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il <br /> APPLICATIG.� FOR CONSTRUCT�.JN PERMIT �'`'`�`" <br /> rno e�-P�n«��� TO BE COMPLETED IN INK—PLEASE PRINT � ,. <br /> CITY Of <br /> eve rett HEATING SYSTEM: ❑GAS ❑ELECTRIC U_ <br /> BUILDING DEPARTMENT <br /> 259-8810 � <br /> DEMOLITION COMBINATION �BUILDING MECHANICAL PLUMBING SIGN i <br /> � MMLAODRESS Lltt Z�� PNONE <br /> p}yNEH <br /> �('iCa�r,p Al,vc6�.�nRF .5'Flas-c�i�E`G,,� a /7u� Eu<R6 i r 4R',za 3 's'��=s 3'�d <br /> TENANT IAFILADDRE55 CITV ZIP PNONE <br /> qqGNRECTONDEStGNER MRiLADORE55 GITY 21P PNONE <br /> Q6Afr _ <br /> GENEMIGONiFAGTOR M>ILAO�RESS CITY IIP PNONE UGENSE• _ <br /> yr� SRr� E o�✓,✓c�e. <br /> �9H M1IECHANICALGONiHRCTOR MAILRODRE55 CITY 21P PHONE IICEN5E1 <br /> C�i-x+ � <br /> 9Hy plU��.piNGCONTRACTOR M�ILRDDRE55 GIiV ZiP PHONE LIGENSE• <br /> H �3 <br /> Nr <br /> y H CLA5�5 F WORN <br /> �C y� <br /> ✓NEW � �. ADDITION ��. ALTERATION ��. I.EPAIR �� '�. DEMOLITION �. WOODSTOVFJFRPLINSERT .�. BUILDINGRELOCATION <br /> CONTRGT PERSON AND PNONE NO. <br /> � �� CONtRACT PRICE OF WC�HK � CT�l- �L II . <br /> y r DESCR�BEWOFNRND`OUA�EFOOLAGEINVOLVEO � � <br /> � f� <br /> � y d /' � <br /> p H PROPoSE�USEOFlUILDING t HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> H ��y � ^�� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> � �� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> H� n LEGRLD-SCRIPTiONOFPROPERTY�SHOWNOEIOWORRTfRGHFOURGOPIE51 yyORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> Z H� �OT_�_ BIOCN oF � �r ��5 NOT. THE GRANTING OF A PERMIi DOES NOT PRESUME TO GIVE <br /> � �"7 Z AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �.,�y �G/ 17 s� � _ OTHER STATE OR LOCAL LAW AEGULATING CONSTRUCTION OR THE <br /> �y (p H � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � dy OWNER OF THIS PROPERTY TO PERFORh7 THE WORK FOR IYHICH <br /> q �^ APPLICATION IS MADE AND I �OMPLY WITH TNE STA7E <br /> 3 C+7 t'� CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> fs1 C� SIGNATUREOFCONLRRCTORORRUtNOFIZEDAGENT DATE <br /> H O fyi� / <br /> / <br /> PPOJECTADDPE55 '" �� ��".Ii ��_�_ <br /> �y�l APLIANLS 'IIVBUSI4ESSlIGENSEt10ANDBU .E55NRME <br /> �.`7 ') �."I . Lc <br /> PLUMBING MECHANICAL <br /> / NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATcR CLOSET(TOILET) •` A�C—NHNDLG UNITS—H.P. _ <br /> I� � BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORV(N'ASH BASIN) UNIT HEATEAS—B.T.U. M �_ <br /> SHOWER � CLOTHES DRYERS <br /> '"" � KITCHEN SINK 8 DISP i VENTILATION FAN <br /> � ' �ISHWASH[R RANGE HOOD <br /> LAUNDRY TRAY � WATER HEATER i� <br /> CLOTHES WASHER � W�OD STOVE � <br /> I� � URINnL ' METAL FIREPLACE 8 CHIM EY <br /> DRINKWG FOUNTAIN ,� FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> +.� ROOF DRAINS—RAINLEADERS EKHAUST FAN <br /> SINK(SERVICE—BAR.ETC.1 <br /> i — <br /> f�1�� ' <br /> � .� SUB TOTAL S SUB TOTAL 5 _ <br /> '' � PERMIT $ PERMIT S <br /> TOTAL FEE 5 � TOTAL FEE S <br /> ,`�,, FOR OFFICE USE ONLY: <br /> fROqiSETBALK REAqSET�ALK Si�ESETBAf:R PIANCNECKNWAOER FEE RECEi�'TNO <br /> 5e� av,w�w, �►�� � ��?o ��i�s� C� . a� 1n3�3o <br /> usezor+e �oTnnen vncnnrsne FEES VALUATION FEE <br /> � <br /> �Z �� N BUILDING " ' ��� <br /> tYP(alGONISAILOWABtE 1VPEOf ONSfALNAI aar�Ntv NOqoxuu�cunns <br /> .,.y.,�( �J'� � °B '° 1�i PLUM�ING � <br /> .JG.!� .Y-r v �/ � <br /> Si2[ovBIDG NOOFSTOPieS 8�5EMENT MECHANICAL � <br /> 'v ''�'•'� � �� ADDITIONAL PLAN CHECK <br /> OCCUPANCYLORD FIRESPRfIXlERSRWD NE�GIITU�rtq7iOM <br /> /U� NV _ OTHER � <br /> ---T— <br /> liE490N FOR SPFiNNlENS <br /> STATE�UIL�ING SURCHARGE �f �,�11 <br /> iH1AKC.OV PIANSAPPPOVEDBY CITY OF EVERETT PU�LIC WORK$ —� <br /> LOCALSALES �— <br /> � n� TAX CO�E IS 3105 TOTp� ia3 �S7� <br /> 4''3�i�' J <br />