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APPLICATION FOR CONSTRUCTE�9N PERMIT everett <br /> ,re E�ro�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> iTr oF <br /> everett HEATING SYSTEM: ❑GAS ELECTRIC ❑ � <br /> lUILDING DEPARTMENT <br /> 159-8810 <br /> ! DEMOLITION 1 I COMBINATION � BUILDING I i MECHANICAL I 1 PLUM8ING I_l SION <br /> �NRlER M�R��ORE53 CIIV 21P P�qNE <br /> � �,��uG �c, . PoB 3�10'> �rn; ��-76,S���t��, �✓n , 4F��v _zzo� �y�-oF7/ <br /> fN N M�R� OfiESfi ���� ��P ���E <br /> ��T'�d Gn. , l io l s" — Y 7�• /}VL� . (✓ , CJErLET , 1.J�}. 9�'t-u� ?1jc� •-9/'7�— <br /> �nc�mectoaoesbr�n M�K�ooness cnr nr r�ar�e <br /> �ENEN/�ICONTRnCTOf1 Y�IL�ODRE69 CIfY 21P PIqNE LICENSEI <br /> Avsnd �J. � ��orr _ v7 �� /�ve . w, �vE2cT-r-, t„�q-• 98z.,y zzZ�Qr�u-s;-re-r3��N3 <br /> •AECN�NIGILCONTR�GTdi M�R�DDIlE55 CIIY ZIP PIqNE LICENSE� <br /> 'LUTABRqCONfMCTdI MIIM1AOURE89 CItY 21P 1'IqNE IICENSE� <br /> :IASSOF WpiK <br /> � NEW I.1 ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSEHT I J BUILDINO RELOCATIOK <br /> ca+uer rensoN uio o�arre ra7.� <br /> ' ':d/1R�CTPRICEOFWOHK ��NI}A.p J 1 fJsT� BeF-SK f ,6 JZ� <br /> �tEBCRME YNIII(�ND SOU�RE FOOT�4E INVOlVEO <br /> CONyT2v[�-lOr/ T�-h�LS2 - %; a SF� <br /> �noroseouseoreunou/o I HEREBY CERTIFV THAT I HAVE READ AtlD EY.AMIN.D THIS <br /> G�N�T�t,✓�tlo�1 Tti�I�2 '� 'Z APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ' 'EMLOE6C1UPiqNOiPP01'ENTVISNOWNBELOWOR�TT�CIIiIX111Cp'IES� PROVISIONSOFLAWSANDORDINANCES60VERNINOTHISTVPEOF <br /> � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OH <br /> �ot eiocK ov N07. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER SiA?E OR LOCAL U1W REQULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WOHK FOR WHICH <br /> APPLIC�TION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW ANG 298.200 WAC. <br /> � 6qNQUREOiCANiRACTp110f1�UTIqiV2E0A0ENT U�TE <br /> i <br /> rROJFCT/�DORE68 �ti 'z/" � " I� • ��4:� ' �lyy l�I <br /> 3� 43 W � �/ �• i►' y APPIIC�NI CITYBUSME6SLICENSE/q�NDBU51NE89NM1E <br /> .�t�..,�_ <br /> PLUMlINO MECHANICAL <br /> NO. TYPE Of flIITURE OR ITEM fEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(iOILET) � AIC—MiNDLG UNITS—H.P. � <br /> �� BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ; � <br /> LAVATORV(WASH BASIN) i UNIT HEA7ERS—B.LU. M i �� <br /> SHOWER � CLOTHESORVERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � , <br /> UUNDRV TRAV ; WATER HEATER ; � <br /> CLOTHES WASHER � WOOD S70VE �_ i <br /> URINAL ' METAL FIREPLAGE 8 CIiIMNEV <br /> DFINKINa FOUNI'AIN � FIREPLACE INSEIiT �_ �i <br /> FLOOR DRAIN HEAT PUMP � ' <br /> BACKFLOW PREVENTEHS � 6A5 PIPINO ' � <br /> P.00F DRAINS—RAINLEADERS � E%HAUST FAN i '� <br /> SINK(SERVICE--BAR,ETC.) ' ' <br /> � <br /> � i <br /> � � <br /> — � � <br /> � � <br /> � � � <br /> SUB TOTAL S i SUB TOTAL f ' <br /> PEHMIT S � PEHMIT S i <br /> TOTAL FEE S ' TOTAIFEE S � <br /> FOR OFFICE USE ONLY: <br /> I110NT BETBACN RE�R SETBACK SIUE 6ElB�CN PLM!CHECR NUMBEII iEE� � ' AEfj�yJT W. <br /> �6 �(..4�-t� <br /> use ia+e ior�nen veennr sne FEES VALUATION FEE <br /> �{O BUiIoiNG� O O � lr G O � SZ> <br /> nrtacoxisuiow�eic imacaxsi.�ciuu n�.+r�. +�ai,.ru�+o�w��s — -- ; <br /> ��� � N �"°"° � rwuervo ; <br /> T <br /> SITEOf8LD0 NO.OFfiiORIE6 BASEMENI MECHANICAL � <br /> ZII�O � NO -- ; <br /> OGCUPM/CYlWO FIREBPRNItLEHBPEOD NEIOIITIIMIf�110N `����L�UNCHECK S/' L� ; 3 j <br /> 2 Z/ �{.D O7HER � <br /> i <br /> i <br /> REA9difOR8P11MNLERS - - �T <br /> STATE BUILDING SURCHAHQE i <br /> MtAItE BY PlANS�PPf10VE0 BY CITY OF EVERETT PUBLIC WOIIN9 � / <br /> � J, LOCAL SALES � � <br /> ,,)�--� TAX CODE 18 3105 *oT�� Q y ;� <br /> 1 <br />