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APPLICATIG J FOR CONSTRUC7_JN PERMIT �'��'��'" <br /> rn�c�n��-��i•� TO BE COMPLETED IN INK—PIEASE PRINT � <br /> cin or <br /> everett HEATING SYSTEM: U GAS ❑ELECTRIC J ___ ._____ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> � ��+ DEMOLITION COMBINATION BUILDING MECHANICAL f�PLUMBING SIGN <br /> OWN[H �Ahp nppq[55 Gliv 11P PHONE <br /> �p � _�� 2rl�if'cdr a.,�o;i 3loZ 3rCoFfw c. Cli��+�TT 9S' zo/ 25 Z - 31�� <br /> � y y iC�i�Ni MAILADDPE55 GITV , ZIP PHONE – <br /> y�� � r�iV ]IP VNONE <br /> AR HiiCCif,d1�6�S1EN M/.LL�DDPESS <br /> K y �, � Fr��,,.�,e Cr�c� i f-c ��s � z e=Y � e•ettt� Sv �s;,�/c%.t� 9�03� <br /> C:LNCiiALC011TFRGTOH AIA�IADDRE55 CIiV 21P VNONF IICENSC� <br /> �yH c _ <br /> �(� CO�I s�. t 'A�tL Q o �ax U9c�gz .st_cYt; u.N. Ydiy� <br /> F] Mf GMANICAI CONiRnC10R MAII�q0�[c5 GITY ZIP PNONE ��CENSEI <br /> ��� S�Kl�i u P � b�a l�(�� �z M�' lU w a wbt�R.w �'800/ 87t��/aS'3 _ <br /> ��uMBMGCOt1iFAGTbR M4ilApDRE55 ��T� Z�P PHONE LiCE45E/ <br /> H <br /> SuNRfPli�o40p <br /> Q�� (:1n550FMIOPN -- <br /> M <br /> NEW � . ADDITION '. ' ALTERATION REPAIR �� DEMOLITION . WOODSTOVFJFRPL INSERT � � BUILDING flELOCA'(ION <br /> 'y F] CONIAGTPERSONANDPHONENO. <br /> r� <br /> M H ::CYTRAGT PqICE OF WORK <br /> y D[SCqiO[WORN ANp SOUPRE FOOiRG[INVOIVE� <br /> H � <br /> ��y � ��,,,���k�, , � add�t��� <br /> �''' ;nov�oscous--coreua�i� I HEREBV CERTIFY THAT I HAVE READ AND ERA�dINED THIS <br /> y� ��1'r<y�_ APPLICATION AND KNOY!THE SAME TO BE THUE AND CORRECT.ALL <br /> H O p� l@4l0ESLPIPTIONO�PPWCflTYI$NOWNBEIOW OR�Tt�CM FWRCAPIES� PNOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED NEREIN OF <br /> �ot BIOCN ov NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIOIJ OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> � ' OWNER OF THIS PROPERTV TO PERFORM iHE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />- � CONTRACTORS LAW 78.27 RCW AND 296200 WAC. <br /> � SiGNAiUREOFCONTRRCTORORAUi�iOH12EDhGENT pATE <br />' � o � �3 � o0.dw� X��,�� �a-��-qd <br /> PROJF.CT A�Da[55 — <br /> APPLIC�NiS CItY BUSwf SS I�CR+SE NO RN[J 9USRlE55 NRME <br /> PLUMBING MECHANICAL <br /> ' NO. TVPE OF FIXTURF OR ITEM FEE NO. TYFE OF EOUIPMENT FEE <br /> ��� WAT[R CLOSET(TOIL@T) A,'�A�'HNOLG UNITS—H.P. <br /> � ; BATHTU� FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> 1 , ='Z LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> � SHOWER CIOTHES DRYERS <br /> ��, KITCHEN SINK 8 DISP VENTILATION FAN <br /> I � DISHWASHER ' FIANGG HOOD <br /> LAUNDflV TRAY � WATER HEATER <br /> CLOTHES WASHEfi WOOD STOVE <br /> URINAI METAL FIREPLACE 8 CHIMNEY <br /> �� _�_ DRINKING FOUNTAIN FIREPLACE II�SERT <br /> � FLOOR DRAIN HEAT PUMP � <br /> i BACKFLOW PREVENTEFiS GAS PIPING <br /> �'� ROOF DRAINS--RAINLEADERS EXHAUST FAN <br /> � ',L SINK(SERVICE—BAR,ETC.) <br />- �� ' '�1`'. SU�TOTAL $ SUB TOTAL $ <br /> ' PERMIT $ PERMIT $ <br /> TOTALFEE $ TOTALFEE $ <br /> 1�� FOR OFFICE USE ONLY: <br /> --- - lRONTSEI�4GN RGRRFETBACN SIOESETBACN PLANCNECNNUMB[R PEE RELCiPiNO <br /> use zorve LOI AREA v�owt site FEES VALUATION FEE <br /> BUILDING <br /> TYPEOfWNiSAIIOWABtE iYi'EOfGONSt.ALip�L Oc[vnx!v MOwMhuix4vvn5 <br /> ,1 ' °R�° PWMBING uo� .� <br /> Q~ <br /> �2� � �. SIZEOF6L00. NO.OfSTOPIES BASEMENT MECHANICA� �I � SO <br /> =�:��..'.'_'��.. . . <br /> � OCCUPANGY IOAp FIRE SPpNKLERS PEO'0 NEIGHi LIMIT�TION ADDITIONAL PLAN CHECK <br /> OTHEfl <br /> RERSONFOPSPRINNLERS �-- <br /> STATE BUILDW�SURCHAFiGE � <br /> INtAKEOY PLANSAPPRO�'ED9V CITYOFEVEflETT PUBIICWORKS <br /> LOCALSALES <br /> TAX CODEIS 3105 TOTAL <br />