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APPLICATIO... FOR CONSTRUCT�JN PERMIT ''`'`'"'" <br /> ,,,,�_ �.n,,•,�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> Urvor <br /> _—_ <br /> ----_—� <br /> _-- i <br /> y p L� . J GAS J ELECTRIC J . <br /> � C'� BUILDING UEPARTMFNT HFATMG SYSTEM: <br /> O 7c1� - 259-8810 � <br /> > y m DEMOLITION COMBINATION J�-BUILDING _ MECHANICAL_ PLUMBING SIGN <br /> C� <br /> ��� �.�/h;��Es � C��ira� 77�� E, �i/�i//�'� r��,/ E�'ErT ;y j��iq <br /> � <br /> f]� II.NPNi MHL��ORE55 Uiv IIP GNONE <br /> ��� �� _ <br /> AR IIfEC10ROE51GNCR MIII ADUR65 GLY ZIV� P��ONF <br /> CyC Z� ��3 1'1 f� �� -J1LLz -- <br /> tj� �� GENfG�yi!ONiRAC10f1 AIL AppRFSS CIIY ZiV PN�iNE LICENSE/� <br /> �°ro g !/o,yFr-�rYv J�,eD7//�,Z'< �t�.�. �lF/�TTz-F $�/�s y�� r/�slsci�uJ <br /> MEGN�NICQGONIR�CTOR M�II�DDRE55 CIIY T�� PMONE IILENSE� <br /> n� o <br /> � y� PWMBiNGLONiB�CiOR M�a���RE55 Ciiv liP PHONE LICENSE� <br /> ~ C1�v50FWONN <br /> �y <br /> d N f-'NEW � ADDITION ALTERATION FEPAIR DEMOUTION WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br /> � � - COrylAC1P[q$ON�NOPHONENO <br /> CONiR�CiPRIf[OI WORN s <br /> � �LS BCWOnKeND50��R[lOOI�GEMVOiVEO <br /> '�v, �T/�//t�/.t'/l li/lJLL � Fearo,rr+v,J — <br /> rAoroseouseoveuamHc � I HERFBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �� ��d� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �ccuocscnirtror+orrnovenrr�,nowNne�owoae�uo�rounco�irs� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTNISTVPEOF <br /> WORK WILI BE COMPLETED WITH WHETHER SPECIFIED NEREIN OR <br /> iot niocK oF _ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GWE <br /> AIITH(1RITV 7f1 VIOI ATF f7R f,ANf.FI. THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTflUCTION OR THE <br /> PERFORMANCE OF CCNSTRUCTION.THAT I AM AUTHOR12E0 BV THE <br /> OWNER OF THIS PROVERTY TO PERFORM 1�HE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRAC LA 1027 RCW AND 296200 WAC. <br /> sicr�eru r . t ioHonnurooaizconcrr+r oerc <br /> ira� -y� <br /> PRO�EC1eD�PF55 � ���� '- - <br /> '�1 ���5 L l � ��' �� 1i501Y9U5ME55LICENSENO�NOBU51HE55K�MC <br /> �Z//LJ 1 <br /> PLUMBING MECHANICAL <br /> '�' NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C-A�HNDLG UNITS-h.P <br /> '�1 _ BATHTUB FORCED AIR SYSTEM=-B.TU. M E.A. _ <br /> ' ' LAVATORV IWASH BASIN) UNIT HEATERS-B.TU. M _ <br /> � SHOWER CLOTHES DRVERS <br /> KITCHEN SIP'K 8 DISP VENTILATION FAN _ <br /> ' ' DISNWASHER F4NGE HC�D _ - <br /> 1 ' LAUNDRVTRAV WATER HEAiER _ — _ <br /> � CLOTHES WASHER WOOOSTOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> ' DRINNING FOUNTAIN _ _ FIFEPLACE INSFWT � r, <br /> -�-- <br /> ' FLOOR DRAIN _ HEAT PUMP <br /> DACKFLOW PREVENTERS GAS PIPING <br /> � ROOF ORAINS-RAINLEADERS EXHAUST FAN __ <br /> ' SINK ISER�ICE-BAR.ETC.) <br /> �I <br /> '�' ____ T <br /> SUB TOTAL 5 SUB TOTAL $ <br /> �' PERMIT 5 _-__ -- PCRMIT 5 _ _ __ <br /> � TOiALF@E $� TOfALFEE S <br /> FOR OFFICE USE ONLY: <br /> TONISE1pp�C�N HFPIISNOn1�N 51[]PtiPbAf,K �lANC11Ef,MNUA1flFR II! ��FCCIPiNO `• " <br /> V� � , � - <br /> us� vyt� ioren[� wceNlvtE FEES ''/�WATION FEE <br /> l�-1 �3 �lSsa.� �/D ouao�Nc [p3 � ll'v <br /> i,rirncoHisAuowenit nrrorcaNsienuu �Kc;n�,.. ,�av�„�,"���,��s .__--- — — -- _ <br /> cPL"" � PLUM�:lIG <br /> SVt Oc BLOG NO OF SiORiES BASEMENi MECHANICAL <br /> p(rUP�NCVWAD FlnESPnKrcLERSn[OU NEIGNiyyALO�iION ADDIT:ONALPUNCHECN — � �U i 5 �j <br /> i%" y OTHEP <br /> HIASONfORSPRINNLEPS ----- - --- -- -- --" -...—T- <br /> I STAT[BUIIDING SURCHAf1GF </�j O <br /> __' ____' _- _"" _—__—_�_-" . <br /> __ -- .. _ _.___ .. . __ i <br /> ��o..c er vuNs�aanpvro a. CITY OF EVERETI PUBLIC WORKS I <br /> � ���� LOCAL SRLES � � � �� <br /> TAX COOEIS 3705 Tor�� <br /> f <br />