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APPLICATIOr�i fOR CONSTRilCT�N PERMIT e"e�e« <br /> ,,,��,�,9,�„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cnv oF <br /> everett HEATING SYSTEM: �j GAS ❑ELECTRIC ❑ <br /> BUILDING DEPAFTMENT — <br /> 259-8810 � <br /> DEMOLITION COMBINATIO�1 �BUILDING MECHANICAL pLUMBING SIGN <br /> OWNER MRILADG�.ESS CITY IIP PMONE <br /> �{/'/'I. /�vun� � �%��� 1i✓c. .?,7/7 /'r.c.v�i.ra`f E�e�r7T , � 5's zd / <br /> iENFNT MAILADDFE55 LI 21P PHONE <br /> .S�7�lG <br /> FRCHITECTORDESIGNEF MRILADDRE55 CITY TIP PNONE <br /> N�C c C'�eol.'C . /'/A. /G Sr,$' .$'tE�G7 Sn.cN�s�is 9�i9d �C� -�3 i/ <br /> GENERALCCWTRACiOR MAILqDDPESS dTV ZIP PHONE LIGEN Et <br /> Gnc r �u,viJP,f�G : � � . 9ao,vE �`0s� S rrrc !tiA �l�i�s s,� ��/ ,r� r�c�a�c s <br /> MECNAM.CAI GONTRnCTOR M(AIL AOD E55 CITY IIP P NE ENSE� <br /> PWMBMGCONTRACTOR IA�ILADDRE55 GTY IIP PMONE LICENSEt <br /> CUSSOF WOPK <br /> NEW �xADDITION X ALTEAATION �. REPAIR � DEMOLITION . WOODSTOVE/FRPL INSEFT � �. BUILDING RELOCATION <br /> GONTAGT PERSON RND GMONE NO. <br /> GONTqAGTPqICEOFWORK � SO �iOC� CL �j�E `�%n/ �j .�� , - C � �4 <br /> UES.^.RIBE WONK�ND SOUnRE FO0IFGE INVOL EO G <br /> %� /IN" ���i'��c x-�.r O icc i�� ,tr - Z1vG - GA�eY [u,voP,c->'y <br /> aaovoseouseoreuaou+c � I HEREBY CERTIFV THAT I HAVE READ AND CXAN'NED THIS <br /> Of�'/�E�{vi}-�'�f/GdS�" - ti%'lCLCSAZE v"T/G-hJ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> icca�oe FIPTIONOFPPOPlATVISHOWNBELOWORATTACH.ouneories� PROVISIONSOFLAWSAhDORDINANCESGOVERNINGTHISTVPEOF <br /> �7 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OFi <br /> nT �' �O eioee �f�9- ov r - ��E NOT. THE GRANTING OF A PERMIT DOES NOT PRESL'ME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANV <br /> OTiiER STATE OR LOCAL LAW REGULATiNG CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTFUCTIO�I THAT I AM AUTHOFIZED BV THE <br /> OWNER OF THIS PROPERTY TO PEf1FORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.2�0 WAC. <br /> SIGNAIURBOFCONTRA�TORORRUtHORIZE��GENT DATE <br /> X /'�f' � J �^ <br /> PROJEGiADGR/EJ5�5r-wn �," ! '�s . � �� // � <br /> aa�7 „Fc�/v/��-"� `/��T% ��/!y APPLICAN CiTVB�51NE55 ENSENO ANOBUSIN [ <br /> �i�-. <br /> PLUMBING MECN[.NICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—lVHNDLG UNITS—H.P. <br /> BATNTUB FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> ,2 LAVATORY(WASH PASIN) UNIT HEATERS--B.T.U. M � <br /> SHOWER � CLOTHES DRYEfiS <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRV TRAV ; WATER HEATeF <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL ' METAL FWEPLACE 8 C EY <br /> ' DRINKING FOUNTAII FIREPLACE INSERT ; <br /> FLOOR DR�IN / HEAT PUMP i <br /> BACKFLOW P VENTE(75 GAS PIPING ; <br /> ROOF DRMNS—RAINLEADERS E%HAU AN <br /> SINK(SESiVICE—BAR,ETC.) ; <br /> � , <br /> SUB TOTAL S ; SUB TOTAI $ ' <br /> PEflM1T $ � PERMIT $ <br /> TOTALFEE $ TOTALFEE $ <br /> FOR OFFICE USE ONLY: �� <br /> FRONTSETBAGK REANSETB?CN SIDESETBACK PIANCNEG NUMBER F[E RGC[IPTNO <br /> � � !O � p' 90 a Goa � � `1�. `/3 / 9.2 .? <br /> use m ior nnen VAGANT S:TE FEES VALUATION FEE <br /> I / r.. <br /> — f bOCX7 /�o eui�ou�c d�8°`' °�' � <br /> rvr�arr,ar�isnuov�mi[ ivr�nrcor�sir,crua� acnrav-. nooro�m,uucuxns fBSL—_ _Z��-gl�• —�rl�� ��_ <br /> V_ � °a00�� l— PLUM�ING <br /> —�_ <br /> 52EOFOt�G NOAFSTORIES BASEMENT MECHANICAL i <br /> �27 F A-Ya� � Na ; <br /> OLCUPANCYLOR�'r� FIqESPRNK�ER5RE0� HEiGHiUAIIIA�ION ��DDITIONALPLANCHECN � <br /> � �`�� �� OTNER i <br /> REFSON FOR SPRINKlERS � <br /> STATEBUILDINGSURCHAFCE ..� �s'7� <br /> INIAKE BY P�ANSAPPROVE�BY CITY OF EVERE7T PUBLIC WORKS � <br /> � LOCAL SAIES —�--�— <br /> TAX CODE IS 3105 TOTAL / 93 �7 <br />