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APPLICATION FOR CONSTRUCTION PERMIT everett <br /> �E�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cm oF <br /> eve rett HEATING SYSTEM: f,�AS Q CLECTqIC O <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> i I DEMOLITION I_I COMBINATION I I BUILDINd �"1 MECHANICAL �PLUMBING ❑ SIaN <br /> ��� I.UIL�OONESS CIfY 21P PNONE <br /> �yrarrr P/}ItK� d Btc�t��ie,v '3oci �u�i�cR� �r�c �vr�cr� y�aoi zs+e-e3eD <br /> � IEN�NI MML�DDRESS ---' CITY 21P P <br /> vae�N Nonli tucru�rE �Rwr� /�9 At�VfiCse,v b�vo �v�sRat� u�� z�,o�fo <br /> �RCMtECiORDE5i0NE'1 MI1l�Dd1Eb5 CITV ZIP PIIONE <br /> fiFNENLLCONTRACTd1 M�RIIWNE53 CItY ZN PIIONE LICENBEI <br /> �w�t��� <br /> �c�uw�c�uconrn�cra+ wti�ooness cnr nr rxor� t�rreer <br /> 1'LUMOINOCONIIUCIOII IMR�WIIE83 CIIY 2A PIIp1E LICENlII <br /> u�,�r,�L <br /> cuss a wow� <br /> I I NEW I I ADDITION �Q ALTERATION IX REPAIR I_I DEMOLITION I I WOODSTOVFJFRPLINSER? ❑ BUILDINORELOCATION <br /> Cp1fAGT OER90N AND PIIONE NO. <br /> CONTP/iLTVR�CEOfWONK IId � _O�OO <br /> DESCqlEWOIMCMqBOW1REF00T� INVOLVEU . /�0 �L� �)/ <br /> RF7VDUA1�' /f�'i/AJOA! G � E� 00 <br /> rroro^..eouseaeuwowo I HEREBV CERTIFV TNAT I HAVE READ AND EXAMINED THIB <br /> pf�L�, i11�E'�/Ndr- aon�.. ����a�t wo ON APPLICATION AND KNOW THE 8AME?O BE TRUE AND CORRECT.ALL <br /> 1Ed40E9tN�PTqNOFV110PERTYI��LOY/OR TACNiWRCOPIE51 PROVISIONSOFLAWSANDOROINANCESOOVERNMNiiH187VPE0F <br /> WOpK WILL BE COMPLE7ED WITH WHETHER SPECIFIED HEREM OP <br /> io� e�ocu av NOT. THE ORANTINO OF A PEiiM1T DOE9 NOT PRESUME TO OIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVI810N8 OF ANV <br /> OTHER STATE OH LOCAL LAW REOULATIN6 CONBTRUCTION OR THE <br /> PERFORMANCE OF CONSTHUCTION.THAT 1 AM AUTHORRED BV THE <br /> OWNER OF THIS PHOPERTV TO PERFORM TNE WORK FOR WHICH <br /> . APPLICATION IS MADE AND I COMPLV WITH THE BTATE <br /> CONTRACTORS LAW t027 PCW AND 296.200 WAC. .� <br /> 6q/N7URE OF fANTHACTq10R AUiNORIgD AOENT UA7F D�G I/�I1�I <br /> PRQIE�T„ODPE88 r " ��'l��/M�l l-�i..� . <br /> I GV v Ly ��� IT 'ITYMINNEB ICENBlNO.NION1611LlbMNI! <br /> ��� MLCMAINCAL <br /> N0. TtlrE OF fllITU11E OII(TEM FEE N0. TYPE Of EOUMMEIR � <br /> �jj WATER CLOSET(TOILET) � AIC—AMNDLO UNITS—H.P. � <br /> ���8 � FOfiCEDAIRSY3TEM3—B.LU. M E.A. ' <br /> LAVATORY(WASH BASIN) U � UNIT HEATERS—B.T.U. M � <br /> SHOWER � CLOTHESOFVEHS � <br /> � KITCHEN 8�NK 8 DISP � VENiMiION fAN ' '�� � <br /> DISHWASHER � RANOE H000 � <br /> LAUNDRV TMV ; WATER HEAtER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> r <br /> URINAI ' METAL FIREPt710E 8 CHIMNEV ' ' <br /> DRINKINO FOUNTAIN r FIREPLACE INSERT � <br /> FLOOR DMIN <br /> � HEAT PUMP � <br /> BACKFIOW PNEVENiEH3 � <br /> OA9 PIPINO � <br /> ROOF DRAINS—RAINLEAOERS � EXHAUST FAN � <br /> SINI( SERVICE—BAR,ETC.) � � , <br /> � � <br /> � � <br /> � ' <br /> i <br /> i ' <br /> SUB TOTAL f .sU ; � BUB TOTAL i ' <br /> PERMIT { O � � PERMIT { ' � <br /> TOiAL FEE { ' ' TOTAL FEE { � <br /> FON OFFlCE USE ONLY: <br /> F110NIBE1911CN PEAR6ETMCK 61UESEtMCN PLANCHECKNUMBEM FEE ���� <br /> .� �v ,r.! �_ f- <br /> uyE xa�E �ot u�E� wcu+r sn e FEEB VALUATION <br /> R-� a���o� � <br /> tYPEdtOMfl.�ILOWMIE IVR0�WN51�CiWt �'�• �a����OUM'�� <br /> � PLUMBINf3 .� '� <br /> BhSEMENT � <br /> s�ze a e�oa. no.oF sron�s MECHANICAL • � <br /> Z1CO � ADDITIONALPLANCHECK , i <br /> OGCUP�NCYLWD RRE6FRN1(IEflSREOD HEqNTIIMIlATK7N <br /> 1 <br /> OTHER i <br /> RFASd1fO115PRMfLERS <br /> SiATE BUILDINO SUNCHAMIE � <br /> � <br /> �iNt�r:ear PUNSAPPf10VEDBY CITYOFEVERETT PueuCwot+Ks � <br /> �ocn�saea <br /> TIUI CODE IS 3105 TOTAL y4 ; Q6� <br />