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" ` evc�c�lt <br /> �►PPLICATIuN FOR Ct)NS'TRUC . ION PERlVIIT � <br /> m��e�-��,n,����� <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> citv or- <br /> everett HEATINGSYSTEM• �GAS UELECTRIC U ----� <br /> BUILDING DEPAFTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING �MECHANICAL PLUMBING SIGN <br /> �iy 7 p PHONE <br /> OWNEF MRRFDOPE65 <br /> � W ro ��=+–+'-�����` C� GItY ZIP PIIONE <br /> p A !; i[Nr1NT MAILFD��G55 <br /> e �] y � C102� E�-C oeTi1�"�� �-�T <br /> [T� �RCMItECTORDES�GNER MAIt�DDNE55 CITY ZIP PNONE <br /> F~�] Z M <br /> Hj (� CITY ZIP PHONE LICENSE� <br /> O til O i1ChCRALCONTRALTOFl MRILAOORESS <br /> � <br /> � N M '_ <br /> �dECH4NICALWNiBAGTOR MAIL����[55 CITY 21P PHONE UCENSE� <br /> _ "� T1 �8p4 36z�3� 3� �ro�r.�c,� i c. <br /> ro � L�VI�Fir"*i�SW��C1�S 1I�2.Z0 �7� U11LT 21r � PNON[ ucENse� <br /> O Fi � 1`lU�.�fIiNGCONiRACiOB ANiLAD�RE55 <br /> N � � CLASSOFWJRH <br /> � H � '�-�. NEW �. ADDITION �CALTEPATION . I REPAIR ..��, OEMOLITION WOODSTOVE�FRPL INSERT .. BUILDINCa RELOCATION <br /> y y CONTAGTP[1R/�S/O�NANDPYHO'NENJ. ` ` <br /> (p� ~ GONiRRCTPflICEOF WOfiH � •���~ `� � 1L1�� ������G <br /> n O V1 <br /> � � r �ES \YORN AHG SOU/RE fOOT�GE INVOLVED . � r' �� <br /> � 4 � lU � "b <br /> H O vi FROPOSEOUSEOFBUILDING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> pPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESCfiiPTIONOFPPOPERttI5H0YlN6ELOWORATTpCfIFOl1PLOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETH[R SPECIFIED HEREIN OR <br /> ior BLOCK oF NOT. THE GRANTING OF A PERh11T DOES NOT PRESUME TO GIVE <br /> � AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEF STATE OR LOCAL LAW REGLILATING CONSTflUCT10N OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PFOPERTV TO PERFORM THE WOFK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SIGN4TUREOFCONiRACiORORAUtHOHREDRGENT DATE <br /> X <br /> Il�le��Q�cf:L s-���� <br /> PFQIEGTPD�RE55 ^ n) `'� � pPPLICANiSCITYDU5�NE55LICENSEN .Rtlp005ME55NP61E <br /> ���, ` � �///� WR <br /> � MECHANICAL <br /> � PLUMBING FEE <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EDUIPMENT <br /> 1 WATER CLOSET(TOILET) A/C—NHNDLG UNITS—H P �2�z T'pv� <br /> '�� BATHTUB FORCED AIR S`.'STEMS—B.T.U. M E.A. <br /> �_' LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> i LAUNDRY TRAY WATER HEATER <br /> r� � WOODSTOVE <br /> � CLOTHES WASHER METAL FIREPLACE 8 CHIMNEY <br /> URINAL <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> _� BACKFLOWPREVENTERS ' GASPIPING <br /> ROOF DRAINS—RAINLEADEFiS EXHAUST FAN <br /> � � SINK(SERVICE—BAR,ETC.) � <br /> �I � i <br /> i <br /> I � <br /> l , <br /> ISUB TOTAL 5 SUB TOTAL 5 � �1�� <br /> I �� PERMIT $ PERMIT S � l�7 <br /> � TOTAL FEE S TOTAL FEE 5 �h ' � � <br /> FOR OFFICE USE ONLY: necemr r�o <br /> fi�GNiSETORCN RE�FSETOACK SIDESETBACK PIRICHlCY.NU6��[R FEE <br /> IISI ZONE <br /> LOT�REA v�tu+t5iie FEES VALUATION FEE <br /> BUILDING <br /> ���TO�LON15.AlLOW�BIE 7YPEOfCON51AGNAL ��"Mr �a�M1°"°�'�� <br /> �"a''° pLUMBING <br /> yip�pFg�p�, NO.OFSTONES BASEAIENT MECHANICAL ' f ����_ <br /> OCCUPANCYl0�0 FIPESPPNKLEfiSRE00 HE�GNTUMITRION <br /> A��ITIONAL PIAN CHECK _ <br /> OTHER � <br /> -r— <br /> ��f ASOf!�OIi SPBMKlEflS <br /> STATE BUILDING SURCHARGE <br /> ,,.� i;; – �� - � ��i�nns�aarwveoev CITYOFEVERETT ruour,wonKs � <br /> � LOCAL SALES 7 r�� <br /> ���J� TAX CODE IS 3105 TOTAL � <br />