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APPLIC�►TiOi� FOR COIdSTRUI.��ION PER11�'fIT �"��`'" <br /> N;el.-����rg�r��� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CIiY OF <br /> everett �HEATING SYSTEM: J GAS ❑ELECTRIC ❑ — _ — l <br /> BUILD�NG DEP�RTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL I !PLUMBING SIGN <br /> � �,W��[q AIAiLADDRE55 GiY ZIP PlIONE <br /> o f � .1fU.66�1,- rrwo� D3(, 2- 30 � <br /> b�� � �� �, Z�P PIION[ <br /> 1 N i 1.1AilPD�RE55 <br /> � y ` _�_���e,1 �3aR c�{� e� � — <br /> H � N <br /> ARO�11E ROESi0NEi1 MMLAOORE55 CITY LP PNONE <br /> K (� <br /> H 7tl — <br /> bM b G[NERALCONiRACTOR MAILApDRE55 QiY 21P PNONE LICENSE• <br /> N M�+ <br /> ro p �p �dEC11ANICRLCONTPRCTOR MAILAOORE55 Clh' ZIP PNONE UC[NSG <br /> H d <br /> O F+ <br /> � PWI.IBINGCONTFACTOR MAIMBBRE65-- Ci1V ZIP PHONE LIGENSE• <br /> c �° <br /> q y � C1A550F WGRN � <br /> ��� �y y NEW ��. ADDITION LTERATION � REPAIR � � DEMOLITION �. -� WOODSTOVElFRPL INSERT � BUILDING RELOCATION <br /> y H O� C0:lTAG EPSONA {ONEN . <br /> d y �,�2-30 <br /> C� � ""^"^'PPICE OF\VOliY, <br /> � SCFIBEWORNFNP50 AR[FOOTAG IN LV�%/\ ` `` <br /> O fyll � lh LLl�l Q �1`��\ <br /> i�r+orose . _ovom�oiNc � � I HEREBY CERTIFV THAT I HAVE REA� AND E%AMINED THIS <br /> � _ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �tcn�oescmPnorv rnorenrv�sNowr�oe�pvoaarlaci+Founcowes� PROVISIONS OF LAWS AND ORDINANCES GOVERNIN6 THIS T�PE OF <br /> WORK WILI BE COMPLETED WITH WHETHER S°ECIFIED HEREIN OR <br /> ior o�ock or NOT. THE GRANTING OF A PERMIT OOES NOT PFESUME �(O GIVE <br /> 13�� � � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR',-HE <br /> PERFORMANCE OF CON TRUf,TION.THAT I AM AUTHORIZED BY THE <br /> �WNER OF THI PROP Y TO PERFORM THc WORK FOR WHICH <br /> _ APPUCATION S MA E AND I COMPLY WITH THE STATE <br /> CONTRA TORS W 18. CW AND 296200 WAC. <br /> SiGNATURE CONT Gi0 R IZE�FGENT DFTf <br /> X <br /> ;� ` <br /> ❑r+accrno ness <br /> � ��,' 9� � APPLICANLS . DUSitlE55LICEN5EN0ANbBU5ME55NAM[ <br /> rcr� <br /> � t—'l� <br /> PLUMBING MECF! NICA <br /> iNO. TYPE OF FIXTUFiE OR ITEM FEE N0. TYPE OF EDUIPMENT FEE <br /> � WATEH CLOSET(TOILET) _ NC—AiHNDLG UNITS—H.P. <br /> =�1 _ BATHTUB FORCED AIR SYSTEMS—B.T.U. M i 4. <br /> � IAVATORY�WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> � KITCHEN SINK 8 DISP VENTILATION F�N <br /> DISHWASHER RANGE HOOD <br /> I �� LAUNDRY TRAV WATEH HEATER _ <br /> CLOiHES VIASHER WOOD STOVE <br /> URINAI METAL FIflEPLACE 8 CHIMNEY <br /> � DRINKING FOUNTAIN FIREPLACE INSERT � <br /> . '� FLOOR DRAIN HEAT PUMP —� <br /> BACk:FLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> � '=t`' SINK(SERVICE—BAR,ETC.) i <br /> I —� <br /> \' y — <br /> �►'� SUB TOTAL 5 SUB TOTAL $ <br /> , PERMIT 5 PERMIT 5 <br /> TOTAL FEE S TOiAL FEE $ <br /> FOR OFFICE USE ONLY: _ <br /> FRONiSETBACN REARSEt9ACH SIpE5ET0ALK PIANCMECNNUMBEF fEE RECEIPTNO <br /> �- <br /> useiorue tornpen VACRNTSITE FEES VALUATION FEE <br /> �UILDING I 5 ' G � <br /> iYPEOiLON15.AllOWA9lE 1YPEOftONSi.ACNAI aau��':v xoorowlu+,;ur.rs <br /> cxou> p�Uh101NG <br /> � SSEOFBL�G. NO.OFSTOFIES BASEMENT h1ECHANICAL <br /> OCCUPANCV LOAD FIRE SPflNNLEPS REO'D HEIGIIT LINIiAiION ADDITIONAL PLAN CIIECK <br /> i <br /> OTHER <br /> 11EASON FOR SPRINHlERS —�--- <br /> STATE UUILOING SURCHARGE L �S� <br /> i���nHeav riar�snrrnoviour CITY OF EVERETT PUOLIC WORNS <br /> LOCALSALES <br /> _�[� TAX CODE IS 3105 TOTAL � �j <br />