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APPLiCAT10�� FOR CONa1PR ��i�.��.��PERMr.-IT <br /> �ll i I!1 evemtt <br /> `"-u JUN %7 i990 `"" <br /> m��E:�.,,��<<„� � <br /> ccvar _ ....._......... <br /> eVCrett � CITY OF EVERETT <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE�B,��kTWorks �cpt. <br /> 259-8810 BUILDING XMECHANICAL P'�UMBING SIGN <br /> DEMOLITION '. COMBINATION -- — <br /> (((]]] 21P PHON[ <br /> � � �7 O1YNE MAILAD�Ri.S C'�iY <br /> y ZIP PHOBE <br /> � y y ifNnN w1A1fIlA��BES.i (�L�'� dTY _ '� �� <br /> !'C�l Mf;NI <br /> C' 7 G � yv PHONE <br /> �.1 � 'j • CITV ZIP <br /> y Z M pqp111ECTOH�ESIGNER ldR�LA�OPE55 <br /> � H A Z�p PHONE LIGENSE� <br /> K' N � GCNERn�CONiR�CTOB MAILA�DRESS CITM � L ! C <br /> �+ . ) $ ' I � ��' ��-' � } IICENSE/ C+Pn:E- 3/�7��1� <br /> $ citt zm P��oNe <br /> IU O EV �CNANICAL WNTPACTOR AIAIL�DDflE55 C����n � _A ^�� ��i�L't *2��Z D(..� <br /> O N -�i_ v � /.I Y) I)� f�i�Jct L V <br /> H ty , �"^ �,�I � 1 G��I QA1 � ZtP PH016 LICENSE I <br /> z c) O Ls-�1i.7..�- � cin <br /> � lC � PWMDINGCONiRACTOR lAAILPODRESS <br /> 7 H QRSSOFWORN . � __ <br /> � N H NEW �..�. ADDITION 7C ALTERATION , REPAIR � � DEMOLITION . WOODSTOVEiFRPL INSEflT '�. 1 BUILDING RELOCATION <br /> CONTRCT PERSON AND PHONE NO. ^ A n��G <br /> R � y TENPNT IMPFOVEMENT OR IM�RiGR FGA10D[10�1LV i N i�C� O�`1 � <br /> �,.-1 �, � <br /> Cqp CONiRAG1PRIGEOFWORN: � / <br /> ry �y � OESCRIBEWORKAHOSOUfiNFP� ���� `' __ <br /> H O N /, '" N � V <br /> L� Y�� }Z �D � p <br /> raoPosEous OFOUILDING I HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED TH�S <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �% ' IL� PROVISIONS OF LA'JJS AND ORDINANCES GOVERNING THIS Tl'FE OF <br /> L[GALOESCFIPTIONOiF80PERttISHGNTl9ELOWOFATTACMFOURCOPIE51 y�ORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERBN OR <br /> BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ��T AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � k � 1^' � s OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> IV PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNEfl OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH <br /> IS S � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18,27 RCW AND 296200 WAC. � ZS <br /> SiGNA�FCOtITPACLORORAUiHRi?E N' PFTE� � ��1' <br /> X �,,�.d4 ��'� <br /> 1 , T fJ_(%°�J[z�-1-�!_�' LTI� � I 31 c14- <br /> ���.; PRQIEGTADDRESS � rj7N�,0�1 P � APPLiC�NTSCiTVHUSM[SSIICE�15Et10AN�BU9NE55NAR1E <br /> I � � MECHANICAL <br /> � � PLUMBING TYPE OF EOUIPMENT FFE <br /> 1 FEE NO. — <br /> NO. TYPE OF FIXTURE OR ITEM p;�_q,HNDLG UNITS—H.P. ���o,• <br /> �_ WATEF CLOSET(TOILET) FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> �—� BATHTUB UNIT HEATERS—B.T.U. M <br /> LAVATORY(WASH BASIN) CLOTHES DRYERS <br /> SHOWER VENTILATION FAN <br /> KITCHEN SINK 8 DISP � RANGE HOOD <br /> � __ _ DISHWASHER i WATERHEATER <br /> i LAUNDRYTRAY � WOODSTOVE � <br /> CLOTHES WASHER � METAI FIREPLACE 8 CHIMNEY --�— <br /> URINAL � FIREPLACE INSERT <br /> DRINKING FOUNTAIN HEAT PUMP <br /> _� FLOOR DRAIN —�_ <br /> � GAS PIPIN6 <br /> BACKFLOW PREVENTERS <br /> � EXHAUST FAN <br /> � ROOF DRAINS—RAINLEADERS <br /> ��1� SINK(SLRVICE—BAR,ETC.) <br /> �� __ i <br /> i <br /> I !I��! SUB TOTAL S SUB TOTAL 5 r76 D � _ <br /> � PC-Rh11T 5 PERMIT 5 � <br /> ' TOTALFEE 5 TOTALFEE 5 / <br /> FFON�SET�RCN PEARSEI9RCK SIpESEIDACK <br /> PLpryLNECNNU�ABER f[@ PECE�PTNO. <br /> lOT RREA VACANT SIIE <br /> FEES VALUATION FEE <br /> usezoNe � YES � ' N� � — <br /> BUILDING <br /> i <br /> o�a�re�.cr i,�c�onunM1;r;:is <br /> 1YPEO�LONSi.AIIOWFBIE 7YPEOFCON.L.AC7UAL � „ p�UMBING <br /> SiZEOFOIDG 1lO.OFSI0RIE5 OfSEMENT I,IECHANICAL ' ��'� 1� <br /> ��! VES i I NO � <br /> O7HE(7 <br /> ���Pµ�y�ppp FIRE SPPNKLEPS REO'D NEIGHT LIMIIATION i <br /> r ; yES � �. NO STAiE Bl11LDING SURCHARGE �_ <br /> _ <br /> REASONFORSPHINNLERS S7ATE ENEFiGV SURCHARGE ' <br /> APPUCRTIONAGG.BV PLANS�PPIlObE[�OV CITYOFEVERETT PUBLICWORK$ <br /> LOCAL SALES � ' �- <br /> �C.,' TAX CO�E IS 3105 TOTAL a�S <br />