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� � ,. .� �� ,.z�< < ,�, ,�... <br /> APPLICATIOrI FOR CONSTRUCT�ON :�ERMIT <br /> e��«« <br /> „.�.�,,..�,.,, � <br /> �,��,o� <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> zss-aeio <br /> �� �� DEMOLITION COMBINATION _ BUILDING �XMECHANICAL _ PLUMBING SIGN <br /> nwr�tn A�t�oDNlSs fdlr I�n PwDNE <br /> rO �U� �������p _'� . � _��. —����L`.C�1 ��li�- C�VT ��J � �" ��� _�— <br /> � �y ifN�� IAAIL�O�RF55 11V ]iP PNONE — . <br /> t � <br /> y �' �RCHiiEJiORDE5IONER MAa�UDRE55 GTv IIP PMONE <br /> K' l�. <br /> � y�� � Q ryp� <br /> A `N_i�1�iP�R MRI.. 9 RC55 l�'1��1 l'I J / / •l. l ,I �_^J/Lx ll Y � V [� J ( _�L" `�E� <br /> I <br /> r�. �� ulGN�NIG�Lf,pN qCTON MRIl1.DDRESS CIiY 31P VHIX�1 I�CENSE/ <br /> C�1 C7I� 1l��lL�1U� /S�C<L c.�.��s�� ) <br /> r] <br /> O H I��UMBINOCONIR�QOR MNL�D�RE55 LRV ZIP P1�ONE IICENSE� <br /> � �g <br /> a�• o <br /> �.y fLR550F WOPN <br /> 1' y NEW A�DITION �LAlTERATION REPAIR DEMOLITION WOODSTOVE/FHPLINS[RT � BUILDINGRELOCATION <br /> � H y 1CN�NLIMPROVEMENiORINiENM)OREMOOfLONLV CONT�CiPEA50N/NpPHONENO <br /> �J�A CONiR�CTPNICEOfWORN: , 1 �� �' � -- --- <br /> � �...�y DESGFi,'CW_O �NO:OW�R[FOGi�G;I�vf':D� ^ <br /> � _ ����E�"'1 <br /> w� f�'�k� � ii -- — <br /> � ovoseouseoroui�owe ti. I HEREBV CERTIPV THA7 I HAVE READ AND EXAMWED THIS <br /> � HO y �� / APPLICATION AND KNOW THE SAMF.TO BE TRUE AND CORRECT.ALL <br /> IEG�l�ESCRIVTNMOFPROPERTYISNOWNBELON'OH�TT�CNLOURfAPiES� PROVISIONSOFLAWSAN�ORDINPNCESGOVERNINGTHISTVPEOF <br /> WOfiK WILL 9E COMPLETED WITH WHETHER SPECIFIED HEREIN OF <br /> �or e�ocK oF NOT. THE GRANTING OF A PERMIi DOES NOT PflESUME TO GiVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIGNS GF ANY <br /> OTHER STATE OR LOCAL LAW REGULAIING CONSTRUCTIOM OR THE <br /> PERFORMANCE OF CONSTflUCTION.THAT i AM AUTHORIZED 9Y THE <br /> OWNER OF THI',� PROPERTV TO FF.RFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANU I COMPLV WITH THE STATE <br /> CONTRACTORS I.AW iB.27 RGW AND 29fi200 WAG. <br /> SIGN�NREOFCONiP�CiOROR�UTNORIZE�AOENi DFiE <br /> X _ �� �lft_(��/��i� I �a� ,� <br /> VROJECi�D � �qNitiCli'IGL'SiNl' LLlNSC7l�O RN�fi�15ME5511�ME <br /> �� I �t l�G1 � <br /> PLUMBIN6 MECHANICAL <br /> ���� NO. TYPEOFPI%TUREORITEM FEE NO. TVPEOFEOUIPMENT FEE <br /> WATER CLOSET(TOILETI A�C—M'HNDLG UNITS—H.P. <br /> '� �I BATNTUB _ FORCED AIR SVSTEMS—B.T.U. M E.A. _ <br /> � UNIT HEA7ER5—B.T.U. M <br /> LAVAIORY�WASHBASIN) <br /> ._�t' _ SHOWER CIOTH[S DRYERS <br /> L� KITCHEN SINK 8 DISP VENTILATIO��FAN <br /> � � DISHWASHER NANGEHUOD <br /> � LAUNORVTRAV WATERHEATER <br /> �� CLOTHES WASHER WOODSTOVE <br /> I ��I URINAL METAL FIREPLACE 8 CHIMNEV _ <br /> DRINNING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP __ <br /> '�1 ' BACKFLOW PFEVENTERS — GAS PIPING J— <br /> F EXNAUSTFAN —� <br /> _ ROO. DRAINS—RAINLEADERS _ <br /> ' SINK(SERVICE—BAR.ETC.) i <br /> i =1�1 — — _ - — __— —— <br /> i SUB TO7AL S ; _ SUB TOiAI. E _��� <br /> �� PERMIT $ —�— PERMIT 5 /� <br /> I _ 70TAL FEE $ TOTAL FEE S 3 <br /> � �� nECEirrHo <br /> \ �PONI SET9�CN 4EAR 5[iP�CN 51pE SE16�GN �LAN CIIECF Nl1MI)UV �I E <br /> usezar �orenee wc�Hrsrte FEES VALUATION FEE <br /> �- <br /> VES NO nm�uiNc <br /> rvPFOlCONSi�IlOWABIF IYVFO(COHSI�CNAL ��rur�xn q��acw!ii�e5��„is —.-- . --.-- ------�-- - - -- <br /> r,no.i� <br /> PWM[3�Ni, <br /> SiZE Oi BIDG No oF SiONiES PASEMEN� MECHANIUL _�(� ' � <br /> VES NO — ----— ��- <br /> OCLUP�NGY\OAD FNESPNNNlERSPEOD ��FIGr1il�Mit�liON O1MER <br /> 1'ES NO ___ S7ATEBUIl01NGSURCHRRGE <br /> RE�SONiORSVRiNKIERS � �� <br /> SiPTE fNERGY SIIRCNAfiGF <br /> �PPUI�.A�iUNRCL �V r�.ns.rrHo�eun•� CITY OF EVEHETT PU(1UC WORK$ � <br /> LOCAL SALES <br /> � TAX COUE IS 3105 TOTp� 3 C' <br />