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�. .. - _... . . . . . .. . .., _ . , . . . .. . � �_�_.:..':ea.,. <br /> ��. <br /> � <br /> APPLICATIG.J FOR CONSTRUCT.JN PERMIT everett �' <br /> ,� <br /> rn.E��.� TO BE COMPLETEO IN INK—PLEASE PRINT � �� <br /> CITV OF <br /> everett '` <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS O ELECTRIC ❑ E, <br /> 259•8810 �� <br /> +': <br /> i I DEMOLITION I i COMBINATION i i BUILDIN(i i �MECHANICAL I i pLUMBINO I i SION �; <br /> �Ep MAlLA0DRE55 GTV SIP ! PIqNE f} <br /> i....G i rf �pL�U"A�l/iilt+•i L? 1/T �3/-y�/dU <br /> T�UNT MAII�DOPESS dIY TIP PNONE �� <br /> C� <br /> MCNITECTORUES16NER MAIl�00RE5S CIiY 2iP PNONE <br /> 6ENE11ALCONTRACTON M�ILADDPESS CItY 21P P1qNE LICENSE/ � <br /> r <br /> YECIUNIC�ICOMTMCT09 1MILADORESS CITY ZIP PMWIE IICENSE• � <br /> uw N�.�,�I� �li�-f/.« .rw k✓i Sytvi 1 )y •)'13/ /1.1,.�w� ioaRL �., <br /> PLINlIqOtONTRACTOfl MARAODRE55 C11Y ZIP PNONE LILENSE� ;' <br /> �� <br /> CUBB OF Wqllf �. <br /> NEW L I ADDITION 1 I ALTERATION I I REPAIR I ' DEMOLITION I I WOODSTOVEiFRPL INSERT I-1 BUILDINO RELOCATION " <br /> I: <br /> JD�u CONT�CT PERSON AND PNONE NO �' <br /> : ` <br /> Cp1TMCT VRICE OF MAfllt _ <br /> i: <br /> ;.p�('q, I!E Wp1Yf 11ND 8q1A11E FOOTA6E WVOIVED <br /> �i. <br /> r � . .a �� �; <br /> � p eeousEOFauwo� � I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED TMIS p�. <br /> I ��� �� �.f4,.��I APPLICATION AND KNOW THE SAME TO BE TRUE AND CORPECL ALL k� <br /> �a�oe IPTIONOFYROVERTY� IOWNBEIOWORATTACMFWRCOPIEb� PROVISIONSOFLAWSANDOROINANCES60VERNINOTMISTVPEOF , <br /> WORK WILL BE COMPLETEO WITH WHETHER SPECIFIED MEFEIN OR �� <br /> �or aiocK oF NOT. THE dRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE 4. <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PROVI610N3 OF ANY <br /> OTHER STATE OR LOCAL LAW RF6ULATINO CONSTRUCTION OR THE <br /> PERPORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE �, <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH ` <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE � <br /> CONTRACTORS LAW 18.27 RCW AND 288200 WAC. <br /> 610NATIlREOiCONTMCTORORAUTHORIffO�OENT O�TE � <br /> � <br /> Xr1 <br /> k� � , �� <br /> MOIECT�D011E88 ,F, <br /> C� / ,� APPIICANTBGITVBUSINE IILENSENO�qOBIlSME48NM1E h <br /> 1 f <br /> Kyy�p MECHAINCAL � <br /> N0. Tr►E OF fllITU11E OII REM FEE NO. TY�E OF EOUIrMENT f!! `� <br /> WATER CLOSET(TOILET) � NC—M1NDL0 UNITS—H.P. � fr <br /> B�THTUB ' FORCEO AIR SYSTEMS—B.T.U. M E.A. ' 1i• <br /> UVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M � '' <br /> � <br /> g�Ep � CLOTHES DRVERS � � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ' <br /> DISHWASNER � HANGE HOOD � � <br /> LAUNDRVTRAV ; WATERHEATER ' �� <br /> CLOTHES WASMER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEV ; <br /> DRINKIN(3 FOUNTAIN � FIFEPUCE INSERT T_ <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS i �AS PIPINO ' <br /> ROOP DRAIN9—RAINLEADERS � EXHAUST FAN � <br /> &INK(SERVICE—B�R,ETC.) ' � <br /> — ------ ------�— — � <br /> i <br /> . � --1-- � - �� <br /> 1 � <br /> � 1 � ' <br /> � � .1 <br /> � 1 � <br /> SUB TOTAL S � 6UB TOTAL S �'O ' OG '. <br /> PERMIT S � PERMIT t S � �` <br /> TOTAL FEE S ' TOTAL FEE S �'., <br /> � <br /> FOR OFFICE U8E ONLY: <br /> F110NTBETBACN NE�RfiETBAGM SIOESETBALN PUNLNEGKNU1ABEfi FEE RECEIPTNO � <br /> r� <br /> 11 <br /> usEmr/e IOi�REA VAC�NTSIiE FEEB VALUATION FEE <br /> euIL01No � f <br /> � <br /> TYPfOfCONISUIOWABIE 7YPfOfLON5IIG11W ocuww[r rwnow�i��sGUWtt i `� <br /> w� PLUMBIN� i <br /> 611E Oi BLDO. NO OF 6TORIES B�SEMENf 5 �Q � <br /> MECNANICAL � <br /> � <br /> OCCUPANGYLO�O FIqE6PBNNLER5PEQ0 NEqMTIIMIUT10N ADDITIONALPUNCHECK i �' <br /> � �� <br /> OiHER � � <br /> PEA9pIfORePPMlKLERS <br /> STATE BUILDINO SURCHAR6E � <br /> WTiU(EBY RANSAPPflOVEDBV CITYOFEVEREIT Pl18LICWONKS � I'� <br /> LOCAL SALES <br /> TAIf CO�E IS 3105 tou� ;DO <br />