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k <br /> p <br /> ._...r� <br /> � - APPLICATI�.a FOR CONSTRUCTrJN PERMIT � <br /> �•�E��« <br /> � rno tvo,y,ea� � <br /> GIiV OF <br /> �everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEAS�PRINT <br /> 259-8870 <br /> DEMOLITION COMBINATION BUILCING MECHANICAL PLUMBING _ SIGN <br /> ------- - - ----- --- <br /> � ' --- -------- .„ n�v.�nii <br /> ... UWNE� MAiL�COVIF4S LYv <br /> 1. I _________.______._.___. . . <br /> 1[M�Nr � NML�oDil[ss c�rv Pr �`HONE <br /> eq�rutECTOFDES�GNF.R IAMI�DONt55 GIfY Zi� PNONE <br /> � I„� GENlRQCpTNAC10R NIIl�l10PF55 f,11Y ZIP VNONE ULENSE• — � <br /> � � <br /> MCCH�NiC�LCOIIR�CTO�' MAIL�DI1RE55 CRV 71P f'110NE LICEIISE• <br /> A� H . — _ — — <br /> rI�� VW�APINGLONiR�CipR M�IL�[lDAE55 LIIY l�P PHONF LILENSF� <br /> "L <br /> Hr..� ___ —_—__'__— <br /> y iH ci�ssarwonK <br /> � �"A NEW ADOITION ALTEFATION REPAIR _UEMOLITION WOODS10VEiFRPL INSERT 13UILOINC RELOCATION <br /> � y.�� 1E4AN11MYROVEMENiORIMERiOR9EMODFLCNIY COM�C'1Y�SON�1104'110NENO <br /> N H --.- — <br /> CCNiRAP!vpILE O�WOR<t -- <br /> � �Yi� DE>f.R�OC 1V09N�ND SOU�'�E FOpUCE INVG\CU <br /> �e -�3�I��Ga�--�`�'��',1�-�Lrr�u — -- -- <br /> � ^� rn aos n si o eunoiic I HEREBV GERTIFV THAT I HAVE READ AND EXAMINED fHiS <br /> APPLICATION AND KNOW THE SAME TC�BE TRUE AND CORRECT.ALL <br /> ,n� --- PROVISIONS OF LAWS AND ORDINANC,ES GOVERNING THIS TVPE QF <br /> IEWL�FS:��HiKIN Of VROPERiV ISHOWN BEIOW OB AIT�CM fOUR CfWIE51 I <br /> � H WORK WILL BE COMPIETED WITH WHEIHER SPECIFIED HEREIN OF <br /> y io� g�oc. oF NOT. THE GflANTING OF A PERMIT 7QES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLA'E OR CAHCEL THE PROVISIONS OP ANV <br /> � 1-�H OTHER STATE OP LOGAL LAY/REGULATINfi CONSTRUCTION OH THE <br /> g y�„� - -- PERFORMANG[OF CONSTPUCTION. THAT I AM AUTHORIZED B/7HE <br /> ��y - -- OWNER OF THIS PROPERTV TO PEFFORM THE WORK FOR WHICH <br /> � APPLICATION IS MACE AND I COMPLV WITH THF. STATE I <br /> CONTRACTORS LAW �B 27 RCW AND 296200 WAC. <br /> �y SiGNAIUREC"CON�R�LiORpPA'J1HfHIIE��GEN1 D�LE <br /> N <br /> X <br /> rn�,ecreooaess - -- - <br /> PIiUN" NU � .StiUGfNSFNO V10BU5ME55NAME <br /> '� - <br /> PLUMBIN6 MEC NICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE � <br /> �� • WATER CLOSET(TOIIET) — — ___ a�C-A�HNDLG UNITS-HP. <br /> f���� BATHTUB FORCED AIR SVSTcMS-B.TU. M E A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS-0.T U_ M _ <br /> SHOWER _ CLOTHES DfiVERS <br /> i'"' �1 _ VENTILhTION FAN <br /> � _ KITCHEN SINK 8 DISP RANGE NOOD <br /> � DISHWASHER _ — - <br /> ' LAUNDHVTRAV WATER HEATER <br /> � � CLOTHES WASHER WOOD STOVE <br /> !�' URINAL METAL FIREPLACE 8 CHIMNEV _ <br /> DRINKING FOUNTAIN FIREPLACE IIJSF.RT <br /> FLOOR DflAIN HEAT PUMP _ <br /> � � � GAS PIPING <br /> 6 `' BAGKFLOW PREVENTERS — <br /> ROOF DRAINS-RAINLEADERS El(HAUST FAN <br /> SINK(SERVICE-GAF,ETC.1 <br /> �� ` - <br /> i ' _. <br /> - ; I <br /> '�. � � _ SUB TOTA� S I <br /> + SUB TOTAL 5 _�__ pERMIT S � <br /> TOTALIFEE S TOTALFEE S �' <br /> N��NCIIICrt11UMOEH �FE PkCE1PiNJ I <br /> � ffiONiSEtBACN PEARSEIDACY Si�ESCIBALM I <br /> � <br /> useza+[ �or�nt� ' vec�HrsrtE FEES VAWATION FEE _ �' <br /> VES NO BWIDING __ __ <br /> 1YVE Of LON51�LLOWABI[ Irv[O�C04S1 ACI Wl amw4n Na u:m.e,�.�"� - ------ --- --- <br /> ��p��` PLUMBWG <br /> SUEOFB�06 NOOFStORiES B�SEJEHf MFCIIANICAL _ I <br /> �ES NO --___ .- _____ —_-- ; <br /> ___— -- OTHhH —_ __ ' I <br /> OLCUPANCYlWO fIHESPNN¢Lt��S11fU0 NFGMiI�MIU110N . �— <br /> VES NO S7AtEBWl01NGSURJHARGE ' <br /> __' "_ _ __ �— <br /> R[�SOIIfORSPRiNnL[R:i -- — ' I <br /> 5lAIE ENERGY SURCII.�(1GE � <br /> /PPI�Ub!Y.IA�CMY P..�NtiAVPHpVl�13Y CITYOFEVEflE7T Pl10lICWOHN_�—�- --�_-� — � I <br /> i IOCAI SALES —�— I <br /> 1------- TIUU CODE IS 3105 ror�� I <br />