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' APPLICATION FOR CONSTRUCI.ON PERMIT `'�`�`'" <br /> tnae.a�m�cn TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ciTv oF <br /> everett HEATINGSYSTEM: ❑GAS DELECTRIC ❑ —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION ' COMBINATION �BUILDING MECHANICAL f:pLUMBING SIGN <br /> ON'rvEP IAAILMDFE55 Cltt ' ZiP PIIONE <br /> � � "' Ill/�63 �32 S C��1 b y�e�� 1F�-1 <br /> p � 1CfiAIR MRRW�RESS GitY ZIP PnONE <br /> C M <br /> Y �3 N <br /> y �i eee��e <br /> N A��CNItECTOR�ESIGNEN M�M1AD�PE55 CITV ZIP P�E <br /> K (�/K INIr Cc�nJc7��'��w' j'v��`r`i� 9Bu'1 ,?S9'TZ.6� UlK1NG<=llGCL <br /> O m O <br /> GENCpQCONTRAGTOR MA6AODNE55 CiTY ZIP PNONE UGENSEI <br /> �C M �V <br /> N M <br /> � � � IALCMANiCALGONTMGTOR MAIL�DOFE55 GITY ZIP PHONE 4CENSE• <br /> � A � PtUA181NGCONTP�LTOR N�dADDHE55 GIT' ZIP YNONE IIGENSE• <br /> � � � <br /> H <br /> � p.� ClAS50FWOHN <br /> 'j NEW '�. ADDITION -i ALTERATION �l REPAIR -�� DEMOLITION .��. WOODSTOVEIFRPLINSERT ,,�: BUILDINGFELOCATION <br /> �y y CONTACTPERSONANDFMONENO. <br /> � O N CONLRACT PPiCC OF WORN I� WCJ G'� <br /> � � r DESCRIBENOPNRNOSOWPEFWAGEiNVOIVED <br /> i y y , �-OF-'F ,c:�/�ErE �P/�f -- <br /> � � y PROPOS OUSEOFBUIlO�NG � I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPUCATION AND KNOW THE SAME TO BE TRUE ANO COARECT.ALl <br /> �Ecr.�oe cnivnor+oF ra vennisHowr+oeiow HATTACM FOURCGVIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPc OF <br /> N'ORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or etocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANV <br /> OTHER STAIE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />� PERFORMANCE OF CONSTFUCTION.THAT I 4M AUTHORIZED BY THE <br /> OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH <br />��� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACiORS LAW 18.27 RCW AND 296200 WAC. <br />' SIGNPtUREO`GONifVAC10RORAt1TMOB2ED/GEHT MLE <br /> P(iQIECTA0�RE55 ��� �� <br /> �' �, APPLIC4NTSCITVBUS�NESSUCENSENO.ANDBIISINESSNnME <br /> I �f PLUMBING MECHANICAI <br /> � N0. TYPE OF FIXTURE OR ITEM FEE N0. PE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) !v(�AiHYDLG UNITS—H.P. <br /> FO(iCED AIF S`.'STEM115—B.T.U. M E.A. <br /> '��1 BAfHTUB UNITHE�17ER5—B.T.U. M <br /> �� LAVATORV�WASH BASIN) <br />�. • SHOWER CLOTHFSORYERS <br /> KITCH[N SINK d DISP VENTILATION FAN _ <br /> DISHWASH[R RA�GE HOOD <br /> I �-� �� LAUNORY TRAV WATER HEATER <br /> I CLOTHFS WASHER WOOD STOVE <br /> UFIN4L METAL FIREPLACE 8 CHIMNEY <br />• I <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> i !I I FLOOR DRAIN HEAT PUMP ' — <br /> �ACKFLOW PREVENTERS GAS PIPING <br />� �. ROOF DRAINS—RAINLEADERS ERHAUST FAN <br />', � '.� SINN(SERVICE—BAR,ETC.) -;— <br /> q,^_1 ' ' � <br /> I --r <br /> i <br /> I�I_� SUB TOTAL S SUB TOTAL 5 <br /> PERMIT $ PERMIT S <br /> � TOTALFEE S TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FBONLSET�PCK REPRSEtOACN SIDESETBAGK PIANCNECNNUM�Eq FEE IIEC[IPTNO. <br /> � <br /> usEzorve IOTARC� V�CANTSITE FEES VALUATION FEE <br /> �UILOING <br /> *YPFOFfOHiSAl10WABlE iYPEO{CONSt.ACLUAI OCaw�m' �roRbMWxcirviis <br /> �AaP PLUMBING <br /> � SIZEOFBLDo. IIU.OFSTORIES OASEMENi MECHANICAL <br /> . i <br /> OCGUPGNCYlOAO iIFESPPNNIERSRE00 H[IGNTUMITATION ADDIiIONALPLANCHECN � <br /> i <br /> OTHER <br /> � <br /> REASON FOR SPRiNKlERS <br /> SiATG BWIDING SURCIiARGE <br /> u„n..�nv rv.r+savaaoveoar CIT`/OFEVERE7T puoucwoHHs <br /> LOCALSALES <br /> TAX COUEIS 3105 TOTAL <br />