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A/,�p�.ICATILN FOR Ir'(��I'STRUC7`�ON PERMIT � <br />TO BE COMPLETED IN BLAC�: IPIK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: GAS U ELECTRIC I_J __ <br />— -----� � <br />259-6810 <br />� DEMOLITION i! COMBIN 4TION BUILDING y� fiAECHANICAL I I PLUMBING I I SIGN <br />owr+en una noonEss ciir .ia r�wr+e <br />',�l�c���,�-� ►.l�'-�- ��23 t�=���u�K� i=�i,���= � r � <br />, � �ss-35'��� <br />iennnr unanoone:s arv � zm PhONE — <br />nncwier,Tonoesicrrzn innnnooness �� cirv - zm w�orm <br />UENGRAICdifO�GTOp �MqIL,�Df1ES5 CIiY 21P y11pN[ ST�iELICENSE• <br />I7 <br />ME���RNIC�LCONTR�CIOII M�IL�DDqC55 CITV iIP PIIONE SiRTELICENSE� <br />:�L�� I-k���..��-, Pu �..vx 33S Lk��-�;..-,z�r-t ,�i�,t,� `1uzZ3 U3�-�-lady cc�zH�►,-� <br />rwMniNacor�rnncron unnnuon�ss atv zm riwr�e srnrei�ceNse� �22M,�9 <br />c�nss or wonK <br />' I NEW I I ADDITION l!" ALTERATION <br />� corvTnncr rmce ov wonH <br />DFSCR1I�E WOI1K �NO/SO�U.RIIE <br />, 1�\1'•U� RJ n- <br />P80POSED USl. OF 0 WL�ING <br />l2tLS�67,z,i--lTl <br />'�, iece�oescmoriouovvnoNc <br />LOT OLOCN <br />'� I REPAIR I I DEMOLITION �� WOODSTOVEIFRPL INSEFii I I OUILDING RELOCATION <br />coNrncr n_;,�r� nuo r�wrue No <br />I HEREBY CERTIFY TI1AT 1 HAVE FEAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CONf�ECT. ALL <br />�owoennnairouncor�esi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 1�PE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED FiERE�N OR <br />°P NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GNE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF A�Y <br />_ _ OTHER STATE OR LOCAI l AW pEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTFIORIZED BY TNE <br />OWNER OF THIS PROPERTY TO PERFORM TiiE WORK FOR WHICH <br />— APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />_CONTflQCTORS LAW 1827 RCW AND 296200 WAC. <br />— , X Il ���>yL _ 1 —�I—�I,Z <br />�. rr,wect �ooaess <br />�k3Z� \��¢..J CC.�(C,1.3'l � . <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DI,�'iP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS � <br />SINK (SERVICE—BAR, ETC.) <br />SUBTOTAL S <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />rnoursr.ioncn nennse�nnce �� <br />us�zone �otnnu <br />ivrcmcomseuowem� rrr[nrr,orvs�ncmnt <br />srze or ntu, ero ov srorucs <br />OCCl1P�NCYIOAD FlRGSPfitlNL[fl5f1E00 <br />�I[A501! lOfl SPRINNLF AS <br />SNE $C1114cN <br />VFCANf Slif <br />MECHANICAI <br />NO. <br />FORCED A�R SYSTEMS—B.T.0 <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DF�YERS <br />VENTILATIUN FAP! <br />RANGEHOOD <br />WATER HEATER <br />WOnD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSFRT <br />HEAT PUMP <br />GAS PIPING <br />PIAN CII[CN NUldfll. <br />,�a <br />I 9UILDING <br />occumrxr nn��.vnuxcuuns - -- <br />cnwr PLUMOING — <br />9ASCMENI� MECIIANICAL <br />neimu ui.umnor+ ADDITIONAL PLAN CHECK <br />_ SPRINKIER <br />srnrt eui�oiN� suncnnnc� <br />CITY OF EVERETT PU�LIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />E.A. <br />SUBTOTAL $ <br />PEFMIT $ / <br />TOTAL FEE $ L <br />FEE <br />a <br />H <br />� <br />