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� I <br /> APPLICATI�i�I FOR CONSTRUCti�:�ON PERMIT everett � <br /> ��E���p,� TO BE COMPLETED IN INK—PLEASE PRINT � I� <br /> everett HEATING SYSTEM: U GAS ELECTRIC U II <br /> BUILDING DEPARTMENT <br /> 259�8810 , <br /> ' � DEMOLITION I I COMBINATION �� BUILDINCi i I MECHANICAL I I PLUMBINO f 1 SION <br /> OWIIEp M�R�DORE55 CItV 71P PIIONE <br /> rt'N6�oEfN c_�, . 1'c� B -3•l�•1 � r�; F,r-7�, ���n-�c.E , wn_, 9�rzv _vra� 3y�- a87/ <br /> ��FN �1� M�II� onE55 cltr 71r rrqNE <br /> �T'�rJ Gcr, , Itnl�- - Y7�- /}uL W_ C�RKET � ��IF. `j8za�1 7sjo -9/�z- <br /> nnc�aiecr�,nnesbr.m M�R�DORE55 cnr zm r�roNe <br /> aFNrnniccwm�cTon u�tinoonrss �� cnr �m rrar�e IICEN3E1 <br /> AVsr�a r. . � lio�� _ �� 7 _ /�v� , „�, l�.vE�z�qT-� 4�i� � yX•z .,.� zZ1•�Iku-sT_ie-��y�{ <br /> MF�II�NIC�LCONIII�CIOf1 MAR�DDRE55 CI1Y ZIP PIIONE IICENSE/ I <br /> I <br /> r�uunn�ncaanecion M�IL�ODPE55 CIIV Z�P PIIONE IICENSE� I <br /> CLIC90F WOIIN -'— I <br /> 'IL NEW I I ADDITION I I ALTENATION I I REPAIR I I DEMOLI710N I I WOOpSTOVE/FPPL INSERT (J BUILOINO RELOCATION <br /> GONUCT PERSON�NO PIIONE NO <br /> Cd/tq�CTPRICEOf Wd�N L�a ni.t��-D f� /�T�7+� 6sF-�K� �6G 3.T� <br /> UESC�IflEWO�IR�NDSW�f1EfO0UOEINVOLVEO �i�a• <br /> C_.nr�3r� �'�� �n�� T•+ n �t �t:� - �C o Sf' — <br /> Pf10P75EDU5E0i9UlAINO I HEREBV CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br /> � Cp,��nw�rror� T�LA.IL�R, �� �/ APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEOl1l�E�CRIFIION M PIIOPERIY�SIIOYM BF�OW OR�i1�CR f Wfl COPIPsi PROVISIONS OF LAWS AND ORD' ANCE9 OOVERNINQ THIS TVPE OF <br /> WORK WILL BE COti1PLGTEO WI7H WHETHER SPECIFIED HEREIN OR i <br /> ior oiocK a . NOT. 1HE 6RANTINO OF A PERMIT DOES NOT PRESUME TO OIVE . <br /> AUTHOHITV TO VIOLATE OR CANGEL THE PROVISIONS OF ANY '. <br /> O1HE'i STATE OR LOCAL lAW REOULATINO CONSTRUCTION OR THE ' <br /> PERfORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNEH OF 7HIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> . APPLICATION IS MADE AN� I COMPL`/ WITH THE STATE <br /> CONiRACTORS LAW 1B21 PCW AND 298.200 WAC. <br /> SION�TUIIEOFCWTR�CI,w10R�UTNqIRED�OENT WTE <br /> PRQlECU0UPE35 — � o��� C`j��/`�, Y��'s�/9f <br /> �PPLICANTS CITY BUSINEFS IICENSE NO�NO BUStt/E8B NMIE <br /> � PLUMSINO MECHANICAI <br /> N0. TYPE OP FII(TUR[OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLUSET(TOILETI � A/C—IVHNDLO UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYST[MS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) ~ UNIT HEAtERS—B.T.U. M i <br /> � SHOWER ' CLOTHESDRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGEIi00D � <br /> �_' _ <br /> �� LAUNDRYTRAV ; WATER NEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAI ' ME7AL FIREPL'ACE 8 CHIMNEV � <br /> DRINKINQ FOUNTAIN i FIREPLACE INSERT i <br /> � FLOOFi URAIN � HEAT PUMP � <br /> BACKFLOW PREVENTEflS i OAS PIPINO ' <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ' � <br /> � <br /> � � <br /> � � <br /> -- � � <br /> � � <br /> _�� <br /> 1 1 <br /> SUB TOTAL S ; SUB 70TAL S ' <br /> PERMIT S PERMIi S i <br /> iOTAL FEE S ' TOTAL FEE f � <br /> FOR OFFICE USE ONLY: <br /> �Rfk1I5Ef9�CF 11EMSEtB�CM SIOF6F.tp�CN PIIWf.HECRNUM9ER fEE RECEIPTNO <br /> use za+e iot enee V�C�Nf Slif FEES VALUATION FEE <br /> ND BUILDW� Z� �Z°° � f8 �Sd <br /> Irl'fdcoxtS�LIMV�eIF IYI'Fa[plsl.�ctueL a[urew:, I xnnmwnwawnf — � <br /> � 'N g� N I��".�I �- PLUMBIN� � <br /> _ 1 —� <br /> ai7EaBlDa NOofSToniES nesF.MfNt MECHRNICAL <br /> i <br /> rZY S F � NO <br /> occurnr¢riaeo n;2srnrm�ensneoo HEq11t1lullAlKk! �ODITIDNALPLANCHECN �(„ � � 0,3 <br /> i <br /> —_� I�� �__ ' OTHER i <br /> ��F�SON fOP FP�MlMiERS -- <br /> STATE BUILDINO SUfiCINf1OE i� <br /> _' —' —____ <br /> IHf�NfPV R�NS�PF110VFOOv � <br /> CITY OF EVERETT runi ic wonKs <br /> /, ]s IOCAL SALES � <br /> TAK CODE IS o105 roTa� /�3/ ; � <br />