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APPLICATIbN FOR CONSTRUC'r-iON PERMIT <br /> - � everett <br /> �E���� e <br /> cm oF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE FR�VT <br /> 259-8810 <br /> �DEMOLITION I 1 COMBINATION f I BUILDING i I MECHANICAL I I PLUMBING ❑ SION <br /> "bEST/E�lii�ilON�+s'•L o�ess�BOX 90B .�D���SA� zl�t�! 56fS'��lff <br /> hNµT M�R�DDRESS CITv ZIP PHONE <br /> �BM,r' 9/�f E• !'i!S/NO EI�eC?l W�9 915203 <br /> �RCNRECT011DEBqNER M�1L11UGHE55 CITV � IIP PNONE <br /> OENEHALCON7N�CTON M�6�DOAE65 CI�Y 21P P110NE LICENSE/ <br /> YECN/JlICALCONTR�CTOII M�R�DPRF55 CITv ZIP PNONE LICENSE� <br /> P.UMBINOCOBTRAGTOR M�R1100RE65 FIIY ZIP PHGrE LiCENSEI <br /> IXA88 OF N"7111f <br /> ❑ NEW fJ ADDITION � I ALTERATION I � 17EPAIR �DEMOLI710N I I yyppDSiOVE/FRPLINSERT I I BUILDINOflELOCATION <br /> TEN�WT IM/qOVEMENT OR INTERIOR REMODEL ONIY GONt�CT^EfiSO�N��N/O PMOHE NO <br /> CONTR�CTPPICEOFWOPK: _��`TIi�/�. Sb8'' 758y _ <br /> p[CCRIBE WORK�N08dUNE FOOt�OE INVOLVEO <br /> �nopos¢�use�tio��� ���` �,�>SF 1 HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> � — �� ��Q (��'jTj APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ��pwp[ppp�piqNpiPROPEPTv�81qWN8ElOW011�TT�CHiWRCOPIE9� PROVISIONSOFLAWSANDORDINANCESQOVERNINOTHISNPEOF <br /> WORK WIIL BE COMPLETED WITH WHETHER Sf'ECIFIED HEREIN OR <br /> �oi ��K � NOT. THE ORANTINQ OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> �l��l,� _ OTHER S"fATE OR LOCAL LAW REOIILATINa CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTIQN.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF iHl3 PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND � COMPLV WITII THE STATE <br /> CONTRAG�ORS LAW 1827 RCW A�JO 298.200 WAC. <br /> SqN�TURE OL CONT{I�CTOR OR�UiN71111ED AOENT D�IE <br /> PHO.IECTMDRE88 �pp�IC�NiSC�NE`85LICENSE(�'SI�NMIE //�/� <br /> 9�y E. C�+sr�v �earn ��l e <br /> PLUMlIN(i MECHANICAL <br /> N0, TYPE OF FOfTURE OR ITEM FEE NO. T�PE OF EOUIPMENT FEE <br /> WATEH CLOSET(TOI:ET) � A/C—A/HNDLO UN�TS—H.P. � <br /> BATHTUB ' FORCED AIR S'/SiEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' Cl0?HES DFYERS ' <br /> KITCHEN SINK 6 DI9P � VENTIIATION FAN � <br /> DISHWASHER � RANOE HOOD ' <br /> UUNDRV TRAY ; WA7ER HEATER '_ <br /> CLOTHES WASHER � W000 STOVE � <br /> UHINAL ' METAL FlREPLACE 8 CHIMNEY _ ' <br /> i_ <br /> DRINKINO FOUNTAIN i FIFFPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' <br /> _�_ <br /> BACKFLOW PREVENTERS ; dAS PIPINO � <br /> ROOF DRAINS—RAINIEADERS � E%{IAUST FAN ' <br /> � <br /> SINK(SEPVICE—BAR,ETC.) � , <br /> � <br /> � T <br /> I <br /> I <br /> 1 �� <br /> �. 1 I <br /> SUB 10TAL S SUB TGTAI S ' <br /> PERMIT S PERMIT S � <br /> TOTALFEE E TOIALFEE S ' <br /> FRONTBETBACN RE�B6ETB�GR SIOESEiB�CR PI.�NCNEGNNUMBER fEE RECE�PTNO. <br /> U8E ZONE LOi�RE� V�CAN7 SIIE FEES VALUATION FEk _ <br /> I I VES I I NO BUaDu+O ' <br /> IYPFOfcONSt/LLIOWMIF tYVEacONSf/�t1UAl aM�nt. MoaUNt�inauYi�i i <br /> a� PLUMBING i <br /> T <br /> g�ppg�pp. NOOF6TORIEH ��SEMEIIT M�:CHANICAL � <br /> I I YES I I NO � <br /> � <br /> OCCUPANCYIWD fIRESPRNkLERSREdO NE�OIIiIINIUtION OTHER � <br /> � <br /> I I YES I I NO STATEBUILUIN45URCH�ROE ' <br /> � <br /> RE�80M FOR BPRINItlER9 <br /> STAiEENEROVSURCNAROE � <br /> __ i <br /> �P%IC�TqN�GC.BY MANS�PPROVEORY ` f,ITYOFEVERE7T PUBUCWORKS � <br /> ILCf.AI SALES , <br /> TAX COf1E IS 310ti TOTAL � <br /> ,�, . . . <br />