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;� ., <br /> f �� l'�'l��'�� <br /> �`°`�" APPLICATIO. . F6R CONSTRU�T[" t�l P�RMIT � � <br /> ` in�c�-e�a���� TO BE COMPLETED IN INK—PLEASE PflINT � i <br /> ciTv oF <br /> �verett HEATING SYSTEM: ❑GAS U ELECTR!C J ___ ____—__ —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION )( BUILDINCz MECHANICAL PLUMBING SIGN <br /> O':.fleR AIPILADOFE55 GIiY Z�� PHD1![ <br /> �'�ui� lnJr�or� 30 (I?rlEnr,c �x I�UE €ii��I 93�03 3�� C-;ic/ <br /> TENANT MRILP�DHE55 GI:'I 21P PMONE <br /> nRCNIiECTORDL SNEP NARAD�RE55 LITY ZIP PHONE <br /> y�H GENF:�ULWNTPACTOP IAArtApOFl55 CITY ZIP PNONE LiCENSE� <br /> ��� ��A VA�� <br /> �9F3 IA[LNANI�A��ONTRaCiOR MAILAD�RE55 CITY ZIY PHONE LICENSE� <br /> C�H <br /> ay5y PWIIB�NGCONTl1ACTOR MAILAOpRESS Gtt 2iP PNONE LiCENSE/ <br /> H >3 - <br /> y xH ctAssoFwoarc <br /> � H R7 x NEW �. � ADDITION � ALTERATION . REPAIR DEMOLITION WOOOSTOVE/FRPL INSERT .�_ BUILDING RELOCATION <br /> � H� LOI�IACT PERSON�ND PHONE NO. <br /> y~ CONiRACTPPICEOFIVORK CjJ1�L- ��r•U 3SJ'CS/J <br /> 'S. 7+� D[SCRIFE WORK MID SOUPRE FOOTAGE NYOLVED <br /> (i� <br /> d SN�/� — i�'�'S S9. F� T <br /> r,�ovoseouseoFeuitoir+c I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � �� CiIoO/� SHE-�� — �'NNv TnoGS APPLICATION AN[7 KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> q ucn�oesceiorbwoFaaoreatrisHrnyNeaowoAnlv:nvcuRcoPies PROVISIONSOFLAWSANDORDINANCESGOVERNWCaTHISTYPEOF <br /> x H 3 � ��� AIRPo�27 NCRGS WORK WILL BE COIdPLETED WITH WHETHER SPECIFIeD HEREIN OR <br /> Cy�Z ior 5� +5° e�wK ocopoo. oF NOT. THE GRANTWG OF A PERMIT DOES NOT PRESUME TO GNE <br /> H y AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTFIUCTION OR THE <br /> y H PERFORMANC[OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> n d y OWNEF OF THIS PPOPERTV TO PERFORM THE WOFl: FOR WHICH <br /> Cd r <br /> APPLICATION IS MADE AND I COMPLY WITH TV1F STATE <br /> CsJ CONTFACTORS LA�J 18.27 RCW AND 296200 WAC. <br /> 'Y. Hy SiGNAIUR[OFGONT4IACIORORAULNOFRE�AGENT ORiE <br /> HOV� <br /> . .. rna�cTnooaEss X �J;�� Un wl�a» �,_z L - `� <br /> 3U ���J�E.A.IOLIN �U(- - ��_)�_ � _� AP°"�`''��;crtvau. sucer�ser�oauonusw SNAME <br /> PLUMBINC MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> �� WATER CLOSET(TUII.ET) A.�C—A HNDLG UNITS—H.P. <br /> '�� BAT4?U�3 _ FJRCED AIR SYSTE6IS—B.T.U. M E.A. , <br /> LAVATORY(WASH BASIN) UNIT HEATEFi&-B T.U. Id <br /> SHOWER fLOTHES�RVERS <br /> '�''� VENTILATION FAN ' <br /> ' KITCHEN SINK 8 DISP <br /> �— <br /> �� DISHV✓ASHER FIANGE HCOD <br /> LAUNDRV TRAY WAl'cR HEATER <br /> CLOTHES WASHEP WOOD STOV[ <br /> ,r— URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> — --�— <br /> FLOOR DRPIN fiEAT PUMP <br /> ' BACKFLOW PREVENTERS GAS PIPING <br /> +�'�' ROOF DRAINS—RAINLEADEHS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETQ) <br /> �n.� <br /> --�— <br /> !�� SUB TOTAL $ SUB TJTAL 3 <br /> � PERMIT S PERMIT S <br /> TOTAL FEE 5 T.�T�I FEE S <br /> FOR OFFICE USE ONLY: <br /> fR01�T5ELpACH HEAPSElOACK SIDESETOACK fLANCHELKNUMpER fEE P[CEIPTNO <br /> ti! 2(p � <br /> use::oNe �ornnen vacaHrsae FEES 4ALUATION FEE I <br /> BUILOING �� ;(}� <br /> IYPE OF CONiS ALLOWRBLE lYP[Of GCIlSi ACIURL IXav�ea NO p ow[um,U4c5 - � — <br /> �:nWv P111610�N3 <br /> SREOFpLOG. NOAFSTOPiES 0/•SEMENT MECHANICAL <br /> OCCUPANCYLOAU FIRESPHNHLERSPEOD HE�GlITIIMiTATiON AODITIONALPLANCHECK <br /> f'MER <br /> NEASONFORSPNINKlERS ---- --- <br /> STATE BUILOING SURCHARGF � i S L� <br /> irvTAxE OY PLANSAPPRUVED�v CITY OF EVERETT PUBLIC WORK$ <br /> � <br /> L�CALSALES <br /> j c_.� TAX CODE IS 3105 TOTAL Z�} ��_�j <br />