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APPLICATIO�FOR CONSTRUCTIL.��1 PERMIT everett <br /> p„E,�,o,,.,, TO BE COMPLETED IN INK—PLEASE PRINT � <br /> citr oF <br /> everett HEATING SYSTEM: U GAS ❑ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I I DEMOLITION i i COMBINATION ' � BUILDING ! �MECHANICAL i !PLUMBING f i SIGN <br /> p 1 / / MAILAOORE55 �IIv LIP PHONE <br /> ��W�f"4t�6���„o9v� - �sw%�1 d�L{�?,Ipl 2SY�3�LL <br /> ARCMITECTdiDE51GNER M�ILADIXIESS CIIV 21P PIqNE <br /> GENEMLCONtR�C70B MAIL�UURESS CIIY 211` PHONE UCENSEI <br /> N•��µ��M^�' rDE'S �'C-- �7"y/ tY SOY�—L_L��/�JIIIONE �OY/•'f/""C/UJ�Z <br /> PLUUBRIOCONiP�C7011 M4M1.ADORESS CIIv )II' PIIONE LICENSEI <br /> C11155 0F V/OR1( -- <br /> �I NEW I I ADDITION I I ALTERATION ' ' REPAIR t I UEMOUTION � � WOODSTOVE/FRPL IHSERT I i BUILDING RELOCATION <br /> y d� CONl�CTPERSONpN�P110NEN0 <br /> Cp/TRACT PRICE 0F WOi1K � <br /> OEBCRlE WD11K AND SqURE FOOf116E MV VED <br /> ���J1tc. �+es /�+✓!� <br /> �� &�M1 I HEREBV CERTIFV THAT I HAVE REAU AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO RE TRUE AND CORRECT.ALl <br /> LEOAl0E3CPMT1(MlOFP110PEtliY�51qWNBELOW011AT1�GIFIXIIICOPIf.S� PROVISIONSOFLAWSANDORDINANCESCaOVERNINpTHISTYPEOF <br /> ior e�ocn oF WORK WILI BE COMPLETEU WITH WHETNER SPECIFIED HEREIN Ofi <br /> � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO QIVE <br /> AUTHORITY TO VIOLATE OR CANCEL TI1E PROVISIONS OF ANV <br /> OTFIER STATE OR LOCAL LAW qEGULATINO CIXJSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTFiOqIZEO BV THE <br /> OWNER OF THIS PROPEfiTV TO PERFORM THE WORK FOR WHICH <br /> — /1PPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONiRACTORS LAW 18.27 RCW AND 2g62pp WqC. <br /> sicNmunr:orcoeinncionon�unwnrzeoecenr onre �j/e�� <br /> vra�creoones r � ---------- x��-..r��'---------- --- <br /> �� APIIM�NISf,IIVDl15 F.SRIICFNSFNO.�NDPUSMESSN�ME <br /> ��� MECHANICAL <br /> N0. TYPE OF FlXTUHE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> W iTER CLOSET(TOILEn � NC-q/HNDLG UNITS-H.P. � <br /> �TMNB ' FORCED AIR SYSTEMS-B.T.U. M E.A. � <br /> UVATORY(WASH BASIN) � UNIT HEATERS--B.T.U. M � <br /> SHOWER � CLOTHESDRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER RANGE I100D <br /> LAUNDRVTNAV � - � <br /> CLOTNESWASHER ---- ' � _W�tERHEATER ____ i <br /> —r- WOOD STOVE ; <br /> URINAL METAI FIREPLACE 8 CHIMNEY � <br /> DRINKINO FOUNiAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � fiEAT PUMP �— <br /> BACKFLOW PREVENTERS _�_ GAS PIPING � <br /> ROOF DRAINS-RAINLEADERS EXIiAUST FAN , <br /> SINK(SERVICE-BAR,ETC.) - , <br /> ---T- <br /> � <br /> � T <br /> 1 <br /> � i � ' <br /> �1 <br /> " 1 <br /> SUB TOTAL $ ; SUB tOTAL $ � <br /> PERMIT S '— � <br /> ___ ' PEFMIT E / i <br /> TOTAL FEE E 10TAL FEE E � <br /> FOR OFFICE USE ONLY: <br /> FRONTSE7BACK IiF�I15F10�CK till)f:5G10Af.K p�ANC1IF.CNNUA1pF❑ fEF OECCIPTNO. <br /> usEzorie iornnen Vr1C�NI511E FEES VALUATION FEE <br /> BUILDING ' <br /> � <br /> �«QN�$���DIS'A�11� IYPEOfLONSI�CIU�I rccnrµcr NOpryM�pyf.11N115 <br /> �p��r pLUM�ING i <br /> _ _ ' <br /> SIiEOFBLO(3. NO.OFS10f1IF.5 OpSf.MENt _— � <br /> MECHANICAL Q �� <br /> i <br /> OCCUPANCYIO�D fII1FSITNNlEf1511ft]b 11[If11i1�411�f!UN ADD1110NALPLANCIIGCK � <br /> � <br /> OtHER --- ; <br /> NE�SONfOliSPfIINNlEf15 _ ___.,__ ___ � <br /> T— <br /> s�nie oun.nwc sur�ci+nncr- � <br /> MUKenr rinNsnrrnrnrnnr CITYOFEVERETT ruAiicwonKs ' <br /> LOCAL SAIES � <br /> TAI(CODE IS 3105 �OTAL 3 e � � <br /> I------- -- <br />