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. - """� <br /> � APPLICATIC� FOR GONSTRUC�N PERMIT cVef1t """ <br /> ,� � <br /> � tlieEvmg�own TO BE CQMPLETED IN INK—PLEASE PRINT � <br /> GTY OF <br /> everett H[ATING SYS'EM: ❑GAS U ELECTRIC U _-----� <br /> BUILDiNG DEPAFTMENT � — <br /> 259-8810 <br /> '� (� DEMOLITION COMBINATION BUILDING �(MECHANICAL PLUMBING SIGN t <br /> • a owNEa uALeoDnEss crtv z�r rnoNe w�\y' <br /> � � . �/�-32Q��sLes��•ya .�./ Eva.t� w, y,��a y 3 5/2 735/Z — 1 <br /> TEN�HT M�IlA0DNE55 CIIV 21P PNONE <br /> ��� �t�,�-S __— <br /> e� �RCII�iJTECTORDE51GNEf1 MMI�DONE55 C� v ZiP GNONE <br /> ��� /Ji i.�� __._ �� e}��F � <br /> dENER�I CONT OR MML�� RE55 CIiY ZIP PNONE IICENSE• <br /> W�,,,�C7�Sf !_� �,-L��' 1a�e�3 6 S� 96io s �f12�3 �u h�s.,s[s.0 Z./9 ea �' �'�{; ,". <br /> MEC ICKGONiR�CTOR M�M1ADDRE55 CitY IIP y yrPz ��E ,}�CENSt1 �, r� l� �,;� <br /> ��� a N.0 C r y}� /22/NarJ�l 2.v��t �..�f�. S 1SYf700 �1�'�-/YMc. 2/TNT <br /> 4, <br /> RUMDINOGONTR�Cf011 M4��DDRE53 CILY 21P PHONE I�CENSE� "r�: <br /> �A <br /> �Y GUSSOfWORI( � <br /> �„� � NEW . AODITION �(ALTERATION FiEPAIR DEMOLIiION � WOODSTOVE/FRPL INSERT � , BUILDINQ RELOCATION <br /> y � LONT�CT PERSON AN�PIqNE Iq <br /> M CpITRACT VRICF Of Wd�Y �/ 7 �Od . �i�.., i t /Q.i t� r �y� 7 9S 3 <br /> 'A� DESCRIBE WORN NID SOUMIE FOOtA E INVOIVED <br /> Yqy.I iy /Ju�L d0 <br /> w���'''!!! V SEDUSE U�IDING JY 1 NEREBY CER7IFY THAT I HAVE READ ANO E%AMINED THIS <br /> �� �� APPLICATION AND KNOW THE SAME �0 BE TRUE AND CORRECT.ALL <br /> �EW� S�piPTpNpGFROPERTYISNON'NBFIOWOf1�iT�CNiWRGOViE51 PROVISIONSOFLAWSANDOFDINANCES60VERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br /> ioi eiocK oF NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> �UTHORiTY TO VIOLATE OR CANCEL TFiE PROVISIONS OF ANY <br /> OTHER 97ATE OR LOCAL LAW PEGULATING CONSTFUCTION OR TNE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOH WHICH <br /> APPLICATION IS MAOE AND I COMPIV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SK.NATl1RE0 ONTHACTONOR�Ui110H12E0A0ENT D�TE <br /> LiC <br /> x ez�s7 <br /> vAaecr�ooness n- � �"'�'� <br /> D 3 �I / ,A O�OI SW wF� �PP���N�ESSIICENSENO AN SMEeS�H�ME <br /> PLUMBINU MECHANICAL <br /> `''' - NO. TYPE OF FII(TUHE OH ITEM FEE N0. TYPE OF EQUIPMIENT FEE <br /> � WATER CLOSET�TOILET) A/C—NHNOLG 11NITS—H.P. _!_ <br /> � � BATHTUB FORCED AIR SYSTEMS--B.T.U. M E.A. � <br /> ' LAVATORV(WASH BASIN� UNIT HEATERS—B.T.U. M __� <br /> SHOWER CLOTHES�RVERS ' <br /> C�' VENTILATION FAN � <br /> KITCHEN SINN 6 DISP ��— <br /> DISHWASHEH RANGE HOOD <br /> � LAUNDRV TRAY WATER HEATEF _�__ <br /> CL07HES WASHER WOOD STOVE _ <br /> � � URINAL METAL FIREPLACE 8 CHIMNEV <br /> ��� DRINNING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DFAIN HEAT PUMP ' <br /> BACHFLOW PFEVENTERS _ GAS PIPING <br /> �I �� SINK(SE VI CE BARLETCERS EXHAUST FAM — — <br /> J/ /oeo — C <br /> � � — N / J� � <br /> � <br /> ' SUB TOTAI E SUB TOTAI S 'a00 '` <br /> ' PERMIT S PERMIT E �O� <br /> J TOTALFEE S TOTALFEE E S�' ` <br /> � FOR OFFICE USE ONLY: <br /> - - ' {pONiSEI�ACn NEAHSEiOACK SiDF.SELBACN VI�NCHECnNUM11FN f[(. RECEIPINO <br /> aC r <br /> use za+E �or ene� VAC�Ni 511E FEES VALUATION FEE <br /> BWLOING <br /> • fYPlOfCONISAIIOW�BIf IVVEOIWNSIACIWI a��..rwcr bnuux�. n•�si,ru - -- <br /> cncuv PLUMNING <br /> SREOfBlDO NOOFSIDNES flA5EMENi MELNANICAL ��} i � <br /> OGGUP�NCVIO�D FiAeSrnrvKiensnEoo neieNiuuiunor� ADOITIONALPIANCMECN <br /> OTI/Efl <br /> — — — _—�_— <br /> RE�SON F0115POiNKI ERS <br /> STATE OUILDING SUPCMARGE <br /> OITANE9V PUNSRPPROVE��Y CITYOFEVENETT PUBIICWOHK$ <br /> LOCAL SALES / <br /> � h/ TAl(CODE IS 3105 7oT�� ) /j ; V <br />