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"� <br /> ; � <br /> APPLICATION FOR CONSTRUCTI�ON PERMIT �� � � ' <br /> everett <br /> ��f� e <br /> an oF <br /> everett <br /> BUILDING DEPARTMENT <br /> �y 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> �p���q b I_I UEMOLITION !' COMBINATION BUIIDING MECHANICAL PLUMBING ' SION ,.,:,,,..' <br /> i�a <br /> ON'NER u�iIADDRE55 CItY ZIV PMONE <br /> � � 1 �( Zior✓ .Luf�wranCl�krcl� �/�,��'oL-1�6 Ev���c�� 981 3 .�52- 5�� � ' <br /> ��� TEN�NT M��L��DRE55 CIiY — Z�P P�F <br /> � �p T /1 R'� l� �p1��� 1/ f.ITV ZiP .� PNONE j(O � ` <br /> �- _X ' . �~ �-� Ree.c � � _ (nfd2��3�. <br /> NEMLCpITMCTON AUR PE35 �-�aa / U GI V ZiP PNONE IICENSE• <br /> �tl�� h � !i'l�� �!' �.e�•etf yp".�o3 ��3�3/7� Gascom'��Z��tLP� <br /> �r�.� l � � i <br /> ��( MECHIWIC�1lG TR�CTOR MARAODRE58 CITY IR' PNONE IILENSE� <br /> H <br /> QH� PlUM81NOGONTHACTOH M�R�D�NE65 GITV IIP PNONE LKENSEI <br /> 9 <br /> �w � <br /> �Gi�"� `!NEW�RCJ ADDITION i_' ALTERATION �. �. REPAIR �.. . DEMOLIiION I-� WOODSTOVE/FRPUNSERT l..i BUILDIN3RELOCATION <br /> G��� TEIUNTMPROVEMENiORINTEH10RflEMODELONLY /�/��-��JV CONT�CTPEPSONNIDVNONENO. _ <br /> �� /l�'L� � <br /> X fANTRACT PRICE OF W011N: <br /> � .� �DE RI EW011KN! BOU� EFMTAOEINVOLVED �Jr '"�µµ/y�pM�Y/3 pV���7��� _ <br /> r ouse e �o I HEREBV CERTIFY THAT 1 HAVE READ ANO EXAMINED THIS <br /> �( APPLICATION AND KNON'THE SAME TO BE TRUE AND CORRECT.ALL <br /> � AlEOAL DE6Cn�i^oF.�v.ecL?ERTY IS��[iQp1yop� r�cH s R COP�ES) PROVISIUNS OF UWS AND ORDINANCES QOVERNI�lQ THIS TVPE OF <br /> ' Lor,�P= �bcR QO� Y••, oc 'K� _� NOT THELORA T�INO OF AD ERMIT/DO SENOT PR'ESUME TO 61OVE <br /> ; � � � � AUTHORITY TO VIOLA7E OR CANCEL THE PHOVISIONS Of ANY <br /> OTHER STATE OR LOCAL LAW REGUUTINO CONSTRUCTION OR THE <br /> - PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 298200 WAC. <br /> SIGNaTUREOFGd1TR1CTONOR�UTNOqIZED�OENT OATE <br /> �/ n - OCL�JLG LCoS�� <br /> �q T�D E t Q!!l LL2C�7 <br /> •. O 4 �FPLIC�N73 CI7Y BUSWESS IIGENSE NO�ND BUSME59 N�ME <br /> � � � . PLUMBIN� MECHANICAL <br /> NO, TYPE OF flIfTURE OR ITEM FEE NO. TVPE OF EOUIPMEHT FEE <br /> �C�t . __ WATERCLOSET�TOILET� � NC—A/HNDLGUNITS—H.P. ' <br /> I BATNTUB �ORCED AIR SVSTEMS—B.T.U. M E.A. � <br /> f UVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M i <br /> C� _ SHOWER � CLOTHESDRVEFS � <br /> KITCHEN SINK 6 DISH VENTILATION FAN <br /> , DISHWASHER RANGEHOOD _ � <br /> UUNDRV TRAV WATER HEATER <br /> � �! CLOTHES WASHER WOOD STOVE _ i <br /> J URINAL METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN FIREPLACE INSERi <br /> I FLOOR DRAIN HEAT PUMP _ � <br /> � BACKFLOW PREVENTERS GAS PIPING ; <br /> I __ _ ROOF DRAIN�RAINLEADERS EXHAUST FAN � <br /> . SINK(SERVICE—BAR,ETC.) ~— <br /> � — <br /> __ � <br /> I ' <br /> SUBTOTAL E SUBiOTAL E <br /> PERMIT S PEHMIT 5 <br /> I � TOTALFEE f TOiALFEE S <br /> ` � FIANT SET&�CK aE�P SET&1CN SiDE SETB�CM PIAN CN GM NU OEP fE 7J AECEiPT NO <br /> � u � s�, o �9' � <br /> usezor���' �ouaee vecu+rsrce _ F ES VALUATION FEE <br /> �. '. VES � O BWl01NG � <br /> IYPEOfCONSiALIOWdBIE !W[�p0151ACfU�I acurucr wamvt��iwuFi�s �n <br /> cnar <br /> PWMBING <br /> SIZE OF BLDO NO Oi ST�ES BASEMENI MECHANICAL <br /> ��� <br /> OCCUPNIC�LO�U FRESPRNNLERSREO'D NEIGHTliM�1�T1pN �TMER � <br /> �+ ' ��. VES �NO _ STATE BUILDIN(i SURCHARGE � <br /> flE�50H FOR SVRINI(LERS <br /> ST�TEENEROYSURCNARGE <br /> �PVLIC�TqN�GC.Bv PUNS�PPPOVFp� CI7Y OF EVERETT PUBLIC WDRN$ <br /> � LOCALSALES <br /> � TAII CODE IS 3105 TCT�� <br />