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pppLlC/�Tt�.N FOR GONSTRl1C1 .ON PEF�MIT <br /> evereft <br /> . �, ,.... e <br /> ;rG <br /> everett <br /> EUILDING DEPARTMENT Tp BE COMP�ETED IN INK—PLEASE PRINT <br /> 259-88" pLUM81NG SIGN <br /> DEMOLITION COMBINATION X BUILDING MECHANICAL�E <br /> mna wor+ess crtr ziv <br /> � �vmEA � L//a• laLol .�rT4- s-990 <br /> � '� Georc-E �Y1ar�oXa '�017 Gb/6J /,�� JEv P� <br /> p. G TEN�Ki MAILIIDD9E55 Cm <br /> 21P <br /> 9 y w � � crtv zm vHor� <br /> t"y � Z nrcwrrzcroaoes�cr�n nuunoonEss <br /> y �e J PNONE . IIGEN5E1�/ ���/��/��t/) <br /> K "j ^' GCNERnILONTN�CTOR MARRODf1E54 � 7 � �L(LYj���,{[� '1'/�., 9aaa� La / ��^ V��IYS�_^ <br /> ) �`� /'� _'_ l/ _ <br /> ° y ° � �,vs-L Cor�. �� ����. <br /> �+ III I � CRV ZP PY10NE <br /> C 2' I !.�[GNRNILI�lGO':fR1GTOF MAIM�RE65 <br /> t0 ? t��. LICENSE� <br /> 7 CITW ZIP �� <br /> Q PLUMBMGGpRMLTOH M�M1�ODRE55 <br /> N {1� R <br /> M , C ��A55OFN'd�M ' � <br /> � �3 � . NEW .-��. ADDITION x AITERATION . REPAIR .� DEMOLITION ��. WOODSTOVEfFRPLINSERT . BUILDINGRELOCATIUN <br /> M � LONiACT PER90N RIp VMONc H0. <br /> y �[!�hNTIMPROVEMEM061tt1TEFKKiREMC�[LONLY ,� s^!I J,�� 54�7�� <br /> � iW.rwc <br /> � N f.T1TRALTFRICEOFWORN: <br /> � � r 6ESCRiBE VIORK�ND SOURAE FOOTRGE MVOIKD R�jNLL <br /> y y RpNW�L� .K <br /> H O �n rnoroseousEOFounnrt+e 1 HEREBV CEFTIfV TNAT 1 HAVE READ AND "eXAMINED THIS <br /> R�,�� ;��, APPLIGATION AND KNOW THE SAME TO BE TRUE hND COFRECT.ALL <br /> PROVISIONS OF LAYJS AND ORDINAIJGES GGVERNING THIS TYPE OF <br /> �ecuoesceivTar+oFrr+oa�ATr�seowr+eeiowonnrrncNFouncovies� WORK WILL BE COMPLETED WITH WHEIHEF SPECIFIED HEREIN OR <br /> �or� BiaK (O oF LAIIV� � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCcL THE PFOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING GONSTRUCTION OF THE <br /> PERFORMANCE OF GONSTRUCTION,iHAT I Atd AUTHOR2ED BV THE <br /> APPLICATFONiSISRMADET ANDPERCOMPLY EWITOHKTHOER STATE <br /> CONTFACTORS LAW iB27 RCW AND 296200 WAC. <br /> S�Gn+�tUPEOFGONiMGTOF09AUTHORiZEDRGENT D47E <br /> X �, � o..�.�,�.L.�- �S �3� <br /> PROJtCT ADDPE55 ppp�i�nNiS Crtv o'JSi�lESS LiG[NSE NO.�ND BUSINE55 N�'aF <br /> i�� �j �£ <br /> PLUMBING MECHANICAL <br /> � FEE NO. TVPEOFE�UIPMENT FEE <br /> NO. TYPE OF FlXTURE OR�TEM 0.'C-0.'HNDLG UNITS—H.P. <br /> i WATER CLOSET(TOILET) <br /> FORCED AIR SYSTEMS—B.TU. M E.A. <br /> '�� BATHTUB <br /> ��I LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> CLOTHES OfiYERS _ <br /> SHOWER � <br /> KITGHEIJ SINK 8 DISP i _ VENTILATION fAN �— <br /> i RANGEHOOD <br /> r` DISHWASHER WATEFi HEATER <br /> � v! , LAUNORYTRAY _ <br /> � CLOTHES WASHER WOO�STOVE <br /> METAL FIREPLACE 8 CHIMNEV <br /> URINAL FIREPLACE INSERT <br /> DRINKItJG FOUNTAIN HEA7 PUMI' � <br /> I,—' FLOOR DRAIN — ' i <br /> � BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOFDRAINS—RAWLEADERS � E%NAUSTFAN <br /> SINK ISERVICE—BAR.ETQ) i — <br /> � � — ' � <br /> � � <br /> i <br /> SUBTOTAL S ' SUBTOTAL S <br /> �1s PERMIT S � PERMI7 S _ <br /> TOTALFEE $ TOTALPEE 5 -"C <br /> ('ROM SETB�CK RE�H SEiBACK SIDE SETB/.CN <br /> PL�NGHECNN'l1AGCR �EE PELEIPTNO. <br /> ��S VALUATION FEE <br /> USEZONE IOTAHE� V�GANTSITE � <br /> !-; YES �-� N� BUILDING - <br /> ouuwr¢r rroaowtum,ums � <br /> ivM ot t�t�LLOWnBIF tYP[0�COti��tiU�/ cr,art „�. PLUMBING ' <br /> ,l'-/t/ .�_. -z � <br /> SIZEOF . NO.OiSTOHIE3 BASE�ENi MECHANICAL � <br /> � � / ❑ YF.S ' NO � <br /> 018ER � <br /> OCCUPl�NCVLJM F�RE6PflNNLEfl5RE0'D HEUiMTIIMIT�TIdI i <br /> NA� i� YES !1 NO N� SIATEBUILDINO6URCHARGE , <br /> nEnsON fOn 6Pnn1KlER6 STAiE ENERGY SURG:�ANGE <br /> IJ•fucniiONPCG.AY FVdIS�PPPOVED9Y CITYUFEVERETT PUBLICWORKS I <br /> J LOCAL SAL[S <br /> y7� TAX CODE IS 3105 TOTAL <br />