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AP'PLICATI�►N FOR COI�I:iTRUC1 .ON PERMIT <br /> �:������« <br /> . � ..� �, � e <br /> ���, �� <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> DEMOLITION �COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> y n o(N''N[R � rd�aR-AD�ORE55 c�`ix iIP rHON[ 1�.� <br /> q trtrt`ff ro y'�� f]N�T P�YJC��-�TI\y� �]� �0�� Ji t�1o2 S�AYi�� �I ����1��Z.J� <br /> p � � 1 HANI MAIIP�DRE55 CIIY 2iP PHOI <br /> �c ����; �F T(��sso�a� �oa aoz�,�.�,t�e��►�v.��y E�� << �aH <br /> �y � y pRG1atECTOR�ESiGNER MAILADDRE55 CITY 2iP P�����E <br /> �] N <br /> �� (� ��Ty Z�p PMONE LICENS[e <br /> �jYE,�CON ACT MAILADDRESS <br /> �°a � �°a �K��.�►JF����/ �'.p�T-P .�c��n � �� 6�3�35� TiC'a ,�3E'.eG�3Yy <br /> N ~ N,LCHANiCRLCONTRACTOR AIAILAODRESS ( Y � 2�P PMONE IICENSE� /7�E <br /> �c ,f^.�3 - /�9`.� 9�/ii 3��s/s <br /> � � Ei <br /> m <br /> O H PWMBINGCONiRAG70P MAllA0�RE55 QTY ZIP PMONE LICENSE <br /> � CUSS OF WORK <br /> � y � � NEW ADDITION ,��ALTERATION ' � REPAIR � ! DEMOLITION �.�. WOODSTOVFJFIiPLINSERT '._�� BUILDINGRELOCATION <br /> �y � iENANTIMPR [MENTORINTERIORR�EfMOOELONIV a� CONTAGiP�ER50NRND�HONENO. ^ <br /> � O N CONiRACTPPICEOFWORN: � LO � � ��� S�„ A� ���5�� <br /> � � r DESGRiB[WOPN PND SOUAAE FOOT(.GE�IN\V LV[D ���� � <br /> cu � Q N S� �� � <br /> p y aHoroseou=�oFouaoirvc p I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> 8 SOII. �o �PPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �cc��oescniPnoNOFanoPeRn�si�owrvoe�owoannncr+FouAcovies PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PPESUME TO GNE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTflACTORS LAW 1827 RCW AND 29G200 WAC. <br /> SIGN�TUH[OFC NiRA�TOROFAOiHORAFOAGENt pAiE <br /> PROJEGTRD�R[55 ����-�\�{� <br /> � _. . ���� �� �G _( � (. la APPIi��NiSCITV�U51N[55 Eh LNO ANOf1U516E55NR1AE <br /> �q �N <br /> �,� PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPC-OF EOUIPMENT FEE <br /> � � WATER CLOSET�TOILET) NC—A:HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> I � �' LAVATOflY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> _� SHOWEF CLOTHES DRYEflS ' <br /> ' KITCHEN SINK 8 DISP VENTILATION FAN � <br /> ' DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV WATER HEATER � <br /> I �� � CLOTHES WASHER WOOD STOVE � <br /> � URINAL METAL FIREPLACE 8 CHIMNEY �— <br /> ORINKING FOUNTAIN FIREPLACE INSERT <br /> � FLOOR DRAIN HEAT PUMP <br /> 1�► BACKFLOW PREVENTERS GAS PIPING <br /> fl00F DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) � <br /> � � 1 <br /> �� <br /> �� SUB TOTAL S SUB TOTAL $ <br /> �I �� PERMIT $ PERMIT 5 <br /> TOTALFEE S TOTALFEE S <br /> FRONTSETBAGN �[4l15[T�ACN SIDESETOAGK PLANCHECK M�FR FEE �g RECEIPiNO <br /> c�'t��..1� � 4�(CIS `f6 I� 30.�7�" <br /> us�zoNe iornaen VACANi51TE FEES VALUATION PEE <br /> b-ZWj YES ! NO pUILDING ''/3 ;Oo_ <br /> 11PEOfCONSLLLOWABIF IYPEOfGON51AGiUAI atunaxcv xoixOw[umcWuts <br /> v i 1 °P0°' �.,�_ pLUMBING � <br /> �;1 �v <br /> SiZE OF BIOG. NO.OF SiORIES DASEMENT MECNANICAL i <br /> C+-�OCD o�l� I l YES ' O ; <br /> f�CI1PANCYLOA� FIPESPRNKLEPSREO'D ��EIGNTlIMilqilON OTH[R � <br /> � 7 I�] yES '�('NO STATEOUILDINGSURCHARGE y 'S� <br /> i <br /> qEASONfO[i568W� � <br /> �p iasuv.a /2- 2f3-72 As g'�/�j�� STATE[NERGV SURCHARGE � <br /> �yp�,qt �n�c-a�� PUNSAPPy�+I:D6Y CITY OF EVERETT PU�LIC WORKS <br /> ]i��q Lc1.�� �'.! LOCAL SALES _ <br /> s•�—�. TAX CODE IS 3105 TOTAL / � 5� <br /> — <br />