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APPLICATION r`OR CONSTRUCTIO i PERMIT e,'�fe�t <br /> �„�E�,e,�„ TO BE COMPLETED IN INK—PLEASE PRINT � . <br /> CITV OF <br /> eve rett HEATING SYSTEM: ❑GAS ❑ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259•6810 <br /> DEMOLITION COMBINATION UILDING �CHANICAL PLUMBING SIGN <br /> OMR![R �+,�,�+� MAILADDRE55 CITY 71P 9�'zO� PNONE <br /> BRRCv e,,,l �R I�RIS C•S 20Df0 f3t2X1C�(j���� C U�crtt'�. CZCL.) 2..�`L•4�L7k <br /> TENANT MAiLAD�RE55 I�CTY ZIP F ONE <br /> BAf�'Co �'M'�rZr�fZ��s 2c�� (3roa�lcu�.:,• �'��c�re7�' 9kz��x'�)2a z-Sa�r- — <br /> 0.RCHITECT OR DESIGNEfl MAIL RDOAE55 G V 21P PNONE ' <br /> ��w kii..c li01g R�.(�+er �va.- $�,c�'ff C��e.Cc���.RoZ"ab Cz�3� ?�i-8t3S <br /> G ERAL TRACTOR MAII AD�RE55 � C� ZIP PHONE LICENSE Y <br /> �1�RCo �A�T�RPR�S�S �� a:,���,�: ����,��t- � cz�>zs�-���� <br /> MLGHRNICALLONTRAGTOR MAILADpRESS G Y ZIP VHONE LICENSE/ <br /> i3A1� �r,T�RaR��as x«x� i3�d�: tv��� �)Tszso�� , <br /> Pl11MBINGGONiqAGTOR M�IIADDRESS CI ZIP PMONE lL^ENSEs <br /> CUSSOF WORK <br /> NEW IC ADDITION �.��_ ALTERATION � � REPAIR �. DEMOLITION �. �� WOODSTOVE/FRPL INSERT ._� BUILDING RELOCATION <br /> �'� C TAGT PEPSON ANO PHONE NO. <br /> CONTR�GT PRICE OF WORK Q��(/� �MS��� �L'�� <br /> DESCRIBEWORKANDS]URREFOOTAGEIN aveo <br /> aisln�. � wd- (v�� s Crecr � e�o� I-8� - 3 -( G� <br /> ' PFOPOSEDUSEMBU�LDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> S p APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> iec��oe ceivrioNOF raoPesrr�sNowN se�owoa anncM Fwa coriEs� PROVISIONS OF LAWS AND ORDINANGES GOVERNING THIS TYPE OF <br /> ioT 62q oiocK �12D ov E��BYB�'�O� , H'ORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> PIc[l p�' �I�. �ZO VGO ^ i �T'F�O OTHER STATE ORVLOCAL LAW EGULATING CONSOTRIUCOT ON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFiIZED BY THE <br /> OWNER OF THIS PROPEPTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LJ�W 18,27 RCW AND 296200 WAC. <br /> SIGNAtUREDFGONTPACTOFOR�UTHIXiREDAGENT DATE <br /> PRQIECTADOFESS _�_l�qp�•/�/N—/ � ��/ <br /> �/�� n`ro�_ _r�` ^U��# ��� Q p 2�b RPPIIGANTS CITY BUSINESS IIGEN N0.�ND OUSMEbS NAME <br /> �- r� ,..� <br /> PLUMBING MECHANICAI <br /> NO. TYPE OF FIXTURE uR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR E'iSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH EASIN) UNIT NEATE�iS—B.T.U. M <br /> SHOWER CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY ; WATER HE�TER ' <br /> CLOTHES WASHER � WOOD STOVE <br /> URINA! ' METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOfl DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS--RAINLEADERS EXHAUST fAN <br /> SINK(SERVICE—BAR.ETC.) ; <br /> � <br /> � <br /> �— <br /> SUB TOTAL $ ; SUB TOTAL 5 S7/ ' —' <br /> PERMIT $ PERMIT $ /S�� <br /> TOTAL FEE $ ; TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBAGK REAR SET�ACN SIDE SETBACK PLAN CNEC UMBER FEE REC[IPT NO <br /> `/ o��C'�� /J`�c • 1 U <br /> usezor+e LOTAREA VACANTSITE FEES VALUATION FEE <br /> BUILDING � yJ i <br /> IYpE Of LON15 AIlOWF9lE 1VPE OF LONST ACTORI occue�Ncr No p v+muucUxrts -�— <br /> �A�P PLUMPING ' <br /> i <br /> GT[OF9LDf. NO.OFSTOPIES HASEMENi MECHANICAL / /� �'G � � ^ <br /> � <br /> O'GUPANCYLORD FlRESPRNNLERSREO'D HEIGNTUMITATION <br /> ADDI710NAL PLAN CHEGK ; <br /> ��, OTHER � <br /> PEASON FOP SPRINNLFRS —�— <br /> STATE Bl11LDWG SUflCHARGE <br /> INtAKE BY PlANSAPPROVEDBY CITY OF EVERETT PUBLIC WOflKS <br /> '�— LOCAl.SALES � <br /> � TAX CODE IS 3105 T�TA� <br /> �36f ; o• <br /> // � �r <br />