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APPLICA7101. FQR CONSTRUCTI�N PERMIT everett <br /> IM Ewipreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> eve rett �HEATING SYSTEM: ❑GAS O ELECTRIC ❑ -� <br /> BUILDING DEPARTMENT <br /> 259-8810 -/ <br /> DEMOLITION COMBINATION BUILDING '�MECHANICAL PLUMBING SIGN <br /> OVRlER MAII C55 Cliv ZIP PNONE <br /> � Ea�� , +�. D. �n� h�s ��1�5�ik1 i a�-?�z,o� 3�i-sa� <br /> T NI MML OGRESS C1/V IIP PNdlE <br /> �RCHITECT OR DESIGNER M�IL�UDRE55 CILY 21P P1qNE <br /> C'�an�an)�+J6��25 1601 ��i . Su rt�900 `�i4.k�a. 9�}� o► -1(,��z3-o7�7 . <br /> OENERALCONTR�CTOR MAILADDPFSS Crtv ZIP VNONE IIGENSL/ <br /> MECH�N1CAlCONTR�CiOR MA0.�ODRkSS CRY IIP PIqNE IICENSE� <br /> V11¢���� �'a[ �0._�aaLJ��b? 51E.?'�, lvA-, 9�L�—�CES���IE IZI eF <br /> PLUMBINOGONiR�CTOR MAIL��ORE55 CIiV plP p p <br /> CLASSOF WORN+ <br /> : I NEW y AODITION �. . AITERATION �.j�R'FPAIF DEMOLITION WOODSTOVE/FRPL INSERT f_� BUILDINQ REIOCATION <br /> t O�� ` /p/ � CONT�CT PENSON AND PHONE NO <br /> LONTR�C7 PRM.F OF N'ORI / C��3 � <br /> DE RIOE WdiK�N�Sd1�RE FOOT�OE INVOLVF.D <br /> ���LL Z _L1�- ► • <br /> c voseous¢ae annw I HEREBV CERTIFV THAT I HAVE READ AND E%A NED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORflECT.AlL <br /> LEO L DF.SCqIPTIDNOf PROPERP.'( HOWNBEIOWOR�TT� FOURQ7PIES� PROVISIONS OF LAWS AND ORD�NANCES GOVERNINO THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIF'IED HEREIN OR <br /> �oT BLOCK ov _ NOT. THE GRANTINO OF A PEflM1T DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REQULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THG WOIiK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITFI THE STATE <br /> CONTRACTOqS UW 1B.27 RCW AND 296.200 WAC. <br /> SION�iUREO�CONTR�CTOROR TNOH k0� 1 DATE ' <br /> X l� Z , <br /> P ECTA�ORE55 /� � <br /> � / e(�'.IA ' —Lt� � 3, �P . Y NE NSE �NOBUSINE6SN�ME <br /> �L� A■ � � <br /> PLUM NO b MECHANICAI <br /> NO. TYPE OF FIXTURE Oli REM FEE NO. TYPE OF EOUIPMENT PEE <br /> WATER CLOSET(TOILET) A/C—NHNDLG UNITS—H.P. �� <br /> BATHTUB FORCED AIR SYSTEMS-9.T.U. M E.A. � <br /> IAVATORV(WASH BASIN) UNIT HEAtERS--B.T.U. M <br /> SHOWER � CLOTHESDRVERS —T <br /> KITCHEN SINK 8 DISP VENTILATIO�I FAN ; <br /> DISHWASHER RANGE HOOD T <br /> LAUNDFiV TpAV ; WATER HEATER � <br /> CLOTHES WASHER WOOD STOVE ; <br /> URINAL � ME7AL FIREPLACE 8 CHIMNEY � <br /> DRINKINQ FOUNTAIN � FIREPLACE INSEHT ; <br /> FLOOR JRAIN HEAT PUMP � <br /> BACNFLOW PRFVENTERS ; GAS PIPING <br /> ROOF DRAINS--�RAINLEADERS � �' EXHAUST FAN � <br /> SINK(SE7VICE—BAR,ETC.) ; � <br /> � ; <br /> � , <br /> � <br /> � <br /> SUB TOTAL S ; SUB TOTAL s a ao' — <br /> PERMIT S PERMIT S S� �— <br /> TO7AL FEE S TGTAL FEE S 1 3 ' — <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACN RE�RSETBACR SIDESETBIICN PVNCHECMNUMBER A!£ RECEIPTNO. <br /> _ � �/C <br /> IISE ZONE l OT AREA V�C�NT SITE PEES VALUATION FEE <br /> BU�LDING <br /> fYPFOlLONt6�lL0YrAn�� I lYi(OfCONSt/�CTWL occuwrcr xnaoxnurwux�tn ; <br /> cnav pI.UMBING <br /> SQEOFBLIX3 NOOFS�CNIIES B�SEMENT MECMANICAL � <br /> . , <br /> OCGUP�NCY LO�D FlNE 6PRNNlF.RS PEO9 HEIONT LIMIT�I'IC'I AODITIONAL PUN CNECK � <br /> OTHEN � <br /> flEA50N fOR SPqINNLERS � <br /> STATE BUILDING SURCHAROE ; <br /> INTAKE BY %N! APPROVEOBY CITY OF EVERETT PUBIIC WORNS ' <br /> �N LOCAL SALES ' d <br /> �. i TAX COOE IS 3105 TOTAI ��:-ba .� <br /> � <br />