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t <br /> w �� <br /> .{z.,-��. ua..ur� •. <br /> % APPLICATIO�FOR CONSTRUCT'1�1 PERMIT �V2�P« <br /> �E�ro�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> � everett HEATING SYSTEM: GAS ❑ELECTRIC ❑ — <br /> �� BUILDING DEPARTMENT <br /> � 259•8810 <br /> p � ; DEMOLITION COMBINATIOk i BUILDING �MECHANICAL xPLUMBING SIGN °°°�'i� <br /> ��� O�+ER MRII AD�ilE55 Cltt ZIP PHONE � <br /> l 'A,(�� ( �, al'1;11t r�4tY� C,��aCo�L,ntf-I� �� � 5'� -Ir-IP� <br /> N�NT MAR AD�RESS q7V ZiP PNONE <br /> ��� � m <br /> AFCHITECTOROESIGNER MRILRD�RE55 GTY 21P PNONE <br /> �� � <br /> x ,� GFNERQCONTRACTOR M�ILADOFESS CITV ZIP PHONE LICENSE� <br /> �� ry � b��� ; r��- 3110 t�l,�l l /1�� �i�,✓etl- �4�l 2�1�3�i NorFG,��l�lv��� _ <br /> Q^� 9 MECH�Tp��TOH MRI�AD�RE55 CiiY ZIP PHONE LICENSEt — <br /> vq � <br /> PLUMBINGCONTR�CTON M�IL�ODNESS GTY ZIP PHONE IICENSE <br /> ��� ��j ,� I <br /> �M y '�� C SSOF WORK . _ .., ' <br /> �p i�NEW [_i A�DITION . ALTERATION I REPAIR . DEMOLITION WOODSTOVE/FRPL INSERT G BUILDING RELOCATION <br /> �� �j, CONIAGT PERSON AND fNONE NO. <br /> y GONTMGT PRILE OF WARK 4' t' � � �� <br /> � F� DESC�RIBEWORKANOSIXI�REFOOTAGEIN OLVED <br /> ,�'�in (51 V e, -. C Ca� <br /> -- aRoros SEOFB �NG I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> - APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> lEO/�LDESCRIPTIONOF FROFERtt ISHOWNBEIOW OR ATTACII FOUR LOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF I <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HCREIN OR <br /> � �oi B�ceK o° NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE .ti � <br /> i /�� �`�^ — AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � �1� � ��.�� �(iCJ� (�4! OO � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE - <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFOFM THE WORK FOR WHICH �.t � <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE . <br /> CONTRACTORS LAW 18.27 RCW AN�296.200 WAC. � i <br /> SIGNRTUPEOFCONTRACTORORFUTHORIZEDAGENT OATE � � <br /> 1 <br /> (�3ar� �lli��l- U-� Y� X � � � =�/ ; <br /> PRQIECT�DDRESS / <br /> APPIICANTSC BUSMESSUGENSENO.RNOBUSiNE55NAM[ I <br /> ���\� MECHANICAL ! <br /> : . PLUMBING . �� <br /> i NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � I � �- ; A/CrA/HNDLG UNITS—H.P. <br /> , t WATER CLOSET(TOIIET) <br /> ' BATHTUB FORCED AIR S`.'STEMS—B.T.U. M E.A. ' <br /> � LAVATORV(WASH BASIN) i UNIT HEATERS—B.T.U. M � I <br /> � �� } SHOWER CLOTHESDRYERS ' <br /> ,I � ;� KITCHEN SINK&DISP VENTILATION FAN I <br /> � R�NGEli6�8 � <br /> DISHWASHER <br /> , I �� LAUNDRV TRAY WATER HEATER < � <br /> i c CLOTHES WASHER i WOOD STOVE ' <br /> URINAL METAL FIREPLACE 8 CHIMNEV � <br /> � � DRINKING FOUNTAIN i FIREPLACE INSERT <br /> � i FLOUF DR;:V � HEAT PUMP ' I <br /> II �_'�_ : BACKFLOW r'F-VENTERS i GAS PIPING � <br /> . ROOF DRAINS—RAINLEADERS EY.HAUST FAN � <br /> SINK(SERVICE—BAR.ETC.) _ ' <br /> i <br /> �� - — � I <br /> � � <br /> � T <br /> � ry��r.i SUB TOTAL 5 � <br /> UB TOTAL $ <br /> _� ; PERMIT S � PERMIT 5 � � <br /> _. .--�-���--� � TOTAL FEE $ ' TOTAL FEE $ ; <br /> FOR O .FICE S N,I�Y_� <br /> fflONTSEiB�CK REAPSEIBACH SIDESEIDACN PLANCMECHNUAtBER FEE RECEIPTNO. <br /> � 3Sli1�S <br /> USE 20NE lOT RRER VACANT SITE FEES VALUATION FEE <br /> BUILDING <br /> iYPE 0!C0Y15 AIIOWABIE iYPE Oi CONSi AC111A1 atu>��rGr Ho a RnYu�,acuvas <br /> GflWP PLUMBING � <br /> S12EOFBl�G. NO.OFSTORIES BASEMENT MECIIANICAL <br /> OCWPRNCVLOAD FlRESPfiNKLER5RE0'� NEIGHTUMITALION <br /> ADDITIONAL PLAN CNECK i <br /> OTHEF7 � <br /> REASON FOR SPRINKLERS �— <br /> STATE BUILDING SURLHARGE <br /> INiANEBV PIANSAPPROVGDOV CITYOFEVEREIT PUBLICWORK$ � . <br /> LOCALSALES � <br /> TAX CODEIS 3705 TOTAL ' <br />