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/�PP`.1�'.�1�'IONI FOR CONSTRU�`TIOL� Pl� C���nc� <br /> E3MIT � <br /> 1M Ewproon TO BE COMPLETED IN INK—PLEASE PRINT <br /> GIiY OF <br /> everett r F{EATIN(3 SYSTEM: p�AS' O ELECTHIC U <br /> SUILDING DEPARTMEN7 <br /> 259-8810 <br /> l i DEMOLITION U COMBINATIpN C?I'BUILCINQ L.I MECHANICAL f.7 PLUMBING ['J SIGN <br /> OWNEII IMIL I100nE55 P��F -. <br /> �ITY �p <br /> P.P O�L _ 33305 F,asrWYS. FEceeq�- bVAr 9Boo3 874 -75/y <br /> RHMII MA0.ADDflE66 .� . • GTY � 21P v11DNG <br /> � $ /'� DIL S�- As ,�9�F <br /> lRCNITFCTOqDE510NEH M�LL11ppp�35 G�y =�p p�t <br /> P�.K•N. inc. 2ct�lMiNo�eA✓E• E. S�ATTLE 96/oz 323- �/44 <br /> �^MF�CONrnncion AMt�oRGsa �,�/ PlWNE ICEN6E/ " <br /> (SRr�car`fz_. Qio.,�Mc/ 7�0� ��S��yl� (XOa�v p�.c� 9�a9a �j ��3_� <br /> MECNN/1CILLCONIhACTOR MARJ10DI1ESB CITY ZN PNON6 UCCNB[� <br /> MLUMBWOCONTIIK.TOR M�RAWIIf9! � CT' !1P PHONG � LICGNCG• <br /> Gldf.G Of WORK '� _.•..•.•_ <br /> � I NEW f 1 ADDITION LN ALTERATIDN I�1 REPAIR T C� DEMOLITION 1 I WppDSTOVE/FRpL INSEfiT I-I BUILDIN6 REIOCATION <br /> �+�, CONTACT i'!IIlO�N tI�No,.1'.M,O�NE N0. �/� <br /> coN7nA0TPHICEOFNOnM�Ov ��0 .�/M f7►7RKI.riOA� .�z.�' ���I�y ._. <br /> OEBCflIBEWpM(11Nt16p1111REtOOT110EWVOLVED �Im/]�j(� �(y�pPy —_ <br /> wsfou. sT�wE'II.JnPo�z RCc.��"�4 ��yES� �,,� �oar��(�"S <br /> rnonocFouscanun.oiNo I HEREBV CERTIFV THAT I HAVE READ AND EXAM�NED TMIS <br /> �j'.4ML- q5 EjC/ST APPLICATION AND KNOW THE SAME TO 9E TfiUE AND CORRECT.ALL <br /> LFO�� DE6CRmTION W�IqPEpry(SHpWNpLIpWOR�TinCMFOu1100p1kb� PROVISIONS OF lAWS AND ORDINANCES QOVERNINO TNIS TVPE OF <br /> ioi, o�ocK oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEqEIN OR <br /> � NOT. THE OPANTIN6 OF A PERMIi DOE6 NOT PRE6UME TO OIVE <br /> �� SEE f}T%.a C 1�Co Lct�+g�G aFSGeIPr/aN" O7HER STAiE OR LOCAL U1W EGULATING CONS pIUCT ON OR THE <br /> PeqFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZEp BY TFiE <br /> OWNER OF 7HIS PROPEpTY TO PERFORM THE WORK FOR WHICH <br /> '•- APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �� �,�T NQ n COHTRACTOHS LAW 1827 pCW AND 296z00 WAC. <br /> _ ����� /�2'Q� "Q�O� 610NAiUflEOFLONTMLTpiORAUTIONIZC��GCNT DIRC <br /> 3027 Bza9owqY �P-�7T wdsrs,Nr Ta,v X • <br /> �naECt�DDNE65 ` � I ��LZ •�jZ <br /> APPL TYO 1 IICENSENO.l11N0USWESSNAME <br /> PLUMBINO ME AL <br /> NO. TYPE OF fIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLObET(TOILEn � /V�A/HNOL6 UNITS-N.P. , <br /> BATHTUB _ � ' FORCED AIR 6YSTEMS-B.T.U. M E.A. ' �i <br /> UVATORV(WASHBASIN�.� � UNI7HEATERS-B.T.U. M ; <br /> �_._.-..._ <br /> SHOWFR , � CLOTHESORVERS —�- <br /> KITCHEN SINK 8 DISP � VENTIUTION FAN � <br /> __ DISHWASHER � � i ��E H�p "- � <br /> LAUNDqVTRAY ' VyATER HEATEq � i <br /> � CLOTNEB WA6HER � � WOOD STOVE ; <br /> _ URINAL � METAL FIREPLACE d CHIMNEY T- <br /> �RINKINO FOUNTM � FIREPLACE IN3ERT - ; <br /> FLOOR DMIN/� � HEAT PUMP —�— <br /> , flACKFLOW�RF.V6N1"ER8 � OA6PIPIN� � � <br /> ROOF DA)11N5-RAINLEADERS i EXHAUST FAN , <br /> . SIN SERVICE-BAR,CTC.) � , <br /> _.. ._._�.- i � _..- <br /> � <br /> _.._._ ' � <br /> ,.- � ...._ i <br /> � , <br /> � � <br /> SUBTOTAL S i SUBTOTAL 5 ' <br /> PERMIT S � � PERMIT S � <br /> TOTAL FEE S � TOTAL FFE S � <br /> FOR OFFICE USE ONLV: <br /> FNONi6EiB�CN NC�IISETBI1p( 610ESFTfl�CN �IApCHECKNUMBEP FE! REC�IPTNO.�� <br /> � /S i7�/G— ' / , <br /> u5k2arF toTnnu VACAHf3rrF FEE6 VALUA710N FEE <br /> N� <br /> - ( BUILDINO ��e� cC' s-� ,�� <br /> iYVEO�COM6.�ilOwnol[ tYPkOtCONSLIiGNAI omnwcr �o.Hoxc McuMrt� —L+—.�— <br /> �'�J �—N �j�If'y„1 � _ � PLUMBINO � <br /> �F��2�7�C��1�� �.�910flIE6 B SF.A1�v MECHANICAL .. . _"_�— <br /> oLCUP�NCVLOM F�a[avR�NKuLEnsREOv HEIGHTlNi7�7i0�1 �DITIONQPIANCNCCK � <br /> 3 �w OTHER i <br /> pC�SON�oR3!'fllNKlfNS • — —�— <br /> 6TATE BUILDINO SURCHRRG[ ;_{'D <br /> INT{J(GOY PUM6���VEDBY CITY OF EYERETT PUBIIC WOnus .�� <br /> LOCAL SALFS <br /> 3/�/l�t, �f(�- 7AX CODE IS 9105 �u� /f � � '�i a <br />