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�-- APPLICAT14.d FOR CONSTRUCT�ON PEI�MIT <br /> �{ , everett <br /> Ihe Evergrecn � <br /> CI7Y OF <br /> evereti <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> DEMOLITIOPI �COMBlNATION � BUILDING : MECHANICAL PLUMBING SIGN <br /> � OWNER MA1lADDRE55 A�` CITY 21P ���OHE <br /> „ FN�s�.�?��� wa.1�e� ���-�4k � �z�3 35 � --�i/io <br /> 7Eryp T I 'A HAIL�DLFESS CITY 21P PHONE <br /> .. �1 N <br /> APCMITE�CT`ON�DESIGNER M�ILADCRE55 CIiV ZIP PHONE <br /> 1�' . 1'J <br /> y�H NERRLCO iRACTOR � IM�L ADDNESS CITY ZIP 2 g'�HONE UCENSE� <br /> ��� ��w� . ""��o _ �,.,x s�3 h��-'�51��P y��Yo�o�z� PAkI. �.SGiol P�1� <br /> Id[GNANIL�LCONTRRCTOP MAIL�D�RE55 CITY 2�P PNONE LiCENSE� <br /> [A','1�H <br /> ayVJ PIUMBINGGONTNRGTOA MAiLADOPE55 CITV ZIP PHONE ���� <br /> H �3 <br /> 1� H CLASSOFWORN �i <br /> K y� � NEW �. �, ADDITION . ALTERATION . REPAIR �� �� DEMOLITION C'�, WOODSTOVE/FRPL INSERT �. �. BUILDING RELOGATION � <br /> TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY CONT�GT PENSGN/�ND PNON'�\p I <br /> � y� ] '' 2.3Za - U <br /> CONiRACTVRiCEOFYIORN: � \ � �"�� �� �� �� " <br /> z DES=`qiBEWORKAND50UAREF00TAGCINVOLVED <br /> �` y� lo v S2 " r <br /> O H anovosE USEOF(B�U�LDING I HEREBV CERTIFY THAi I HAVE READ AND EXAMINED THIS <br /> H C�]g �� F pC APPLICATION AND KNOW THE SAA!E TO BE TRUE AND CORRECT.ALL <br /> �" n IEGRLDESGRIPT10NOFPROPENtt�SHOWNBElOYlORATTACNFOIIHCAPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNING7HISNPEOF <br /> WORK WILL BE f,OMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> 9 y� ioT BLOGK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> r H y AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � � ��t �,`��t� OTHER STATE OR LOCAL LAW PEGUTATING C04STRUCTION OR THE <br /> H PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEO BY THe <br /> n dy OWNER OF THIS PROPERTV TO PERFORM THE WOPK FOR WHICIi <br /> q �r APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �3 y y CONTRACTORS LAW 1827 FCW AND 296.200 WAC. <br /> SIGNRTUPEOiG�RRFCTONORRUTMORIZED�GENT C]iE <br /> H O tn X //�/ // <br /> -_��//� 3�2/4 C <br /> i <br /> PR0.1ECptApORE55 <br /> p LZ �v`^�` - qPP �CRNTSG YBUSiNE55lICEN5EN0 �BUS�NESSNAME <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF FI%TURE OR ITEM FEE NO. TYFE OF E�UIPMENT FEE <br /> .�,� WATER GLOSET(TOILET) � !bD—loHNDLG UNITS—H.P. <br /> I�= BATHTUB FORCED hIR SVSTEMS—B.T.0 M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRVERS <br /> � � KITCHEN SINK 8 DISP i VENTILATION FAN <br /> !! DISHWASHER RANGE HOOD <br /> LAUNDRYTRAV WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> a�� I URINAL METAL FIREPLACE 8 CHIMNEV <br /> DF7INKING FOUNTAIN FIPEPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> ' ��' BACKFLOW PREVENTERS GAS PIAING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; <br /> � .`� � <br /> T <br /> �+ SUBTOTAL 5 SUBTOTAL 5 <br /> ��� PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE S <br /> fRpNTSETBACN PEAqSETB�LK SiOESETBACR PIANCMECKNUMOER FEE RECE',PiNO <br /> � <br /> uSEZONE LOiAREA vecN+isrte FEES VALUATION FEE <br /> '._ YES �. . NO BUILDING <br /> ivY(piWNSfAllPN1BlE IYPEOiLdI51.KtUAI �`' toonn�ia,u���s <br /> �'�' PLUTABING <br /> SREOGBLDG. NO OiSTOR�ES BASEMENT MECNANICAL � <br /> ❑ YES I : NO � . <br /> cXGUPIWCYLOAD FIR°SPPNNI[NSREOD NEIGNTLW�I�TION OTHER � �, <br /> i <br /> �� YES �. NO STpTEBWLDINGSURCHnRGE ; � <br /> —�— <br /> REASONLONSPRWNlEPS � <br /> STATEENERGYSUPf,HARGE � <br /> APPIIGATqNACC.BY RANSAPPROVEOBY CITYOFEVERE7T PUBL�CWORN$ <br /> LOCALSALES - <br /> TAX CDDEIS 3105 TOTAL <br />