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:"� i •VPfPI� <br /> l <br /> pP�PLICATIO�� FOR CONSTRUCT�JN PEA�MIT <br /> �n��ew„�,��„�� <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> citv oF —_-- 1 <br /> everett I HEATING SYSTEM: �GAS U ELECTRIC U _ <br /> BUILDING DEPAfiTMENT <br /> 259-Ei810 <br /> 5 n � _DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> PIIONE <br /> [a� MAILAD�RC55 UIV 2�� � � . 1 / ✓�1 <br /> ow [n 1 '��L � �S\�ILI � � G''C:r�f� � �7�C� ' t.•�'li`� <br /> ,o � k�s e-�,, ���(�.yT�.�'f'���C� L�`I 1 �'�_�..> <br /> � CITV 21P PMONE <br /> � ICNANI ��A�LAODRF55 <br /> N <br /> CILY ZIP PlIONE <br /> I-3 ARCIIRECTORDES�GNER MARADURESS <br /> � � __ <br /> y� H �EN[RALGONIRACiOF MMLrIODRE55 <br /> ��TY Z�p PNONE LICENSE� <br /> ���. Z�p PHONE UCENSE� <br /> x ECH�NICAI CONLRRCiOR MAIL FDD E55 <br /> l <br /> �Qy b ��C�1.-�c V�_ 7 1' �- vHor+e IICENSE• <br /> Q LI PLUMBiNGGONTMCTOR 1AARADDRESS <br /> CITV ZIP <br /> H � g <br /> �• n CUSSOFWORK . � <br /> x y� � � NENr . � ADDITION �ALTERATION . �: REPAIR ' DEMOLITION . � WOODSTOVE/FRPL INSERT �.- BUILOING RELOCATI <br /> LCNTALT PERSOH PNO PHONE NO. <br /> o� ���1��• <br /> H y �CONTIiACT PRiCE OF 1Y� '/�4:.J'-� ~ <br /> �J y <br /> O �� DESCNIOEWORNANpSOURIIEFOOTAGEIN\'OLV[D <br /> r� � 1�'�A1r� �/t���-r��'L�� <br /> '�" Paoroseouseocouaou+c I HEREBY CERTIFY T'iAT I HAVE READ AND E%AMINED THIS <br /> J ,�.. �\ ��� �.�v 4 , APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> y�y /` " PROVISIONS OF LAWS AND OfiDINANCES GOVERNING THIS TYPE OF <br /> �cc>�oe I 0'1�>FPBOPEPTVISHOWNOELOWORATTRCHFOUFCOPIES) yyORK WILL BE COMPLETED WITH NlHETHER SPECIFIED HEREIN OR <br /> ��r aiaK oF NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOIATE OR CAN�EL THE PROVISIONS OF ANY <br /> OTHEfi SL\TE OR LOCAL I AW REGULATING CONSTRUCTION OR THE <br /> PEfiFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR 1VHICH <br /> pPPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACiORS LAW 1827 RCW AND 296200 WAC. <br /> SiGN�TU�EOFC01ytP>CTORORAUTMORREDr1GENT DAiE <br /> _ X � ��;.�v� <br /> ��R F.Ci R�CSY-� (\��.[�j�� �(7 APPU ANT^CiTVOl15iYES5LiCENSL�'�w "NAM1IE <br /> � ���i'� �Y.r��l� L�'�lF�� <br /> MECHANICAL <br /> . . F'LUMBING FEE <br /> � � NO. TYPE OF FIXTURE OR ITEM FEE N�' a�_aHNDLG U�NFTS—H.p ENT <br /> ( C� WATER CLOSET(TOILET) <br /> FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � BATHiUB UNIT HEATERS—B.T.U. M <br /> 1 � LAVATORVIWASH BASIN) <br /> SHOWEF CLOTHES DRYERS <br /> '_� ' VENTILATION FAN <br /> L_t _ KITCHEN SINK 8 DISP <br /> i DISHWASHEF RANGE HOOD <br /> LAUNDRYTRAY WATEFiHEATEP <br /> � CLOTHES WASHER WOOD STOVE <br /> � METAL FIREPLACE 8 CHIMNEV ' <br /> j '_' URINAL ' <br /> � DRINKWG FOUNTAW FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> i � 1 1 _ ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> , SINK(SERVICE—BAR,ETC.) <br /> i <br /> ' ��' . <br /> SUBTOTAL 5 _ SUBTOTAL S <br /> ' PERMIT 5 PERMIT S <br /> � '-1�i — TOTAL FEE 5 TOTAL FEE 5 <br /> L� FOR OFFICE USE ONLY: <br /> F[CEIPT NO. <br /> lRONTSETBACK REAPSETBACN Si�ESETpACK PLANCHE!:RNUf.I[IEii FEE <br /> usezone <br /> toteaen vacnNrsrte FEES VALUATION FEE <br /> �uaoirvc <br /> iwEOiCONiSAIlOW�BIF i�'ttOfLON5TAG7UAL oc[p�vcr �.oIXMiwry,uv:n P�UMBIN3 <br /> Si2EOFBLDG. NO.OFSTORIES BRSEMENT MECHANICAL �_ <br /> i <br /> OCLUPRNGYIOAD FIPESPRNNLERSflEO'0 NEIGHTLIMITRTION <br /> ADDITIONAL PLAN CHECK <br /> OTHER <br /> R[450N FOR SPRINNLERS <br /> STATE BUILOING SUFiCHARGE <br /> iI�InKEF1V PUNSAPPROVEDOf CITYOFEVERETT PU�LICWORNS <br /> LOCALSALES <br /> �TAX CODE IS 3105 TOTAL <br />