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i <br /> �..� �y <br /> APPLIGI�TIOIN FOR CONSTRU�T�JN PE�MIT ���«'« <br /> rnx e�nr9ree� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CI7V OF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ _� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION ' COMBINATION \ BUILDING MECHANICAL PLUMBING SIGN <br /> OWI�R // MAIL ADOPE55 CITV ZiP PHONE <br /> :���• �'� ��� P�����,�—t 9�d'� 6 3 �.S" �- � o a � � <br /> ��� � fT[J�'NT � MRILA RE�S CITY 21P PHONE <br /> J G-zvi o <br /> � pHCHIiECTOR0E51GN R MRILAODRE55 CITY ZIP PNONE <br /> Q <br /> y�� GENERALCONTRACTOR MRILADDFlESS Cltt 21P PNONE LICENSE� <br /> � � MECHRNICALCONiRALTOR M�ILRpDRESS CITY ZIP PlIONE LICENSE/ <br /> '��.,,� � PWMB�NGCONTR�CiUR MnIL�DDBE55 CITY ZIP PHONE LICENSEt <br /> � <br /> R'�� CUSSOFWORK <br /> ��y �l NEW ;_I ADDITION ��-�. ALTEFATION . REPAIR � ��. DEMOLITIOY , : WOODSTOVFJFRPI.INSERT �� BUILDINGRELOCATION <br /> �N � �A CONiTf,TFERSONANOPHONENO. <br /> Q w CONTRACT PRICE OF WORK �'// .�_ � � �2 Y 6 G _ <br /> • <br /> OESCRIBE WORR Np URRE�OOTAGE INVOIV� � <br /> ry� <br /> � � SEOF�UILOING —Z I HEREBY C[RTI�Y THAT I HAVE RE4[1 A.`1D EXAMINED THIS <br /> �� APPIICATION AND KNOW THE SAME TO BE'i RUE AND CORRECT.AL� <br /> �� IEGALDESCRIPT10NOFPROPERtt�SNOWNBELOWOPFTTACHFOUdJOPIES) PFlOVISIONSOFLAIVSANDORDINANCESGOVERNIN�;THISTYPEOF <br /> � WOflK WILI BE COi.iPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot BLOCN oF ,aOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> —� [I ,� /1UT40R17'i TG VIOLATE OR CANCEL THE PROVISION3 OF ANY <br /> ��p �..�.. �C�G Q . �(J��i _ UTt;cN :�T�•'�C'. '-OCAI.LAW REGULATING CONSTRUCTION OR THE <br /> „ _ —� ' PF�F�CP�.:'��r•:e J`�ONSTFUCTION.THAT I AM AUTHORI2ED BV THE <br /> � OWNE" ��:��� '�.�.ii3 i-ROP`cRTY TO PERFORM THE WORK FOR WHICH <br /> _ . APPLiC:.i!ON IS A�ADE AND I COMPLY WITH THE STATE <br /> CQNTRACTURS LAW 1027 RCW AND 296.200 WAC. <br /> SIGNRTUfE��CONTRACTORORAUTHOPIZE'JAGENT OATE <br /> X <br /> PRQIECiADDRES.�7 �� _/�_ �/ <br /> - // /Q �„_„� APPLICnNTSCITYBUSMESSUCEN5EN0AN�8USINE55NAME <br /> V� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N7. TYPE OF EQUIPMENT FEE <br /> I C, WATER CLOSET(TOILET) A/G—AIHNDLG UNITS—H.P. i <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATOFY(WASH BASIN) UNIT HEATERS—B.T.U. M i <br /> � SHOW ER CLOTHES DRYERS <br /> � I ' KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> i DISHWASHER RANGE HOOD <br /> � LAUNDRYTRAV � WATER HEATEfl <br /> � �-. CLOTHES WASHER � WOOD STOVE i <br /> IURINAL METAL FIREPLACE 8 CHIMNEY � <br /> 1 ��I DRINKWG FOUNTAIN FIREPLACE INSERT ; <br /> � FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING ; <br /> �. � ,~I ROOFDRAINS—RAWLEA�ERS EXHAUSTFAN � <br /> . _'� SINK(SERVICE—BAR,ETC.) ' <br /> ' I�I_� <br /> SUB TOTAL $ SUB TOTAL S <br /> j PERMIT $ PERMIT $ <br /> I � TOT.4LFEE S TOTALFEE 5 <br /> �r,� FOR OFFICE USE ONLY: <br /> � FRONTSETUACK qERRSETBAGK SIDESETB�CN PLANCMECKNUMOER FEE RECEIPTNO. <br /> �Oc� ; <br /> USE20NE �ornaen VRCANTSIiE FEES VALUATION FEE <br /> BUILDING �J/ �� <br /> IVPEOfCONi5.0.LOWRBIE iYPFOfLONSiACNAL aNva•p NouowRuxcuxrt5 <br /> �Pa1° PLUMBING ' <br /> i <br /> 52EOFBLDG. NOAFSTOPIES 9n5EMENT MECHANICAL � <br /> i <br /> AOOITIONAL PLAN CHECH � <br /> WCUPANCYl0A0 FIRESPRNKIENSREOD HEIGNTLIMITRiION � <br /> i <br /> OTHER � <br /> pEF50N FOR SPRINNlERS <br /> STATE BUILDING 3URCHARGE i,SJ <br /> INTANEBV PUNSRPPROVEOOV CITY OF EVEREIT PUBLIC WORK$ � <br /> LOCALSALES <br /> TAX CO�E IS 3105 T�TAL � � ��� , <br /> , <br />