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' APPLI�ATION FOR CONSTRUCTION <br /> i PERMIT <br /> j Ms Everyreen everett <br /> I CITY OF <br /> � everett <br /> I BUILDING DEPARTMENT <br /> ; 269•Beto TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MML�ODRESS Ci1V ZIP PIIONE <br /> JOE MC DONALD 9327 CRESCENT AVE. EVERETT 98203 P2�52-6490 <br /> i TENANT M�ILAODPESS <br /> i <br /> pppNITECfOF0ES10NER MAILAO�PE55 GITY 21P PHONE <br /> OENEiULGONTfl�CTOH MAIL�DDPE55 CIfY 21P PNONE L�GENSE• <br /> MECH�NICALCONTMCTOP M�IL��OPE55 GTY Zi� PNONE LICENSEe <br /> RELIAHLE SHEET_METAL�DHA3810-196th St .SS4, #8 Lynn�aood 98036(670-1256) ARCOIL*141LE <br /> PLUM& A� M�IL�O�RE55 CITY 2�P PHONE UGENSE• <br /> i <br /> � CW90FNORK <br /> �' ❑ NEW ❑ ADDITION CI AITERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILOINGRELOCFTION <br /> i CONiACTPEH50NANDPNONENO� <br /> i TEN�NT�MP110VEMENTORINTERIORREMOOELONLY <br /> I WNTMGTPRICEOFWORk . Z i Z�JY•OO <br /> � pElCRIlEM/ORK�NOBOU�REFOOT�UEINVOLVED <br /> INSTALL GAS FURNACE � HOT WATER TANfC <br /> PIqP09E0 USE OF BUILOINO I NEREBV CERiIFV TF�AT I HAVE READ AND EXAMINED THIS APPIICATION AND <br /> SFR RESIDENCE KNOW7HESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLETED WITH <br /> LEWLOESCRIPTIONOFPROPERtY�SHOWNBELOWOFRR�CNFOURCOPIES� y,r�{EiHERSPECIFIEDHEREiNORNOT.THEGRANTINGOFAPERMITDOESNOT <br /> � PRESUME TO GIVE AUTHOR�N TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> � �m B�aK oF ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER• <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> TFIIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> I AND I COMPLY WITH THE STATE CONTPACTORS LAW 1827 RCW AND <br /> 298200 WAC. <br /> � SIGN�IOPEOFLONiFRCfOROF�UfHOR12ED�GENt OAtE <br /> � 4327 CRESCENT AVE. X�o'�un.c�w— <br /> ppWEGi ADOPES9 �PPLIC�NT$C�11'BUSINESS IILENSE NO.�ND BUSINESS N�ME <br /> ' PIUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSETITOILEn _ A/C—A/HNDLGUNITS—H.P. <br /> BATHTUB S FORCEOAIRSYSTEMS—B.T.LL . � <br /> LAVATORY(WASH BASIN) _, UNIT HEATERS—B.T.U. M <br /> SHOWER <br /> r_LiJTHES DRYERS <br /> KITCHEN SINK6�ISP. VENTILATION FAN <br /> DISHWASH[R _ RANGEHOOD <br /> LAUNDRYTRAY 1 WATERHEATER 6 5O <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACEB CHIMNEY <br /> DRINKINO FOUNTAIN FIREPLACEINSERT <br /> I FLOOR DFiA1N HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> � ROOFDRAINS—RAINLEADERS EXHAUSTFAN <br /> � SINKISERVICE—BAR,ETC.) _ <br /> SUBTOTAL S SUBTOTAL S <br /> 1 PERA!IT 5 PERMIT 5 <br /> TOTAL FEE S TO7AL FEE S <br /> FPONTSETBAGN flEABSETBI�GI( SIOESE7BI�CN PIANGHECKNUM9ER FEE PEGEIPfNO. <br /> useZONe LOT�PE� V�C�NTSIIE FEES VAIUATION FEE <br /> O YES ❑NO <br /> BUILDING <br /> ttiEOFCONSi. OCCUPAIlCYOROUP NOOFOWEllIN0UNIIS <br /> ALLOWABLEI�CTU�L PLUMBING <br /> 912EOFBLUO. NO.OFSTOPIES BSMT. OCGIOAD MECHAN�CAL � <br /> OY <br /> ❑N <br /> IIEIOHfLIMIi�ItON OTHER <br /> iIRESPRINNLER5RE0UIPE0 ❑YES ❑ NO STATEBUILDINGSURCHARGE <br /> STATEENERGYSURCHARGE <br /> �PPLICATIONAGGBY PLANSAPPN.BY PUBLICWORKS <br /> TOTAL <br /> .-...""__.._,."__.___. .r.,-..,. �,,,.. � -�• ' <br />