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APPLICATId�`ti;� F�R CONSTRUCY��.:�N PERMi'p' PVe�P�t <br /> mne�-w��een TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cirv or <br /> everett � ryEATINGSYSTEM: ❑G/1S ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> i I DEMOUTION ❑ COMBINATION ❑ BUILDING �I[.�ECHANICAL IJPLUMBING ❑ SIGN <br /> �WH q M41L�ODRE55 CITY ZIP PIIONE <br /> f�j_,�. wGI7ZE2— <br /> Nom»+�-1._ loao3 is��Pl- SC .sVayontlsf( 9aaso <i�a Y3v8 <br /> iENANT MAIL�DORESS GTY TIP PIiONE <br /> MICIIIIECiOfi�F.51G!1F.R MRIL4��f1E55 CI1Y ZIP Pf10NE <br /> GENERALCONTRACTOR MqIL��OPE55 CITV ZIP PHONE LICENSER <br /> IAECHAYIC�Lf.ONiiihCTOfl �tAIIADDRESS CI7V IIP PHpNE a.ICENSE/ <br /> �C� I{J�tm�7 Po,Usr�°uC�a� s�.vie //Un1rl7f=cni.26CD <br /> PLUMBINGCONiR�C10B MMLAD�RESS CITV ZIP PHONE LICENSEI � <br /> CLASS OF WOfiK <br /> I�?NEW ❑ ADDITION ❑ :.LTERATION LI REPAIR I I DEMOLITION I.I WOODSiOVE/FAPL INSERT L] BUILD�`JG RELOCATION <br /> CONiACT PERSON�ND PNONE NC <br /> CONTRACT PfiICE OF WORH <br /> DEQSC�R�JIOE WORK AND SOUr1RE FOOTr1GE INVOLVEO — <br /> `��'l fi RtK( � S <br /> rnoroseo � eoF ILDING I HEREBY CERTIFY THAT I HAVE READ AND E;(AMWED THIS <br /> � APPLICA710N AND KIJOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �ecnioes PIPTI01tOFPROPERTY�SHOWNBELOWOR�TTACHFOIIRCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVFEOF <br /> WORK WILL BE COMPLETE�WITH WHETFIER SPC-CIFIED HEREIN OR <br /> �or OU:^.N oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 3fVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> _ OTHER STATE OR LOCAI LAW REGUTATING CONSTRUCTION OR THE <br /> PERFORM�NCE O�CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> ��— APPLICATION IS MADE AND I COMPLY WITH THE STP,TE <br /> CONTRACTOPS LAW 1827 RCW AND 296200 WAC. <br /> SIGNAiUfiEOFCONTR4CTOROBA1Jt4GRRE0AGENT O�TE ^/��/9/' ' <br /> 1 � <br /> x �Q��� �A ;' <br /> rnaecr nooness <br /> Y-SVJ JLt� �y-yE� A�PLIC4NTSCITYOUSINESSLICGNSF .ANDUUSINESSNAME <br /> pLUMBING RIECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC�NHNDLG UNITS—H.R � <br /> BATHTUd FOPCED�IR S`.'STEMS—B.T.U. M E.A. � <br /> LAVATORY�WASHBASINp � UNI�i HE�TERS—B.T.U. M ; <br /> SHOWER ' CLOTHES DRYERS T— <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISH WASHER RANGE HOOD , <br /> LAUNDRY l"RAY ' W.4TER HEATEfl � <br /> CLOTHES WASHER � WOODSiOVE � <br /> URINAL � METAL FIREPLACE&CHIMNEY i <br /> DRINKING FOUNTAIN i FIREPLACE INSERT i <br /> FLOOR DFlAIN � HEAT PUMP i <br /> BACKFLOW PREVENTERS G�S PIPING � <br /> � <br /> ROOF DRAINS—RAINLEADLRS � EXHAUST FAN �--;-- <br /> SINK(SERVICE—OAR,ETCJ ; � <br /> _ � <br /> � <br /> ' � <br /> � � <br /> � <br /> ' � <br /> SUB TOTAI. $ ; SUB TOTAL $ ��) ! fizJ <br /> PERMIT $ � PERMIT $ ' ' <br /> _ � <br /> TOTALFEE $ ' TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> Fn04TSE10ACK REAflSETB�CK SIOESETOACH PL�NCHECKNUTABER FEE RECEIPTNO. <br /> usezoNe ioraAen VACANi51TE FEES .ALUATION FEE <br /> 9UILDMG ' <br /> i <br /> lY"-0�CONtS.M1:IOWApLE tYPEOfCONSi.At7UAl acure':[r xaarvnuuriou¢us <br /> r.nrmr PLUM9ING � <br /> i <br /> S12E OF OlDO, NO.OF STORIES �— <br /> BnSEMENT AIECHANICAI i <br /> OCCUPANCVIOAD FIRESPpNNLERSREO'D IIEIGNiLIMIiATION �DDITIONALPLANCriECK � <br /> OTHEP i <br /> ❑EASON FOR SPRINNLERS � <br /> STATEBUILDINGSURCHAHGE ,� � <br /> rlinKEOY PLANS�PPqOVEDBV CITYOFEVERETT PU�LICWOflK$ i <br /> �ocn�sn�es <br /> TAX COUE IS 3105 TOTAL <br />