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APPLtCATI��'.ii� FOR CONSTRUC�����1 PERMIT <br /> ��E�ro�� everett I <br /> everett ; e � <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK-PLEASE PRINT <br /> I I DEMOLITION ❑ COMBINATION C:I BUII.DING � f_l MECHANICAL I PLUMBINQ ❑ SION <br /> OYME11 � M�IpD\DRE5-9 �CIiV 21P � ,�1p- PnNONE <br /> \ ���"�1���.�1,.10�Y.JC'S�Q �-�iS�v � �02��.41 �CT1'(lU/Q - �`L�J'o2� � � <br /> TENN/T MA0.AUDRES CITY ZIP PIpNE _ <br /> I111CNRECTpIDE610NER M�dADONEBS CITY 21P PNp1E ) � <br /> OENENALCONTR�CTON , WL110DRE89 CIfY iIP PNONE IICENS6/ . <br /> �� <br /> MECNANIC�ICONTMCTOR MAL�UOREB$ CITY 21P PIIONE UCEN9E� � <br /> PllA1BINOCONT C70R NAIL�DORE68 CITY iiA PIqNE 1J_�js�,�ICENB�� � <br /> `�; �Y���t�Y�-'�td-- �.1�iy � • �' cL-3tn�u Oa �r_a,n�s"- - �� !'r+a 0M� n�] <br /> cusaor Q' f"— <br /> GJ'�lEW O ADDITION ❑ ALTEFATION ❑ REPAIR l J DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDINO RELOCATION <br /> TEN47T NAPROVEMEM OH INfERpq IIEMOOEL dILY CANi�CT FERSON I WD PIIONE NO. � <br /> CONTMGi OPICE OF WORN: <br /> UE9CPI9E WOfIK�ND BIX1�RE F(�OT�OE MVOLVED ' <br /> U <br /> �Q 1 x/�(1•�"r' <br /> Pf10POSF.DU6EOFBUIL nw � , I HEREBY CEHTIFY TNAT I HAVE HEAD AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHECT.ALL <br /> LCWLOE9CRIPTIONOFPROPEPTY� IOWOR�iTACNFW ies� PROVIStONSOFLAWSANDORDINANCES00VERNINOTHIStYPEOF <br /> WORK WILL BE :.:.MPLETED WITH WHEiHER SPECIFIED HEREIN OR <br /> LOt__ BIOCN or NOT. THE aRANTIN6 OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITV i0 VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEH STATE OR IOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOAM THE WORK FOH WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW ANU 298.200 WAC. <br /> BION�IUOEOFG(kITR�CTqiOR�UT110RIiED�OENT D�TE <br /> �� �/'�, '\ �T Q�1 <br /> P CTI100PE88 � �\O C��.�/�.O.�t \�IY�O �V'OC /'O <br /> � , \ ` �PPLICMlTBdTYBU91NE88lICENSENO.N/DBUSINE69NM1 <br /> l/\l <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FlI(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � AIC—AMNDLd UNITS—H.P. i <br /> ' BATHTUB ' FORCEOAIRSYSTEMS—B.T.U. M E.A. � <br /> UVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> � SHOWEF � CLOTHES DRYERS � <br /> KITCHEN SINN 6 DISP VENTILATION FAN � <br /> DISHWASHER � HANGE HOOD � <br /> , UUNDRYTRAY � WATERHEATER � <br /> CLOTHES WASHEF � WWD STOVE , <br /> URINAL ' METAL FIREFilACE 8 CHIMNEY � <br /> DRINKINQ FOUNTAIN � FIREPLACE INSERT ' <br /> � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENiERS i QAS PIPINO ' <br /> HOOF DRAINS—RAINLEADERS � EXHAUST FAN � � <br /> SINK(SERVICE—BAR,ETC.) ' � <br /> ' <br /> � , <br /> � � <br /> � <br /> � � <br /> � , <br /> SUB TOTAL f ; SUB TOTAL { � <br /> PERMIT S � PEFiM1T { � <br /> TOTALfEE S ' TOTALFEE S � <br /> F110NT6ETB�CK RE�R6ETB�CN SIOEBETB�CN PIANCNECRNUMBEB fEE RFCEIPTNp <br /> USE ZONF. ior�nu V�CNIT 617E FEES VALUATION FEE <br /> ❑ VES IJ NO BUILDiNO ; <br /> TYVFpiCONSI.ALIOWAlLF rrrcacoxscu�uu ���* +�a�+���W��� — — <br /> Nrour <br /> PLUMBIN4 <br /> 612EOfOLDO NO.OFBiORIE3 B�SEMENT � <br /> MECHANICAL i <br /> U YES LI NO , � <br /> OCCUP�NCVLOAD FIRE6PRNNLEPSREO'D IIEqNTLIMIT�TION OTHER � � <br /> O YES ❑ NO STATE BUILDINO SURCHARaE � <br /> PE�90N fOfi 6PR WNLERS � <br /> STATE ENEROY SUI1C AROE � <br /> nrriq�rroa�cc.er MANS�PPROVEDBY CITY OF EVERETT PUOLIC WORNS ' � <br /> LOCAL SALES <br /> TAX CODE IS 3105 ror�� ; <br />