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APPLICATA FOR CONSTRUC&N <br />1.P EKE TO BE COMPLETED IN INK --PLEASE PRBIT <br />CITYOF <br />everett <br />BUILDING DEPARTMENT <br />259 8810 <br />DEMOLITION <br />PERMIT lew <br />I HEATING SYSTEM: IJ GAS U ELECTRIC ❑ J <br />BUILDING <br />PLUMBING <br />ay <br />„p Sd YtsR�_ 5Q4— eafsal f�y *i2 EMGNR <br />iENAy}. /1.o�JX .1.00LESS Illy zIP ivnxE <br />D /13L3 CS1PN / s V•�.3ox122- /4oAoof wA, 9Iyl}2 LLYL Y91'-5'L <br />ARCNl1ECi C9 DES ER •JAL AODR[GS I'll ZIP plK <br />PLUMSPI M61RACIXI MAI ADDRESS CITY z'P PNONt LIUNSEA <br />OL AZc n SAM L <br />CLASS a won. <br />NEW ?f ADDITION x ALTERATION REPAIR DEMOLITION I WOODSTOVE'FRPL INSERT BUILDING RELOCATION <br />c-' CONfr" Ir PERSON ARDPIv�yypA� orb'-Y9r�- <br />k <br />LEGAL CESCRIPMR 0 PNLNR H II IYM1TMI I — - I I--I--- <br />Loi /- Y BLOC. 769 Lx D -0l -/✓ llh <br />PFOJI cl ADDIII �4 <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME. TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AU I HORIZED BY THE <br />OWNER OF THIS IROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IS 27 RCW AND 296 M WAC, <br />SGNAiUREXCWTRACTORORAUTHECRUTDAGEW DATE <br />X — <br />A,Q, <br />APPI MiSCIiY BU51HE55LtFN5F NJ AIIG BUSMf 55 NAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A'G-AHNDLG UNITS-H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASINI <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK A DEEP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTE96 <br />GAS PIPING <br />�— <br />ROOF DRAINS -RAIN ADERS <br />EXHAUSTFAN <br />J <br />SINK (SERVICE -BA , ETC.) <br />� A.S LL r u012 hN <br />a .L GAJ°3S 1MatH[ <br />K4sA L- /,for ti , r-L, <br />SUBTOTAL 5 <br />SUBTOTAL $ <br />PERAiIT S <br />PERMIT A <br />TOTAL FEE S <br />TOTAL FEE $ <br />Fnm nFF14 IICF nNl V. v <br />FRb T SETBACK <br />REAR SETBACK <br />SIX SLIBAL. <br />RANCHECKN)MRER <br />IEE <br />RECEMTNO <br />USEZONE <br />I <br />LOI AREA <br />I ZeAQ <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />rcrtd EDxrs wmvANE <br />TIK DI LONST MIUI <br />5¢E DP RIOB <br />WOE STORIES <br />BASEMENT <br />MECHANICAL <br />MgMMPLAN CHECK <br />sS <br />DMUAANCVLOAD EIRESPPoMIERSREOD HEGNTLMITATKW <br />REASON FOR SPRM.LENS <br />OTHER <br />STATE BUILDING SURCHARGE <br />�— <br />i S8 <br />WWI <br />PUNS APPROv DBY <br />CITY OF EVEBETT <br />LOCAL SALES <br />TA%CODE IS $105 <br />PUBLIC WORKS <br />TOTAL <br />/` rS <br />