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- - � <br /> Af�PL1�AT10N FOR CONSTRUCt .JN PEE1MIT everett <br /> Me Everpreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CI7V OF <br /> everett HEATING SYSTEM: ❑GAS O ELECTRIC ❑ SP�/N�C.-�=.P � <br /> BUILDING DEPARTMENT <br /> 7.59•8010 <br /> DEMOLITION COMBINATION BUILDING DC MECHANICAL ! PLUMBIN(4 SIGN <br /> OVMEP M�II� .-- CITY 21P <br /> C7i�i�✓� (S.tCCJ PNONE <br /> /� .%�u�/• GAti�vO ?O €'v,��Cl7T TB,Zoy 75�.f .2375/ ^ <br /> 1ENINT M�R�DDRES t ..Tc fZ -I' <br /> CITV 21P p�E <br /> T3qt=/� /Ee/��vKOGY � �✓ ��/S�NO .�0 7� <br /> �RCNITEGTORDESIGNER MAIL�DDRE55 ��7y zip P.�E — <br /> OENERALCp/TMClOR MAN�DURE55 CITY ZIP PhONF �If,EN4E1 <br /> MECMNIILQCANTR�CTOR MARADORE55 CIlY ZIP PIqNE LICENSEt <br /> lR/�/NE/.G 26/r W. GJsi,yO - 3-P �t�L�T�c�7-' 9e�sY 3tS 3C// ciKi.v�vFPi37tE <br /> PlVA181NO CONTRICTOR MAIL/�pDNE55 CITV 21P FIIpHE LICEN9E� � <br /> C1A550F WJ11K _ <br /> � �� NEW ' , ADDITION X qLTERATION . ' REPAIR , DEMOLITION i. i WOODSTOVFJFRPL INSERT ❑ BUILDINO RELO'JATION <br /> COTNTIICT PERSON ANO PIIONE NO. <br /> CONTR�CT PRIf,E C�F WORK � �� y� I 3.t.f=3�11 <br /> DcSCRIBC WORK�NU SOU�PE F A6E INVOIVED <br /> -2,700 %E.viJN .T/JsPlzC✓. <br /> PROP(15EDUSEOFBUttD �`^��L (28 NEitoS I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> WI/SE�� � APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEQ�LDESCRIPTqNOFPRpPERTY�SHOWNBELOWOR �CHFWRCOPIFs'� PROVISIONSOFUWSANDORDINANCES60VERNIN� (HISTYPEOF <br /> �oT �aK � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR <br /> • NOT. THE aRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL UW REOULATINO CONSTFlUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWIJER OF THIS PROPERTY TO PERFORM THF WOHK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLV WITN THE STATE <br /> CONTHArTORS UW 1827 RCW AND 288200 WAC. <br /> __ SqNRNR[OFCONTRACi0f10R�UTIqRREDAOENT OQE �����/ <br /> X <br /> PHOJEG E55 � <br /> W G/qS/ti/O 20H 1� T3GOC� �8 r• scirveu �ceN ra,wo SINE9SNMIE <br /> vwMenro MECNANICAL <br /> NO. TYPE Of flIfTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> , WATER CIOSET(TOILET) � AI�AMNDLO UNIT&-H.P. , <br /> BATHTUB ' FORCEO AIR SYSTEMS—B,T.U. M E.A. � <br /> LAVATORV(WASH BASIN� � UNIT HEATERS--B.T.U. M � <br /> SHOWER � CLOTHESORYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHWASHER RANOE HOOG <br /> � <br /> LAUNOHVTRAV � WATER HEATER � <br /> CLOTru.S WASHF.F. � WOOD STOVE ' <br /> � <br /> URIN��L � METALFIqEPLACEBCHIMNEV i <br /> _ DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DHAIN � HEAT PUMP —,T— <br /> BACKFLOW PREVENTERS ; GAS PIPING �— <br /> HOOF ORAINS—RAINIEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � , <br /> _ � ; — <br /> � <br /> SUB TOTAL S I SUB TOTAL S (J ' — <br /> PERMIT S PERMIT S � — <br /> TOTAL FLE E ' TOTAL FEE S S� ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSEIB�LH RE�R6ETB�CK SIDE6ETB�CN PLANCHECKNUMBER FEE RECEtYTNO <br /> USE 20NE LOT AREA v�c�Nr sire FEEB VALUATION FEE <br /> BUILDINO ' <br /> fYFE01LONIS/�ILOWIiBIE iYPEOfLON57ACiU�I o[[�ouKr NnttpwRunpunn <br /> ��� PLUMBINa � <br /> 61ZE OF�D(1. NO OF STOqIES OASEMENT MECHANICAL � � <br /> i <br /> 7CCUP�NCV LWD LIRE fiPRNNlERS REOD HEIOHT lIMli�ipN ADDITIONAL PUN CHECN � <br /> OTI IER i <br /> REASON FOfi SPRINNLF.RS � <br /> � STATE BUILDINO SURGHAHOE � <br /> INt�REBY PL�NSAPPROVEOBY i <br /> ��J CITY OF EVERETT 1 PUOUC WORKS � <br /> LOCAL BALES F ' <br /> _ TAX CODE IS 3105 I TOTAL ; <br /> � <br />