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A�P�,ICATIO�nr FOR CONSTRU�T�`�N PERMIT e"e�e« <br /> me e�e�9men TO BE COMPLETED IN INK—PLEASE PRINT � <br /> L�TV OF <br /> everett HEATING SYSTEM: i,�GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8610 <br /> � � � i DEMOLITION COMBINATION BUILDING MECHANICAL _ PLUMBING SIGN <br /> � y OWNEP , MAILADDRE55 GiY ZiP PHONE <br /> c H a�.C«pr�.,� C`ons�! I SOI �.nn��,nrrl ���er`^�I{- 9fr`'� I <br /> 'F � V] TENANi MAILADORE55 CITY 21P PHONE . <br /> 1 <br /> � � ARCHITECTOROESIGNER MAILAD��E55 CRY 21P PMOt1E <br /> H �1 <br /> � H � GENEFALGONTRACTOR MAILAD�RESS CIiV ZIP PMONE UCENSEa <br /> fn H <br /> �,Y.� MECHANICALCONiRACTOR MAl1.A�C0E55 CITY ZIP PHONE LICENSEd <br /> H <br /> � yd /X(7�;;;,;;,.�_ r�1n��pl��t I'- I �fiiC�� 0.� CCtT� �18�01 �59�1 �lh CiJlh� 1�� jJ <br /> �y PLIIMBiNGCONTFA iOR � MAILN DFESd Cltt ZIP PHONE LIGENS6e <br /> H� O <br /> 4]V � <br /> � GlAS$OF WORK <br /> � y �.�i NEW �. ADDITION 1 ALTERATION L' REPAIR �� DEIdOLITION _-'�. WOODSTOVEPRPL INSERT ._. BUILDING RELOCATION <br /> � CONTACT PERSON FNp PHONE 110 <br /> H H .��. <br /> �J�/JH CONTFRCTPRIC[OFWORK <br /> � � � �ES/C�PI�BE WORK AND SOUARE FOOT4GE INVOLVED � <br /> �� � ��.lY IC .(� Il P �{l �L111�1CI C F � <br /> PROP seou e BNLDING I HEREBY CERTIFY THAT I HAVE RF.AD AND EXAMINED THIS <br /> y yO � �� APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGRLOESCflIPTIONOrPflOPERTV(SHOWN9ELOWORPTTACMFOUFCOPIES� PROVISIONSOFLAWSANDOR�INANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or BLOCN or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS FROPERTY TO PERFOR�N THE WORK FOR WHICH <br /> _ APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CUNTflACTORS LAW 1827 RCW AND 296.2C0 WAC. <br /> 9CNRTUREOFCONTRACTORORAUTHORREOAGENT DATE <br /> fRQIEGT ADDRE55 \\ Q(l "�ld� U ��OCC � � // <br /> /�O/ �r� � � APP 1 NTS CITY BUSINE55 LICENSE N0.AND Bt151NES5 NAME <br /> PLUM�ING MECHANICAL <br /> - NO. TYPE OF FIXTUAE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> '�1 WAT[R CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB / FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> '�' LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHESDRYERS <br /> , , KITCHEN SINK 8 D!SP VENTILATION FAN <br /> ' ' DISHWASHER RANGE HOOD <br /> � LAUNDRYTRAY / WATERHEATER <br /> '�e CLOTHES WASHER WOODSTOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> ' ' DRINKING FOUNTAIN FIREPLACE INSERT <br /> � FLOOR DRAIN HEAT PUMP <br /> '�1 BACKFLOWPREVENTEr�S � GASPIPING — <br /> � ROOF DRAINS—RAINLEADERS EXHAUST FAN ; <br /> SINK(SERVICE—BAR,ETC.) <br /> �� i <br /> ' � <br /> '�f SUB TOTAL S SUB TOTAL S ,�O; <br /> f�' PERMIT S PERMIT S C� � <br /> TOTAL FEE 5 TOTAL FEE S i+(� ' <br /> '�' FOR OFFICE USE ONLY: <br /> �_-- - PRONTS[T9AGN AEAPSET�ACN SIDESETBACK PLANCHECHNOMBER FEE RECEIPTNO. <br /> usezorve LOTAREA vncaNrsire FEES VALUATION FEE <br /> BUILDING <br /> tVPEOFCONiS.ALLOWAb:E TVPEOiCONSiALNAI oc[uPnrv[r xaOVOwFurtieuxns <br /> cAouP PLUMBWG <br /> S�ZEOFBIDG. NO.OFSTOflIES OASEMENT MECHANICAL (��-� � — <br /> i <br /> OCCUPANGY L04� FIFE SPRNNLERS PEO'D HEIGHT UMITRTION ADDITIONAL PLAN CHECK <br /> OTHFfl <br /> REASON FOR SPFINNLEPS <br /> STATE BUILDING SURCHANGE <br /> INT�NEOV PU�NSAPPROVEDBY CITYOFEVERETT PUBLICWORK$ <br /> LOCALSALES <br /> TAX CODEIS 3105 IOTAL <br />