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AF�PLICATIArv''�FUR CON�iTRU�i:T1�N pE�MIT everett <br /> rn�e,�w�o�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> aTv O� <br /> eve rett HEAT� �NG gyS7EM: �GAS ❑ELECTRiG ❑ _� <br /> BUILDItJG DEPARTMENT <br /> 259-8810 <br /> ' DEMOLITION I I COMBINATION I � BUILDING ,�ECHANICAL ❑ PLUMBING 1=� :irN <br /> WUER rdnlLnoDnEs�� _ _� cliY � �� ��Q� i7�� �� [f� � <br /> � /� /1 / / ! � n i. i � %%% <br /> /S.Gy��.��')�-Y�// � LC/i L( v� <br /> ENA /� n /� b/U�pppqF.55 CIiY ZIP ` PNONE <br /> nR IIIEGTORDESIGt1ER C M0.1�ADDRE55 CITV ZIP PHONE <br /> fl![nnLfC ttnncroa . "" •�nqE55._.. .. .. ., � CITY ZIP PHONE UCENSEI <br /> VALLEY �ATURRL GAS, INC. <br /> h1ECI�ANIC�LCOHLRACTOR ran�CkooaEss •5492— _b5�XR'JO—742•2944 PMONE LICENSE� <br /> 26D5 McDougell <br /> CWMOINGCONTRRCTOR IAALTU�iiEsa c��e�ett, Weshln�ton 98201 r o e ucervse• <br /> _ / L:1._ Z�-/3-�� <br /> CUSS OF WORN -f <br /> I NEW I I ADDITION � I C7IATION I I REPAIR ' I DEMOLI;IpN I.i WOODSTOVE/FRPL INSERT I_1 BUILOING RELOCATION <br /> CONTPACTPBICEOfWOBK (� \-Q �� (, � �0=�0.GTPERSONANDPHONENO. <br /> OESCRI�E WO N A���iE OOTAGe INVOLVED� � � ' ,{ I <br /> �51 a4-- '`�' -- <br /> PHOPOS[DUSEOFBUIIDiNG��—� 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �� APPLICATION AND KNOW THE SAME TC�BE TFUE AND CORRECT.ALL <br /> LEGALOESCNPiIONOFPROPERTI'�SHOYlN�ELOWORATir1CHFOURCOPIES� PROVISIONSOFLAWSANDOADINANCESGOVERNIPl3THIS7YPEOF <br /> WORK N!'LL 9E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioT BLOCN ar� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATIIJG�ONSTRUCTION OR THE <br /> -- PERFORMANCE OF CONST9UCTION.TNAT 1,41u1 AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TNE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLI' WITH THE STATE <br /> COIJTfiACTORS LAW 1827 RCW AND 296.200 WP.C. <br /> SIGNATUREOFCOiJRiFCTORORAUTHORIZE�AGENT DATE <br /> X rd <br /> ,,,o,��T�oo��:5��3aa ��i ��n (�. . - — <br /> � PL ANi5QTY0U 11ESSLIC[ ENO.ANDBUSINE�SNAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—NHNDLG UNITS—H.P. / <br /> B�THTUB FORCED AIR SYSTEMS—B.T.U. E.R. ; <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHES C`RYERS � <br /> KITCHEN SINK 8 DISP ; VENTIlATION FAN ; <br /> DISHWASHER � RANGEHOOD � <br /> LAUNDRYTRAY � J WATEfiHEATER ; <br /> CLOTHES WASIIER —�— WOOD STOVE i <br /> URINAL ' METAL F�9EPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAI� FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP � �- <br /> BACKFLOW PREVENTERS ; GAS PIPIIJG _ _� <br /> ROOF DRAINS—AAINLEADERS � EXHAUST FAN � _ <br /> SINK(SERVICE—BAR,ETC.) �I _ <br /> — —T— — <br /> � <br /> — � <br /> — —— � -- � <br /> , � <br /> --- �— <br /> SUB TOTAL $ ; SUB TOTAL $ ; <br /> PEFMIT $ � PEFMIT $ /d i <br /> TOTAL FEE $ ' TOTAL FEE $ G ' <br /> FOR OFFICE USE Q!JLY: <br /> IIIOtlISEipACK ^ 3E�RSElOAGK SIOESEIO�CK �IANCNECKNIIM�ER FEC RECEIPiNO. <br /> ie,rzor+e tornnen VACANTSIIE FEES VALUATION FEE <br /> --�— <br /> BUILDING � <br /> i'�fEUiLONiS.�L'.OWA9LC �YFEOiLONSi.AC1UAL a[uraxcr vomownuncuxrts i <br /> �nwv pLUNBING i <br /> 9ZEOFBI�G. HOOFS70RIE5 �ASEM1IENI � <br /> i MECHANICAL �' �' <br /> UCCUPpNCYL0�0 FIRESPRNNLERSREO'0 HEIGNTUTAIir1T10N <br /> ADDITIONAL PLW CHECK i <br /> � <br /> OTHER � <br /> ❑�nSG.'1 FOO SPIIINKLERS <br /> STATE�UILDING SURCHARGE i <br /> � <br /> unnKE ur rinr+s nrrnoveu nv CITY OF EVERETT PUBLIG WORHS <br /> LOCAL SALES � <br /> TAX CODE IS 3105 rorn� 6 Y � — <br />