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APPLNCATI4':� FOR CONSTRUCT��?N PERMIT I <br /> everett <br /> rhe Everg,cen - <br /> everett e � <br /> BUI ING DEPARTMENT TO BE COMPLESED IN INK—PLEASE�RINT <br /> 25 -8810 <br /> �� DEMOLITION L7 COMBINATION f i BUILDING l.I MECHANICAL I 1 PLUMBING ❑ SIGN , <br /> JW1lEfl 'e MAI DURESS LITY fe ZIP PMONC �� — �/ �V <br /> 1 1 �6�. -p�,L�{�2, <br /> VL <br /> i� TENRNT IA�iL/u7DHE55 :RY ZN PNONE I, <br /> AqC11RECTOP0E516NEB M�CADpqESS CIiY ZIP PIIONE <br /> �� GEN��i[dCONTRACTOR M�0.A�pPE65 CIiY 21P PIIONE LICEN6E/ <br /> 1 / i <br /> � MECH NI QCONTRACTOq M110.�DDNE6S CRY ZIP PIIONE LICENBEt I <br /> d Iw � PLUMBIHGCd1TRACTOR MRRADDRE55 CITY 21P fM�ONE LICEN6E/ <br /> � � � <br /> CUSS OF WORK <br /> ` I I NEW I I ADDITION I I ALTEI�ATIOfJ I � REPAIR I I DEMOLITION I ( WOODSTOVE/FHPL INSEHT f I BUILDING RELOCA7�ION <br /> . � TCNRNT IMPqpVEIAENT OR MiEH�OR PEMOpEI ONLV CpiT�Ci ER AND PHONE!ry /'7p <br /> -•} CONfRRGTPRICEOFWORN: �KV]� aS-g"b//,3 D✓� <br /> ESCRIBl WOiiK�ND SOVARE FOOTAOE IN VEU <br /> � o � ,�nd.�O�;�- �� s��! �'��. � ��Y-soy5` _ <br /> -evaonw / I HEFEBY C R71FY THA1 I HAVE READ AND EXAMiNED THIS <br /> APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRf_CL ALL <br /> � teon�oEscnirriorv a rnoreRtr�sr�ormeeiov+iiR nnncn rouRcoriesl PROVISIUNS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> ��� ��, �� � ��/Q t U�� � WORK WILL BE COMPLETED WITH WHETNER SPE�IFIED HEREIN OR <br /> �oT A��K O° �' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> /�9 �I . �n �E � / �� AUTHORITV TO VIOLATE OF CANCEL TNE PROVISIONS OF ANY <br /> �� �ru __.���j OTHER STATL" OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br /> /'� � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ' I/_/ � � �j�� OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> ��� �h•VYNO n APP�ICATION IS MADE AND I COMPLY WITH THE STATF <br /> / CONTRACTORS LAW 1827 fiCN�AN 296.200 WAC. <br /> ��,�,��. n t G��D�L�/� /�_ sr,Hniune or crn�TnncTon on au ni �o¢Nt onte <br /> r�ae r noonEss h t � � <br /> �� ' � 'J/� APPLIC�NTS CI 151NfS5 t IGFNSE N0.4N0 BUSINE9Y NAME <br /> /`(/ <br /> PLUMBING MECHANI L <br /> NO. TYPE OF FIX URE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEF9 CLOSET(TOILET) � NC—NHNDLG UNITS—HP. � r <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) i UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLOTHE`u DRYER:I � <br /> KI7CHEN SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER � RANGE I100D � <br /> LAUNDHY TRAV � WATER li[�TEti ; <br /> CLOTHES WASHEfl � WOOD Sl"OVf: i <br /> URINAL ' METAL FIRE?LACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE�NSERT � <br /> —�— <br /> FLOOFi DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ' <br /> ROOF DRAINS—R�INLEADEF,i � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; 1 <br /> � <br /> , �' T <br /> 1 1 <br /> 1 I <br /> 1 1 <br /> I 1 <br /> SUEITOTAL S ; SUBTOTAL $ ' <br /> PEFIMIT S � PERMI7 E i <br /> T0T4LFEE S TOTALFEE t ' <br /> FRONTSETBRCK R[�RSETBRCK SIDESEIDnCK PUNCHECNNUMBER fEE AECEIPTNO. <br /> usemNc_ torav�n vnCnHrsne FEES VALUATION FEE <br /> I 1 VES ( I NO PUILDING � <br /> TYPE Of GONS!ALLOV/RBIF 7vPE Of l'ANST�LNAt �'G r�.r no n vmeuxG uxits �-- <br /> PLUMBING � <br /> i <br /> SVEOFBLDp. NO.OFS'OpIEB B�SF.M[NT MECHANICAL � <br /> I I VES I I NO � <br /> OCWPANCYLO�D FlRE6PRMSLEBSREO'D HEIGNTIIMIT�ilOt1 OTHER � , <br /> i <br /> �l YES I.I NO STATE BUILOINO SU(iCHAflGE �� I <br /> REASON fOR SPIi�NNLEfiS — � � <br /> $TATE ENERGV SUFCIIARGE i <br /> nrrucarroNnceev rur+snrrnovFoev CITYOFEVERETT PUBLICWORKS � <br /> LOCAL SALES � <br /> TAX CODE IS 3105 TOTAL ��, <br />