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�' �..we•g <br /> t... <br /> everett "'��'"':; � <br /> ;�-`" APPLICATIO`•. FOR CONSTRUCTIJN PERMIT ; <br /> r � r <br /> ' tnn[rary�xnn <br /> TO BE COh7PLETED IN INK—PLEASE PRINT <br /> CIIV JF <br /> everett - --- -� <br /> � HEATING SYSTEM: I,GAS Ll EIECTRIC U __ -- - -- <br /> BUILDING DEPARTMENT -��—— <br /> 259-88�0 <br /> "��ry DEMOLITION COMBINATION . BUILDING MECHANICAL 'X P�UMBING _ SIGN � <br /> ta OWNE / MAllA0DHE55 C�1V ZIP �* PNONE <br /> C�� - ��ic�C,� � . C.. �/7 FY �a-�-�a-v_���i-c_� r-. �t- c�3 3 Y 7 - a 8 7 a <br /> TENANT MNL�DDRESS CITV ZIV PHONE <br /> ��� qqCHRECT OR OESIGNEfl MAIL ADURE55 CIiV LiP GHONE <br /> ��� <br /> � GENEMICONTRACTOR MFII POORE55 CRY ZIP PHONE LICENSE� <br /> �w,.�., 6 c df+K,z ��� <br /> z� MECHRNICFLCONTR�CTOR MRILADDRE55 CITY ZIP PHONE LICENSEM <br /> �d ��7� Z�p PHONE LICENSEN <br /> Q�� PWMBINGCONTR4CTOR MNL/�ORESS <br /> [. <br /> p[ag �pe't it` c%sss �/mb .��7%x y<A�'m� � 9Ez�r ?s?3ssz .t'o-rr<r�vcs <br /> N �+ CLFSSOFWORK . . <br /> '_L'y 3 X NEW ADDITION . ALTERATION . �. REPAIR � DEMOLITION . '�. WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> C � CONTACTPERSONANDPHONENO. <br /> �y CONTRFCTPRICEOiWORN <br /> N DE WOHNRNDSOUAREFOOTFGEINVOLVED <br /> "�� ��6 S� <br /> ���'"+ aAoaoseouseoFeui�oirvc I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> y`� ew No✓ � G APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFiECT.ALL <br /> y�� �ecu oescAivnorvoc Pqoaea*v tsxowru eE�owoanrrncN Fouacoaies� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �o* e�ocK oF NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF 7HIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br /> APPUCATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SIGNNTUREOFCONTRNCTORORAUTNORIZEDTGENT OATE �/���/ <br /> � I C F ¢ T .sNt. �' X /'/� �' �� <br /> PRO)ECTFDDRESS <br /> APPUCANTS CITY BUSINESS LICENSE NO.ANO BUSMESS NPME <br /> PLUMBING MECHANICAL <br /> �� NO. 7YPE OF FIXTURE OR ITEM FEE NO. 7'MPE OF EDUIPMENT FEE <br /> WATER CLOSET(701LET) i � N�WHNDLG UNITS—H.P <br /> � BATHTUB /� ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> 1 � LAVATORV(WASH BASIN) S� i UNIT HEATEFS—B.T.U. M <br /> ��- � SHOWER CLOTHES DRVERS <br /> KITCHEN SINK&DISP S � VENTILATION FAN . <br /> .� DISHWASHER S � RANGE HOOD <br /> � LAUNDRVTFAY ' WATER HEATER ' <br /> ' WOOD STOVE <br /> �� � CLOTHES WASHER — <br /> i URINAL METAL FlREPLACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIFEPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPiNG <br /> �t_1 ROOF DRAINS—RAINLEADERS EXHAUST FAN _ <br /> � SINK(SERVICE—BAR,ETC.) <br /> i _� —�— <br /> i SUB TOTAL $ _S SUB TOTAL $ <br /> PERMIT $ ;d PERMIT $ <br /> I �� TOTAL FEE $ 6 � TOTAL FEE $ <br /> � <br /> � FOR OFFICE USE ONLY: <br /> FRONT SETBRCN REAR SEiBPCK SiDE SEt6ACK �'I PN dHECK NUMBER FEE AECEIPT NO <br /> usezaue �ornaen vncnr+TsiTe FEES VALUATION FEE ` <br /> BUILDING <br /> rvPEOiCONiSFLLOWNBIE iVPFOFCON5T4CiUFl OtGu�>NGv x00rOW[uMGUXrtS — --- <br /> GPOu° PWMBING � S <br /> SIZEOFBLOG NOOPSTORIES BASEMENT MEGNANICAL <br /> OGCUPRNCV LGAO FIHE SPRNH�ERS RFO'0 HFIGHT UMITqTiON ADDITIONFL PLAN CHEGK � <br /> OTMEP <br /> RF�ISON FOR SFR W NLERS <br /> STAiE BUIIDMG SURCHAFGE � <br /> �NiqeF Av PIRNSPPPROVEDB� CITY OF EVERE7T PURLIC WORKS t <br /> LOCALSALES <br /> � TAl(CODE IS 3105 TaTA� C r�' - <br />