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� <br /> APPLICATIOnI FOR CONSTRUCT�c?N PERMIY <br /> ��,<« ;� <br /> C�e C-�a+rp•mn � <br /> CIT r OF <br /> everett <br /> BUILDING DCPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOLITION COM�3INATION BUILDING MECHANICAL PLUMBING SIGN <br /> � � o�N�ER AUiIACOPF55 Grtv Z:r r'.nry� <br /> � 13u.o( Ka4 �y[Z��_�E�T zsz- ��a <br /> H <br /> IO L1 iE'•+Nr MFILADO(IES` CITV 21V PMONE <br /> C �+ <br /> Y HF� N <br /> � c. � qqGNiTECTOR0E5iGNER MAILADUiiE55 LRY ZIP PNONE <br /> '? Z M <br /> K y (A <br /> ro M ro GENERQCONTRnCTOP MAR Idi�HE55 GITV ZN PNONE LIGENSE� <br /> N M <br /> � '1 M[GNN111CAlCOfilqAC10R MAILtDDPE55 GIIY Z�,f PnONE LiCENSl• <br /> � � b N.W. f✓�Jlo- r�.c� e f.Jf `IYZ91— 2SYi- S331 Nw�l•vl� l3l K-T <br /> o .. <br /> „ � � PLUMBMGCONiR/�.CTOP IAFIL�DOPE55 C�tt .'iP � PHONE LIC[NSEI <br /> fi 7 • <br /> Z y � G1�550FWOFK <br /> P H y 1[D1EW ADDITION ALTERATION . � AEPAIR DEMOLITION . WOODSTOVE'FqPL INSERT ..; BUILDING REIOCATION <br /> RJ5 y H �ENnN'IMFROV[ME�i70NINT[PIOB/F'�EMODELONIY CONTACIPEPSONRN�PNDNENO <br /> "Cq � y CONTRACT VFIGE Of WOFK: `'�YJ �� — <br /> t! h r DESCPI6E WOPK R110 SOU�RE FOOif.GE INVOLVE� <br /> � � �' .��lp+ —Gat /-.w�. — <br /> N <br /> vaovoseouseoFeuao � � I HEREBV CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAIAE TO BE TRUE AND CORRECT.ALL <br /> iccn�oe aiauonocvaoeenN�snOWNBELOM�OHRTT�CMfIXIRCOPIE51 PROVISIONSOFLAWSANDORDIIJANCESGOVERIJINGTHISTVPEOF <br /> WORK WILL BE COIdPLETED WITH WNETHER SPEGIFIED HEREIN OR <br /> �ot e�or,� oF NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUtdE TO GIVE <br /> AUTHORITV TO VIO'.ATE Oq CANCEL THE PROVISIONS OF ANV <br /> � OTHER STATE OR LOCAL LAW RE6ULATING CONSTRUGTION OH THE <br /> PERFORMANCE Of CONSTRUCTION.THAT I A1d AUTHORIZED BY TNE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COIAPLY WITH THE STATE <br /> CONTRACTOHS LAIN 182i RCl"J AIJD 298200 VVAC. <br />� S�G�aIUFFOFGOvirM1SipFr�iu'.�TCJ'tct[��.rLl:l Dn:f. <br /> X /�n <br /> aaaECTr,00ness r� ��' �---- — <br /> i[� � - C�c�6 ��r �����,,.�,�< <,.,,��,��,�;� _�•.:F����.�� ��. E�;,,,.,.� <br /> � PLUMBING MECHAN�CAL <br /> i � NO. TYPE OF Fl%TURE OR ITEM FEE NO. 7YPE OF EOUIPMEHT FEE <br /> 1NATER CLOSET(TOIL@T1 A'C—A'HN�LG UIJITS—N.P. <br /> ��" BATH7U8 ; / FORCED AIR SVSTEMS—B.TU. M E.A, '�SJ '0'0 <br /> I 1�' LA'�ATORVIWASHBASIN) � UNITHEATERS—BT.U. M <br /> SHOWLR ' CLOTH[SORYEFiS <br /> , KIICHEN SINN B DISP VENTILATION FAN <br /> 1 DISH WASHER RANGE I100D <br /> �r LAUNGRV TRAV WATER HEATER <br /> CLOTHES WASHER i WOOD STOVE _ <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY <br /> ' DRINKING FOUNTAIN FIfiEPLACE INSERT <br /> �'�' FLOOR DFAW HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> � 11 ' SINK(SERVICE—BAR,ETC.) <br /> � —i— <br /> ��� <br /> '��I. SUB TOTAI $ _ SUB TOTAL $ ; <br /> PEIiMIT $ P[FldlT $ ���O a <br /> TOTAL FEE $ TOTAL FEE $ {- '0 D <br /> �POfRSCtORCN A[ARSF.TBACN SIOESELpACK PLRNGMFCNNIIMBFR �E[ R[CCIPTN�. <br /> useza+e �at�nc� vncnNisire FEES VALUATION FEE <br /> YES . NO pU1LDItJu <br /> ��: LYPFOfCON57AlOWABLE 1YFFOiCaN51.PC1U�l o[ar<r�p rvon�ovniuvcuN��s i <br /> �' � �- - �5���� PLUMBING � <br /> � � <br /> +�{!` " SIZEOFOLW. NOAFSi0i11E5 B�SEMENi MLCNANICAI ' <br /> � � ' �� YES ' � NO <br /> f� ���' orHFn <br /> OCCUPANGVlOAO FlRE6PANNLERSREO'0 HEIGMLIMIGTION <br /> ��C?� " ! YES , � NO <br /> _ . S1AT[BUIWINGSURCHARGE <br /> � PEASONFORSPRINNtEPS ------- -- -- �-" -� <br />����f.eT4�'��c—n S1ATE[NERGY SUH(,HAfiG[ <br /> pnp�irqnONAGG 9v PUNSAPPROVE�BY CITY OF EVERETT PUOIIC WORNS <br /> LOCAL SALES <br /> TAX CO�F IS 3105 TO7AL <br />