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—� � <br /> APPLICA7 .JN FOR CONSTRU�. t10�� ����M1�1� I �1 <br /> UL ' <br /> ,r � � r ,..,,- .—. everett <br /> F .-_. . � . �,�i, <br /> r���t,-�,�.PF.� <br /> cirv or <br /> everett EVERETT BUltnlNG DEP <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> �� '�' DEMOLITION COMBINATION BUILDING MECHANICAL _ PLUNIBING SIGN <br /> uW�uF C�`0��� MMIADDRE55 GILV ZIG �'MJNE <br /> v� ¢ �nRay e�rtrrw- 3 �1l /d�������ey 6�.�R��s s�ao� a Sa - 7s �y <br /> �'+ M -�t r� AU�pODRE55 J �J ITY ZIP PHONE <br /> y� � � �.��`��zLi�S' � - <br /> �NCNREQOH�ESIONEA IA�ILPJ �ESS <br /> ITV ain n�ilNF <br /> O CG O �r.raEnni.ccrn � cm ��° � i���� <br /> y y H �512 SMITH ��!������ - <br /> MecNnwcuc ���QLoaess em z�;, rr�oHE uceusc. <br /> � z 3,35-b-s-6i <br /> rJ h. GITY ZIF ^HONE UGGNSC f . . <br /> Q N �WMBMGCONLRACTOR �InilpD�RE69 �� S � 1'.� <br /> � � g y � � <br /> A i r. - i <br /> �• n f1A550FWORN ' . <br /> �� 1 ^4 ��,�, �^r <br /> XNEW � �. ADDITION �.7 ALTEFATION REPAIR - . DEMOLITION �. WOODSTOVE/FRPL INSERT , : BUILDING RELOCATION <br /> ' `3� �/ T[NANT IMPROVEMENT OF IMER�OR PEMO�EL ONIY CONTAGT PERSON RND PHONE NO <br /> r" ri y /� S A'10 t.ta R A<smn 335 -d�s-a-� <br /> �y - ` CONTR�CT PR CE OF WOH1t: / <br /> M CiESCAIBEWOPNR1�50UA�EFOOT�fiE�NVOIVED 70�n� ���'�� 3 ���' <br /> �G v' - > �V / S, — l D Si r N �8'�i !!7� <br /> [�f t" vnoaoseouseov �LDING I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> y� APPLICATION AND KIJOW THE SAME TO BE TRUE AND GOFRECT.ALL <br /> H O f/� �EO���q�piwrypppqppERTYISHOWNB[LOWORATTACMFWRCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �pT etncK o� NOT. THE GFlAWTIIJG OF A PERMIT OOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AIJY <br /> OTHER STATE CR LOCAL LAW f1EGULATING CONSTRUCTION OR THE <br /> PERFORMAIJCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PPOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPIV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 2962001tiAC. , <br /> SiGNRtUAEOFGONTRACTOROHRUTHONREDRGENT OAfE <br /> __ /�CL N�c,N� 7�y�vf iNG <br /> X �L. ��.�u-,�•.-- !$is S <br /> �A�,E�,RL:,�E55 p ,/ —— <br /> � ya l �YI C+�����7 APr���A��TSG USIIIF 3UCF1lSE NO AN�9USIN[SSNAME <br /> PLUMBING MECHANICAL <br /> � � NO. TYPE OF FIXTUFiE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> I �� WATER CLOSET(TOILET) A'C—A/HNDLG UNITS—N.P. <br /> � � BATHTUB FORC[D AIR SYSTEMS—B.T.U. M E.A. <br /> 1 � LAVATORY(WASH BASIN) UNI"f H[ATERS—B T.U. M <br /> SHOWER ' CLOTHES DRVERS <br /> ��' ' VENTILl+TIONFAN <br /> KITCHEN SINK 8 DISP � <br /> � DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY � WATER HEATER <br /> CLOTHES WASHER WOODSTOVE ' <br /> URIIJAL METAL FIREPLACE 8 CHIMNEY ' <br /> � �►� FIREPLACEINSERT <br /> � DRIIJKING FOUNTAIN <br /> FLOOR DFAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> '�' ROOF DRAINS—RAINLEADEFS EXHAUST FAN <br /> �� SINK(SERV!CE—BAR,ETC.) i <br /> i <br /> � <br /> . '`0+1 SUB TOTAL $ SUB TOTAL $ <br /> � PERMIT $ PERMIT $ <br /> '� TOTAL FEE S ' TOTAL FEE $ —�— <br /> ��►' FRONTSE1BArK AEA'iSETBNCN SI�ESETBRCK PLANGNECKNUMBER FEE AEGEIPTNO. <br /> � �� �� <br /> USE20NE iornAen wcu+76rt¢ FEES VALUATION FEE <br /> �� ❑ VES ��� BUILDING � J � <br /> ME 0�LONSi�IIOWABLE iYPE Of CONST AC711Q ����� No.p oMums w1u5 <br /> �"a° PLUMBINO <br /> � <br /> SQEOFBLOG. NO.OF6TORIES BISEMEN7 MEGHANICAL � <br /> i_1 YES ! �: NO ; <br /> OCCU�ANCVLO�D F�RESPiiKKlEPSREOD HEIOHTLIMIT�110N OTHER ' <br /> Ci VES ❑ NO ' <br /> STATE BUILDING SURGHAFGE � <br /> aEASONFORSPRMKLEHS � <br /> STATEENERGVSURCHARGG � <br /> ni-PIIGATI(N�CGBY PlANS�VP�DBV CITYOFEVEREiT PUBIICWORNS � <br /> t LOCAL SALES /� � <br /> TAX COOE15 3105 rora� , <br />