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APPLICATIOr� FOR CONSTRUCTL'JN PERMIT everett <br /> fM Eroryrwn � TO BE COMPLETED IN INK—PLEASE PRINT � �'� � <br /> CIiY OF <br /> everett HEATING SVS7EM: U GAS ❑ELECTRIC ❑ <br /> BUILDINC, DEPARTMENT � <br /> 259-8810 ' <br /> I 1 DEMOLITION I I COMBINATION i i BUILDING i i MECHANICAL I�+LUMBING I I SIGN ' <br /> ONMER MML�DOOF55 C171' IIP PIqNE . <br /> Kas� UqNd�H @�e �.Z�iq 7�`' �� U/. �a. `�Oz�'1 775 7�f 3 `7� <br /> i <br /> TENMIT M�N�DORESS CIIV 21P PIIONE <br /> �RCHITECTORDESIGNEN MA0.�OD11[55 CIiY 21P PIIONE " <br /> OENEIW.CONTR�CTON M�IL�U011E55 CITY ZIP PIIONE I.ICENSE/ ' <br /> Gk� c��fro� �� e ok r���-,�� w., 9s.�d 2���� co��� z yo a � <br /> MECWWIGILCONTPACTOR MAK.�UURESS CITV 21P PIIONE 110ENSE� , � <br /> j.. <br /> PLUAIBMOLONTR�CTOR M�ILMOflESS C17Y 21P PHONE IICENSE/ ; <br /> �sf'�uq ta/uu��or�6516 6'�'`FsrNE.�,�ys�y'/���535/9q %4r�+stp/o6K5 � ` <br /> nS `v` <br /> uessavronK � , <br /> �NEW I�-.I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I�1 BUILDINO RELOCATION I �i� <br /> � �6e�.e�L.ki�vl/c� 2� 3667 �� <br /> �,T�T��E��K /0 aov ;� <br /> '. <br /> ' OEBCflBE WOItl(rHO 8IX1�RE FOOTA E INVOLVED �/_ <br /> r(kwb�w� -/�v G�(es� G:1�"�C{ <br /> pnoroseousea ua/oMa . I HEREBY CERTIFV THAT I HAV[ READ AND EXAMINED THIS <br /> �CQS��ek'f �l ( APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL . <br /> 1Ed40E5CR�PTIONOFPNOPENTY�5110WNBElOWOf1�TTAC11FWflCOPIES� PROVtS10NSOFCAWSANDORDINANCESOOVERNINGTHI5NPE0F <br /> M/ORK WILL 8E COMPLETED WITH WHETHER SPECIFIED MEREIN OR � <br /> �ot �xK °f NOT. THE GRANTINO OF A PERMIT OOES NOT PRESUME TO OIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY , �_ <br /> OTHER STATE OR LOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE � <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOfl WHICH ' �9 <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 flCW AND 298200 WAC. <br /> SION�iUREOFCpITR�CTORORAUTNORIZEDAOENT O�TE <br /> , <br /> PRO.IECTADDRE55 �( .( A � �^ � <br /> . /-NL(( �P � � 5 �USINE55 CENSENO.ANOBUSME65N�ME <br /> � PLUMOMIO ECHANICAL <br /> . N0. TYPE OF FU(TUNE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) �D �p o A/C—A/HNDLO UNITS—H.P. � � <br /> --� <br /> BATHTUB J ' J FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> _ UVATOHY(WASH BASIN) � 6 UNIT HEATERS—B.T.U. M � �, <br /> - SHOWER ; CLOTHES DRVERS � 'I <br /> � KITCHEN SINN 6 DISP U�D VENTILATION FAN ; ��, <br /> DISHWASHER � RANGE HOOD ' <br /> � LAUNORY TRAV _ ; �_ WATER HEATER ' <br /> � CIOTHES WASHER � WOOD STOVE i <br /> UFlINAL ' METAL FIREPLACE 8 CHIMNEV ; i <br /> DRINNING FOUNTAIN �— FIREPLACE INSERT i � <br /> —� —� <br /> � FLOOR DRAIN ; HEAT Pl1MP _ � <br /> BACKfLOW PREVENTERS i GAS PIPING ' <br /> q00F DRAINS—RAINLEADERS � _� EXHAUST FAN { <br /> SINK(SERVICE—BAR,ETC.) ' � <br /> � �Q ,� _ �0 <br /> � i <br /> — — � ' <br /> � i <br /> --�- —r— <br /> SUB TOTAL S _� ;OJ SUB TOTAL S � /F�O U <br /> PERMIT S �+�— PERMIT S � <br /> TOTAL FEE f O✓'L�d TOTAL FEE S � � 'O <br /> FOR OFFICE USE ONLY: <br /> fPONTfiETBACN RE�RSE7BAC8 SI[f5E7B�CN PUNCHECNNUMB[R FEE PELEIPTNO <br /> USE 1oNE LOT�PE� VM:�Nf SITE FEES VALUATION FEE <br /> BUILDING i <br /> IYPFqCONIS�IIOWABI[ IYPEMCONSIAGIVU or[uwcr rwpoxriidtuN�ii — -- i <br /> cnwr PLUMBIN6 l� v � O J <br /> _-- --� <br /> SIZEOFUl00 �K10i5Td11E5 BAiEMENi MECIIANIC�L �9 �Q� � <br /> __ — i <br /> OCCIIPM/CYLO�D FIIIESPRNKlER5f1E0U IIEI[:II7lIMISATION AU�ITIONALPLANC�IECK i <br /> i <br /> OTHFR � <br /> PE�SON FOR 6PRINNLERS — --�— <br /> SUTE OUI�DINQ SURCMAROE i ! <br /> i <br /> MTIINEBY PlANSAPPNOVEDBY CITYOFEYERETT PUBLICWOfIKS i <br /> LOCAL SALES T— <br /> TIUf CODF IS 3105 T�TA� 7'� �l\ <br />