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'� ��� ; �'��� APPLICATION FOR CONSTRUCT ON PERMIT <br /> �� , evemtt <br /> me�q�l� <br /> CI7V� � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-0810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> I OEMOLITION COMBINATION BUIL[IlNG MECHANICAL PLUMBINO SIGN <br /> ONRlER MAIL�DDPE55 — I � � 1�� j� �� /� ��� /�� ���_.-��'-}y(��( <br /> t D i V� C �l ��r� <br /> EN� � ' MARADDRESS G�r ZIP PHONE - <br /> �RLNRECi OR OESIGNER� MAIL ADORESS GTv 21P PHONE <br /> OfNERAlCd/�R�CTON M�IL�DDRESS �V�LL '�/' `��� �SZ� �� �V /�+� ��ENSEI <br /> YALLEI' NATcUR�AL GAS�, INC. <br /> MECNNIICAL � S;*w�,rupnbuf��� CIiY 21P PMONE LIGENSE 1 <br /> 7605 MeDoueall <br /> PLUMBINO— CONTM�!'Uf� � 0 CRY 21P P110NE IICENSE I <br /> CLA55 OF WIMN <br /> ! ; NEW i '� ADDITION . ERATION �. REPAIP . DEMOLITION . �� WOODSTOVE/FRPL INSERT i l BUILDING RELOCATION <br /> TEkANT IMPROVEMENT OR INTERIOR REMOOCL ON Y CONT�C7 PERSON�NO PNONE NO <br /> CONTRACT PRILE OF WqiN: <br /> OESCHIBE ON (�N{� ARE F TAOE INV VE � � / I <br /> {,A� � — <br /> . rno DUSFOFBUi na I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COPRECL ALL <br /> LEMLOESCRiPTqNOFPPOPERTY�ENOWNBELOWORIITUCHFWRLOPIE51 PROVISIONSOFIAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> � WORK WILL BE COMPLETED WITH WHETHER uPECIFIED HEREIN OR <br /> � �or eioc+c or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOfiITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTHUCTION OR THE <br /> ---' PERFORMANCE OF COPlSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPEHTV TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 FCW AND 296.200 WAC. <br /> . SIONAiUREOFCOATR�LTOROR�l11MORIIED�GEHT D�TE <br /> PNQIECTADORESS �� ��"' '��� <br /> I � �PFIIC�NiSCIT�BU�E55lICENSE N0 AN�BOSIN . NNAE <br /> PLUMBIN6 MECMANICAL <br /> NO. TYPE OF FIKTURE OR REM PEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG UNIT.S—H.P. <br /> BATHTUB FORCED AIR SVSiEMS—B.T.UfQ E.A. � <br /> LAVATORY(WASH BASIN) UNIT HEATEFS—B.T.U. M � <br /> �T <br /> SHOWER � CLOTH[S DRVERS � <br /> KITCHEN SINK 8 DISP ; VENTILA-IION FAN ; <br /> DISNWASHER � HANGE HUOD <br /> LAUNDRVTRAV WAT[R HEATER ' _ <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL METAL FIREPLACE 6 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT _ <br /> F�pOR DRAIN HEAT PUMP � <br /> OACNFLOW PREVENTERS GAS PIPING ' <br /> ROOP ORAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � <br /> � <br /> SUB TOTAL E SUB T0T.4L S ' � <br /> PERMIT S PERMIT S � � <br /> TOTAL FEE S TOTAL FEE S � <br /> fRONTSETMCN NEARSET&�CN SIOESETBACN PL�NCNE`CK'��9EDR i'EE HECF�PTNO <br /> use zone l0T AREA V�C�NT SIiE FEES VALUATION FEE <br /> ,. ��. VES � NO BUILDING <br /> iYPF Of LONST UIOWABIE lYM Of CONSf ACTIIAI OCCuwCr ria or�Wftu�uMiR — <br /> ��" PLUMBING <br /> SRE OF BLOa Iq OF STqiIES BASEMENT MECHANICAL <br /> ' ! VES � -. NO ' <br /> OCCUPNICVIO�D FIPESPRNNlERSREOD MEqN1LIMIUt10N OTHER <br /> '. �. YES �. I NO STATE DUILOINO SURCHARGE <br /> REASON FOR SPRINKLFRS — <br /> STATEENERGVSURCHARGE <br /> �PPLICATION�CC BY PlANS�PFROVEG PV CITY OF EVEREIT PUBUC WORKS <br /> LOCAL SIILES <br /> TAX COUE IS 3105 T���� <br />