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. � <br /> APPLICATIO� FOR CONSTRUCT�N PERMIT everett -•:�..� <br /> ��E�ro,�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYS7EM: ❑GAS 0 ELECTRIC ❑ � <br /> BUILDING DEPAHTMENT <br /> 259•8810 <br /> '��(� !"I DEMOLITION COMBINATION _'; BUILDING MECHANICAL PLUMBING 1 SIGN <br /> pyyq[q M�IL MOHE55 CITV ZIP PHONE � <br /> O <br /> ����`- LI`Fir�c r=,i � n �nj '�'�n� M . .7'_ .-.. -c/+ -. ,� ,//tc:•.���"-y -„l : �- ��� <br /> C � ikNNIT M�iL�00PE55 C�TV 2iP PNONE <br /> ��� "-� u:�rJ;�R. _ <br /> �RLNRECTdIDESqNER M�iL�DDPESS / Li1Y 21V PIIONE p <br /> CJ T�:.m" r.-�.t� �^) ✓:. C.�:: �'� ��i � ., ^ "+ tP�'r��i✓ l�Fl. i��'J ��1� �''Z.L- ... �1 .1� <br /> O�� 6ENEfUIGONTMCTOP 1Mil�DDNE55 CiiV IIP PNd1E LICENSE• <br /> �b � �! N `Z �FRVRn!/'i- ` �Ji:Rn�C In^ � '%:/ C: ' L � ) 'L�� <br /> (.lPl{,a vC , ,l P • } ( �Saa �3Y-ovf/ (.o (. lI 1��� <br /> � �� MECNNIILKCdITR1G10R MAILMOHE55 CRV 2iP PHOHE LICFNSE� �L� <br /> � plI1M01NOCONifUGTOR M�IIAp�RE55 JItY IIV PNqIE IIGENSE/ . ,� <br /> Q � <br /> p�°g ��5a�� <br /> '��, H ❑ NEW ' � ADDITION ,��ALTERATION . REPAIR DEMOLITION � �. WOODSTOVFJFRPLINSERT i i BUILDINORELOCATION �� <br /> S H / CONUGi PERSpI N10 PIqNE NO � - <br /> rN� COHTIUCTPRICEOFWORN b �� 1iDii Lt�uNR-n,ln /�-,-�M/'-,Cyc/ �.L•C• -�Sb1 <br />� g y DESCRIBE NONN�NO SOU�11E i00T�OE INVOLVEU - <br /> �n�� <br /> �+ PilOf`OSEDUSEOFBUILDINO _ � L-5 i I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> y�(pq ((L� '�11�✓I� GNlFa i /M f'2uV�;-�'.4 C�i�T- APPLICATION AND HNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> OW IEMlDESCRIPTqNOFPROPENttISMOWNBEIOVIOR•'1Tt�CNFWRGOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVEHNINGTHISNPEOF <br /> i WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OIi � <br /> ior e�ceK a NOT. THE GRANTING OF A PERMIT DOES NOi PRESUME TO�IVE � ' � .. <br />� AUiHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV � ' � <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTHUCTION OR THE - <br /> I� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE " <br /> OWNEF OF THIS PROPEHTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> �� CONTRACTORS LAW 18.27 qCW AND 298200 WAC. � <br /> �.��.61�� � . SIGN�NNEOFGONTMLTOROF�UtMORREDAGEHT OAiE <br /> JJ' J� � , j1 <br /> PR0.IECTADORE85 b��� � .��� �✓"lR�+✓{'��• / t� ;, � � � <br /> r . � . � 1 �VPLILAHiSCITYBU5ME55liCENSENOMlOBUSINE95N�ME ' <br /> y�,c t W, r a s Nc, �z� Cv�2�.r i,,.a . <br /> PLUYlINO MECMANICAL �. <br /> NO. TYPE OF FIXTUNE OA REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WAT[R CLOSET(TOILET) A/C-A/HNDLO UNITS-H.P. <br /> � BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. ' , <br /> LAVATORY(WASH DASIN) UNIT HEATERS-B.T.U. M <br /> SHOWER CLOTHES DRVERS � . <br /> C� NITCHEN SINK 6 DISP VENTILATION FAN <br /> OISHWASHER RANGE HOOD <br /> ' LAUN�RVTRAV WATERHEATER <br /> CLOTHES WASHER WOODSTOVE <br /> � UfiINAL MEiAL FIREPLACE 6 CHIMNEV � <br /> �� DHINKING FOUNTAIN FIREPLACE INSERT ; <br /> , PLOOR DFAIN HEAT PUMP � <br /> � BACNFLOW PREVENTEFS OAS PIPING � <br /> ROOF DRAIN�RAINLEADERS E%HAUST FAN <br /> �� SINK(SERVICE-BAR,ETQ) � <br /> � ,� <br /> �� I <br /> ' SUB TOTAL f SUB TOTAL S �� <br /> � PERMIT f PERMIT S <br /> TOTAL FEE f TOTAL FEE f . <br /> ��' FOR OFFICE USE ONLV: ' <br /> FPp1iSETBFCN RE�RSEiBACN SiDESETB�GN VUANC��E KNIIMBGEP fEE / RnECAEiPINJ li <br /> '/��j � if f L �f'1 ��c � .GGt--Ci I <br /> usETone iorenEe vecu�tsitE FEES VALUATION FEE '� <br /> BUILUING G 8 � 9� � II <br /> IYVf01CONI5AllOWABI! tYMOfCON51ACIWl acuwx[r rqdow�i�ixcux�is I <br /> cAav p�UMBING � <br /> ;: , . / - / /- ' '1 <br /> SRE oe BIDa NO oF StORiEs 8e5EMENT MECMANICAL I <br /> JS JW SQ.�1• /1/0 �.en'T�cw"' . <br /> OCCU N/LYtO�D fIPE�y PJ1NNlER5RE00 NEIGNTUMITATION �+.PUNCHEGN i � �I <br /> �,�' . �(�.U�S(•�8�.3�A /ES OiNER I <br /> 4+ ' <br /> t flE�50NfORSPRiNNLERS i <br /> ' ' U O� STATE BUILDINO SURCHARGE �/ ; Sp I <br /> :��i�:�:,r�-' ��. . . � i <br /> - � - IHTAI(EBY PUN AP ROVEOBY CITY OF EVERE7T PUBLIC WORKS <br /> ,% � LOCAL SALES i <br /> TAl(COUE IS 3105 ror�� �3,.7 1 07 I <br /> �� <br />