�,����,�a�s�, �,. ;,� —�,.,�,�,� <br />buJnl°.r --- -- — -- – --- <br />�� I�11 f(<�fi Df 9GR! ti�y MAiL Af1l1qFSS 1 V JiP I �rt�h� <br />�� �► 7�lS,���3.���'KS1�N)�������1►�q���lZ �2G(r %�-'L�o4''��0 _ <br />r i�.i i�ni � �rr�nai�n ninn noor�[ss cuv , r rn�na srnrr uc[rvs[. <br />_�%MiF%eX — — <br />'�GU�FIUGnLCON111nCiOR 6NRAJ[1RC55 ❑�v Z�P PHONE SLATELICENSE• <br />–0�!'�t'..� . �[� <br />PI.UM1I�IN(i CON1R4CiOR AIAiI �DpR[55 dTV IIP PiqNE STRTE IICENSE � <br />[IONIfiACiPqlf.( O;WORK <br />C'r/ G �l S 000. Oe <br />OFSCfiBE ORKPNDSOl14RE[�fAfEiNV�IVf[r���� <br />T �4. <br />ruocoseo usE <br />I FOAI OESGPIPiIUN Of PROP[qTV 6110\YN OR01 <br />iui� e�ocK ar <br />�w Ne\.__SI e� P1o�:S �� <br />,.���� � �T9Z4���3 <br />—11� —� S�y_.� <br />PHOJECTADDRESS <br />..��-- <br />PLUMBING <br />N0. TVNE OF FIXTURE OR <br />SHOWER <br />KITCHEN SINK 8 DISf' <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUIJTAIN <br />BACKFLOW PREVENIERS <br />ROOF DFiAINS—PAINLEADERS <br />SMK ISERVICE—�BAR. [TC.1 <br />.� 7 i7 / <br />oa nrucr� rwo cori�s� <br />.e� . � � <br />FOR OFFICE USE ONLY: SNLOK: <br />� �a xi� 5i �nnCv �� � HEnn sFtonrK � <br />� 20 <br />,�.,/� ����,�r- - ������� <br />J_`� <br />:��P( IV LON51 NO OF SfOqIGS <br />-1��� _ _ � <br />siJf Of pl f)G 1 iRF SPRiNNLEPS REOD <br />m�v� <br />unn.i irv <br />r inr. ni nrne n[ o 0 <br />A10 <br />n nns n��cnovro nv <br />i,��g/1_Z <br />CUNL�C,T PEIiSON RHD PNONE NO <br />i HEFEBV CERTIFV THAT I HAVE RFAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO RE TFUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COIdPLETED WITH WHE7HER SPECIFIED HEFEIN OR <br />NOT. THE GRANTING OF !� PERMIT DOES NOT PRESU1dE TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER ST�TE OR LOCAL LAW REGULATWG CONSTRUCTION OR THE <br />PERFORh1ANCF OF CONSTRUCTION. THAT I AM AUTHORIZED BV 7HE <br />OWNER OF THIS PROPFRTY TO PEFiFORM THE WORK FOR WHICIi <br />APP�ICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.2i RCW AND 296.200 WAC <br />_,.,,,�,�c�c�..A.�� ���,.�„�,.����g� <br />�,.. �����. ��� s,. �,: �.-� � <br />� MECHANICAL <br />FEE N0. <br />fORCED AIR SVSTEMS <br />UNIT HEATERS—B.T.U. <br />CLOTHES DRVERS <br />VEN71LAilON FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE IWC <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />0 <br />Sif1E5Fipn('.h� l <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FE[ $ <br />o vB�- 195i e�f. <br />� �����(/.��(l I1FCf�� <br />vncnNr snr FEES <br />VES NO �ui�.�iN� � 6 <br />�,, ��.,�. 1� �<<.x,��-,. , - �– � �t-� <br />BASE61F.Hi / <br />YES 1/NO <br />MBCML I iMil�tiOV <br />Cl?� OP EVERETT <br />IOCAL SALES <br />TAX COOE IS 310 <br />PLUl.IOWG <br />MECNANICAL <br />ADDITIONAL PLAN CHECK <br />_ oTHER <br />tiiAiF: f3UILDING Sl1RCHARGE <br />PuflllC WORHS <br />5 rorn� <br />� <br />