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• � APPLICATIG'� FOR CONSTRUC7"°�N PERMIT everett <br /> x�F,s,o�,re� TO E5 COMPLETED IN INK—PLEASE PRINT � <br /> cirvoF <br /> everett n L�� �HEAiING SVSTEM: ❑GAS ❑ELECI RIC � F�EE -�iJLldi_i� <br /> BUILDING DEPARTMENT �1 � <br /> 259-8810 I,, <br /> I I DEMOLITION I I COMBINATION I I BUILOIN � ��f'�ECHANICAL �1 PLUMBIN(3 i l SION <br /> �1VMER MAL�OORE55 Cli/ � ZIP PIICNE <br /> - - �Mi�E(� �<�2rudz<,ii��.� , w� �F,•z�S C�,�c•) 3�- °sis'R <br /> TEN�Ni MML�DINIE65 . .LITY /� 21P ?HONE <br /> �' _ <br /> .�RCBilEGT01111E51O ER M�IL�D011 5 GfY 21A PIqNF <br /> �2Tenl F• fZC-�nl i Etz 11 I 6vC�E„�Hnu L.�v ��Ir f.Yr_1i .�JA- 9Ezc,3B (2e(,)3=I�t7cc <br /> 6CNERILCONiR�LTUN M�K�UDl1E55 C�IY 21P PIqNE LILENSEI (=���4,3_5�� <br /> m�lAnlf� t�QC- �2b'TCCf�cN.� t^'.G_ 3 _1543 V.�bt>Dln\V��Lc ,WC� 9S%r,�2 AWANF��eaB(o <br /> MEGN�NIG�LCONiR�CTOR MA0.ADORE55 CIiY IIP P/qNE �ICENSE/ <br /> -�._ _ <br /> PLUMBI OCONTf1AClOR MAM�UOAE55 GI1Y IIP PIIONE UCENSE/ <br /> CLASSOF WOIIK <br /> 'jU NEW f 1 AODITION I I ALTERATION Ll REPAIq I I DEMOLITION I 1 W060STOVE/FRPL INSERT ❑ BUILDINQ RELOCA710N <br /> �ONT�CT PEfi50N�ND 1'HONE <br /> CONTfUCTPf110EOFWOfIIf ��� ���• �L� � <br /> OESCOIBE WORR�NO Sd1�RE i00T�6E INVOLVED —� <br /> CC'M ' C-T FLRC-��FYLiNU�L 5 �� TC'(L IE CWTS _ <br /> rnoroseou;eoFeuaoiva I HEHEBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> L�V I I.IL? 'T�i.�2�-`�'E APPLICATION A�JD KNUY/TiE SAME TO BE TRUE:ND CORflECL ALL <br /> ieae�oescmrnowarm�remv�s��owr�ee�owon�irecHrauncoaies� PqOVISIONFGFLAWSANDORD�NANLE5f3bVERNINOTSfISTVFEUF <br /> WO�K �VI:L tlE COMPLETED WITH WHETHER 5PECIFIED HERE�N OR <br /> �or_ mocK __ a ._ NOT Tli[ GRANTING OF A pERMII DOES NOT PRESUME TO GIVE <br /> . AUIHCRITV t0 VIOLATE OH r,qNCE� THE PHOVI;iONS OF ANV <br /> � 'j OTHER STATE OR LOCAL LAW REOUL�]'llva CC�YSTRUCTION OR TIIE <br /> PERi-ORMANCE OF CONSTRUCTfON.THAT I AM AUTHORIZED 9W TIiE <br /> /"� (�1��� OWNER OF THIS PROPERTV Tn PERFORM THE WORK FUR WHICH <br /> APPLICATION IS MADE AMD I COM?LV WITH THE STATf <br /> �- CONTRACiOHS LAW 1B 27 NC\V AND 296.200 WAC. <br /> SqNATUFEOFG k�Ci4RORAUf IIEPAOENi D�TE <br /> ' ' x ��_ <br /> rpaecteoon/Ets�s � - 1 / � <br /> I . l./a5 ND �2 . �( "� h �P ANfSGTYBU5INE LICFNSE�q �N�B�, 11MIE � <br /> PLUMBINO ECHANICAL <br /> NO. TYPE OF F�%TURE OR ITEM FEE N0. TYPE OF L'OUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H P T— <br /> BATHTU� ; FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> _ LAVATORY(WASHBASIN) UNIIHEATfRS—B.TU. M ; <br /> SHOWER � CLOTHESDRVERS � <br /> KITCHEN SINK 8 DISP i VENTILATIC�N FAN ' <br /> OISHWASHER � qAVGE HWD —r <br /> LAUNDRVTRAY ; WATERHEATER � <br /> CLOTHES WASHER � WOOD STOVE ; � <br /> URINAL � METAL FIREPLACE 8 CHIMNEY �— <br /> DRINKING FOUNTAIN FIPEPLACE INSERT � <br /> FLOOH DRAIN � HEAT PUMP �— <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOFDR.4INS--PAINLEADERS � EICHAUSTfAN �— <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> — � J — � — <br /> . ` <br /> � , <br /> _ y_ <br /> � <br /> _�_ � <br /> � , <br /> SUBTOTAL E SUBTOTAL S ' <br /> PERMIT S PEHMIT S � <br /> TOTAL FEE S ' TOTAL FEE f �— <br /> FOR OFFICE USE ONLY: <br /> Ff10NTtiETB�CR NE�N^uLT&1CK SIOESE7B�GN PlNlCIIE�K uMBF. FEE�/7�j REJ'.EJqTJ�q.,� <br /> J� � � ��%L� <br /> �J • <br /> USEZONE LOT�RF� VAC�Ni517E FEES VALUATION FEE <br /> BUII.DING ; <br /> iTIR01G0111511L1OW�BlF tYP(Of�pN51AC11Ul rcauwx[r xnnlMl��n�cuNrtS - i <br /> r' �• PLUAIBING <br /> �'' � +� 7�- � 1t'fZ � �n�a1t�>— � — <br /> SIZEO�FyPLI0y0� N�OFSI(NIIES BSEMEyN7/�� MECNANIGAL � <br /> U/�WIC/'� �Z !lj"J — � <br /> occUru+G LO�O FIRESrRNNlER5nE0'D NEaNfuMlrelpN ADDITIONALPLANCNEGK �� ��., <br /> �Y/j- Y�� c� 1q <br /> RE�:iON fOR SPpINdIEfiS �'`� ''�~.I� i' - ����_ <br /> (�j'�G��N��� STATE OUILD d SURCHARGE � <br /> �M�ME Bf M�NS�PPf10VE0 B/ CITY OF EVERETT PUULIG WORKS � <br /> LOCALSALES � <br /> IL> jZ l�y J/V� TIU(CODE IS 3105 rota <br />