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APPLICATIOr. FOR CONSTRUCTI,JN PERMIT everetl <br /> �E„�,�„�„ TO 8E COMPLETED IN INK—PLEASE PRINT � <br /> arv oF <br /> everett HEATING SYSTEM: 0 GAS O ELECTRIC ❑ <br /> BUILDING nEPARTMENT <br /> 259-8810 <br /> -; DEAAOLITION )7 COMBINATION i BUILDING C MECHANICAL ❑ PLUMBING ❑ SI(iN <br /> OMMER MAIL ADUPE55 /C'ITY 21P PHpNE <br /> G �'f�/ /�� �✓��dT'� �/rj'�l 7�?�- ��'8'`l�b� <br /> TENA� N� MAIL ADD� CI��� ZIP p� <br /> G�N CT�OqDE�SICaNER MAIL��DFESS CITY IIP PHONE <br /> r��5�� <br /> GENERQ�+iNACTOR MA�IL�—DDRESS CITY ZIP PHONE LICENSE/ <br /> EM CM�NIC�I. ON��MAIL A�DF� CITY 21P FHONE UCENSE II <br /> PL CONTfl�CTOR MMLADDRE55 CITY ZIP PHONE UCENSE• <br /> /LGI.fi.����'r��i/��.� <br /> ���,K <br /> L NEW ❑ ADDITION i 7 ALTERATION �i REPAIH i-_- DEMOLITION O WOODSTOVE/FRPL INSERT �:� BUILDING RELOCATION <br /> �TR�CT PRICE OF W011K I���/�/ T�CT PER AND E <br /> DESGR9E WORK 11ND Sd1�RE FOOTAOE INVOI EO , <br /> !.�O � - $' <br /> rnoroseouseoreuaoma I HEREBY CERTIFY THA1' I HAVE HEAD AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �etik PIPT R ERTY(SMOWN BEIOW 11TT GH FIX1R GOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br /> WORK WILL BE COMPLETED WI-H WHETHER SPECIFIED HEREIN OH <br /> toT e�ocK oF NOT. THE GRANTING OF A PEHMIT DOES NOT PHESUME TO 61VE <br /> , AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF ANV <br /> qTHER STATE OR IOCAL UW REGUUTING CONSTRUCTION OR TME <br /> PERFORMANCE OF CONSTFUCTIOr!. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO FERFORM THE WORK FOR WNICH <br /> APPLICATION IS MADE P!�D 1 COMPLY WITH THE STATE <br /> CONTRACTORS UW 18.27 RCW AND 296200 WAC. <br /> SIGN�TVRE OF CONTR�CTOR OH�UTHOf11ZE0 A6ENT D�TE <br /> MiOJECT�Dp1E55 � �!ge�I�L%�(!/ ����� <br /> fi/ �P IG iTSCITY8U51NE CEN NO IWDl80&NESS! E� <br /> �J// <br /> PLUMSMIO Eq1�NICAL <br /> N0. TYPE Of Fl%iURE OR ITEM FEE N0. TYPE OF EOUIPMENT fEE <br /> WATER CLOSET(TOILET) P✓C—A/FINDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS�.T.U. M E.A. � <br /> UVATORY(WASH BASIN). UNIT HEATERS�.T.U. M ; <br /> SHOWER CLOTHES DRYERS � <br /> KITCHEN SINK 8 DI5P VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br />� IAUNDRYTAAY ; WATEfl HEATER <br />� CLOTHES WASHER � WOOD STOVE <br /> URINAL METAL FIREPUCE 6 CHIMNEV � <br /> DRINKING FOUNTAIN i FIflEPLACE INSERT i <br /> fLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVE ERS ; GAS PIPING ; <br /> pOOF DRAIN INLEADERS EXHAUST FAN � <br /> SINK(SERVIC —BAR,ETC.) ; ' <br /> � � <br /> —� <br /> SUB TOTAL S ; SUB TOTAL S ' <br /> PERMIT S � PERMIT E i <br /> TOTAL FEE S ' TOTAL FEE S ' <br /> FOR OFFiCE USE ONLY: <br /> FRdITSETBACN REARSETBRCK SIDESETBIICK PIANCHECKNUMBER FEE pECEIPTNO. <br /> USE ZONE lOT AREA V�CANT SITE �E$ VALUATION FEE <br /> BUILDING � <br /> TYPE OF CONiS.AILOW�9lE TYPE OF LONS7.ACiIIRt oCGvnxtr x0 a VxRuhG W irs i <br /> G9�P PLUMBING � <br /> SREOFBLDG. NO.OFSTORIES BAScMENT MECHANICAL � <br /> OCCUPANCY LO�� FINE SPRNKIERS REO'� HEIGHT LIMITRTION ADDITIONRL PLAN CHECK i <br /> � <br /> on+eA � <br /> REASON FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE � <br /> INTAKEBY iM.�NSAPPROVEUBY CITYOFEYERETT PUBLICWORKS � <br /> LOCALSALES � <br /> �,�� TAX COOE IS 3105 Tor�� � � <br />