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;�z.�_- <br /> ,�, . . <br /> APPLICAT�ON FOR CONSTRUL 1'ION PERMIT "`'<<�" . <br /> mce�-e��ree� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cirv oF <br /> everett HEATING SYSTEM: GAS i]ELECTRIC J <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION �(BUILDING )(MECHANICAL PLUMBING SIGN <br /> . � pPMER MAIL RODRE55 CILY ZIP PHONE <br /> �vFizF%TM�ssou�c �o�� /�// Evf��c;r �� E"��r-�.— 96`<0/ a.s-2—i�/ 2 <br /> tENANT MAIIADOPE55 CI�Y 71P PHON[ <br /> AnCw1EGtORDE5IGNER MRILADORESS CIiY 21P PHONE <br /> �//LYTIQ./�/l/•G'SOl� ZB�2 �OLBY ,�1/. �F/IL"TT� l/g7.01 Z.3-2 -2/.r3 <br /> G[NEPALCONiRAGTOR MAitRODPE55, GtV IIP PIIONE LICENSEt <br /> ��~ -���� ��,M_f'YCPiIl� � <br /> � MECMRNICA�CONTRACTOR MAILApDRE55 QiV ZiP PMONE L�CENSE• <br /> a y /�iour aof�e��^' Et Eu ;r� <o, <br /> [`�H i'LUMBItIGCONLPACtOq AU�LR�DRE55 CITV 21P PMONE LICENSE� <br /> ayv� <br /> H �� CLASSOFWORK . <br /> k n NEW xADDITION . ALTERATION . � REPAIR DEMOLITION WOOOSTOVE/FRPL INSERT � BUILDING RELOCATION <br /> H.�V - /-� COpNTRCTPERSONAN,D�jPHONENOl/A c� �j <br /> � H� LONTRACiPRiCEOFWORN C,{ 1', �34�' n� Y� �G�. / ��%��H�TjL '� ��•S `V // <br /> y z�H-1 OESCRi�[\YORRANOSOUAREFOOTRGEINVOLVED <br /> � Y <br /> O C� /':P�i L'tN� �2 Gr^.v/2/FT/e.r/ <br /> HC7 aaoroseouseoFowiowc p I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> O H�y �OOJT/�N q ST/J-/QIVL'Ld- .eC�'�OP� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL <br /> HC�i1 O �L�V/FTO/' f/�1F7 <br /> �� n iecnioesenivnoNocvaovenniseownueiowoapnTTncr+rouneoriEsi PROVISIONSOPLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> z H 3 �8 Gj � /�UCKE�LS IS%� �,�T WOFK WILL BE COMPLETEC�NITH WHETHER SPEGFIED HEREIN OR <br /> �oT TNKUl�oiocK � ov NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 70 GIVc <br /> y y�:� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> L" H y OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � y PERFORMANCE OF CONSTFUCTION.THAT I AM 11UTHORIZED BY THE <br /> �..� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> Cl C7fA APPLICATION IS MADE AND 1 COMPLY WITH TNE STATE <br /> � �� CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SiGNAT,U�AEOFCONiiVACiOROF�UtHOHi2/EJD�AGENi ORTE I <br /> H OCy/1 X /j/.`y/Y i �LY�/��SK jl2E�JSL�ilE�Z 5-�-�/U �1 <br /> /' A <br /> cnaccr noonE`ss �J,/-I/ p <br /> �Gj�� (�(/E2CTT // Y. EvGRFTT�����OlU� pPP��CANTSCIiY8U5ME55lICEN5EN0/•NOBtI5R1E55NAF1E <br /> PLUMBING MECHANICAL <br /> (� NO. TYPE OF FIXiURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> ` WATER CLOSET(TOILET) lvC-A�HNDLG UNITS-H.P. <br /> �'�'°1' BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> I �! LAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> ��, f � DISHWASHER RANGE HOOD <br /> � LAUNORV TRAY WATER HEATER <br /> CIOTHES WASHER WOODSTOVE <br /> j � � URINAL h1ETAL FIREPLACE 8 CHIMNEV <br /> � !� DRINKING FOUNTAIN FIREPLACE INSERT <br /> '� FLOOR DRAIN HEAT PUMP <br /> � � � BACKFLOW PREVENTEFS GAS PIPING <br /> �'— ROOF�RAINS-RAINLEADERS EXHAUST FAN <br /> SINK ISERVICE-BAR,ETC.) I tL ✓ TO/? � <br /> ' '_' - <br /> � <br /> SUB TOTAI S SUB TOTAL j <br /> �� <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE S TOTALFEE S <br /> . <br /> FOR OFFICE USE ONLY: <br /> fR0lIi5Ci0ACK RERq5ET0ACK $IpESETB�CN PLAHC ��K}�N�UMBER M�E ��; �ECEtPTHO ' <br /> � �� � �l .�a )����� ��L�1" . � � <br /> / <br /> �.isevor+� � �oTenen vacer+rsire FEES VALUATION FEE <br /> /V� �sa, u xw� <br /> euaoinc Z �3 75 (0� ZL <br /> t1P(Of LOIIIS zllnp(pP:C IYP(Oi Wfl51 ACf�IFL o[mttBv no a mLLCVG nV-15 <br /> EX/ASTG 49aP � PLUld01NG <br /> SQEOFALDG NO oFSi0PoE5 o�SEMENI MECHANICAL 1 <br /> ^ ADDITIONAL PIAN CHECN i <br /> OCCUP�YIO�D /IIIESPPNKLCI15tiE0'D IrtiG�rtlIAf1Ati0N <br /> n/Q I �J OTHEH ' <br /> NU:AN fOR SPRINNlERS --1- <br /> STATEBWLDINGSUfiLHARGE __ _ ��_ I <br /> e�LA✓IFfiV CUNSAPPRO�EOUY I� CITYOFEVERETT PU�LIC140RN5 � <br /> ��� LOCALSALES � �' <br /> � �_ TAX COUE IS 3105 TaTp� 7 [)�]z � <br />