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� everett <br /> ��` APPLICATIOt�'r�FOR CONSTRUCTI ' PERMIT <br /> ,:: e � <br /> :!� '�E�� TO BE COMPLETED IN INK—PLF.ASE PRINT <br /> • eVel�e ll � HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8870 <br /> ❑ DEMOLIiION ❑ COMBINA710N I� BUILDING 2 MECHANICAL�E ❑PLUMBIN(i ❑ SIGN <br /> �p r.u��ss an , <br /> CM1q� uNN 2Sv2 Aa �c A Ytn wA �S2u1 �E uo <br /> �wwr <br /> euti�oo�ss cnv z�v <br /> �. <br /> ' LItY ZIP PIIONE <br /> •RCAMIECTORDESNiNER WILADORESS <br /> � 1i ZIP F110NE LICENSE� <br /> '.� OEriEN�LCONTPl1C1[Mi <br /> MAL 11DDIIE53 CITY <br /> P (t <br /> �a CITY 21P Pl10NE IICENSE� <br /> 1AECINNICIILCONTMCTOR WIL�OD11E6S <br /> 1� p�E LICENSE� <br /> � WL/iWRE65 GITY ZIP <br /> RlIMMO CONTP�CTOR <br /> 1 «w.�,� <br /> ' ❑ ry�ry ❑ ADDITION TERAT�ON � I REPAIR LJ DEMOLITION LI WOODSTOVE/FRPLINSERT ❑ BUILDINORELOCATION <br /> . <br /> CONUCT PERSON�ND PHONE NO. <br /> � OOMI�MCTMiICEOFW011K <br /> OE�CIME WOIII(MID 80U�FOOT�OE MVOLVED <br /> � �p��.�q�q I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED TMIS � <br /> APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL , <br /> �y�p��{p�p�ppppEpry�g�p�yN�E�qypqAtT/iCNFWRCAP�ES� PROVISIONSOFLAWSANDORDINANCES(iOVERNMIOTMIST'PEOf <br /> WOHK WILL BE CAMPLETED WITH WHETHER SPECIflED HEREIN OR <br /> �__ �� oc NOT.THE ORANTINO OF A PERMIT DOES NOT PRESUME TO dIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVI810N8 OF ANY , <br /> OTHER STATE OR LOCAL LAW RE6ULATINQ CONSTAUCTI0�1�TME I <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE i <br /> OWNER OF THIS PROPERTY TO PERFORM TNE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH TME BTATE <br /> CONTRACTORS lAW 18.27 RCW AND 208R00 MMC. <br /> , <br /> eaeu�tunca ronon�u o�onrc wrE <br /> X <br /> MIO,RCTI1D01lEM �pK�µ}yCITYBUS L ENSE . � <br /> ��� MECNANICAI <br /> PEE N0. TYPE OF EOUIPMENT � <br /> Np, Tt�E Of flXTIME OR ITEM ��yF{NDL6 UNITS—H.P. ' <br /> WATER CLOSEt LET� ' <br /> �TM�B � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> UVATORY ASH BASIN)� � UNIT HEATERS--B.T.U. M � <br /> �ER � CLOTHES ORYERS � <br /> KITCHEN SINK 8 DISP ; VENTIUTION FAN � <br /> DISHWASNER � RANOE HOOD ' <br /> LAUNDRYTRAY ; WATERMEATER � a <br /> , WOOD STOYE ' ! <br /> CIOTHE3 WASHER � � <br /> URINAL ' METAL fIREPLACE 8 CHIMNEY <br /> ORINKIN(i FOUNTAIN � FIREPLACE INSERT ' <br /> FLOOR DRAM � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; dAS PIPINO � <br /> ROOF DRAINS—flA1NlEADER3 � EXHAUST FAN ' � <br /> SINK(SERVICE—BAR,ETC.) � ; <br /> � <br /> � ; <br /> i � <br /> � <br /> i i <br /> SUB TOTAL S ' SUB TOTAL S � <br /> PERMIT $ � PERMIT S � <br /> TOTAL FEE S ' TOTAL FEE S ' <br /> fOR OFflCE USE ONLY: ��,�T�. <br /> fRONTBETBIICK <br /> pE�1pgQT9/�CI( SIOESETBACN PIANLMEC1cNUMBER FEE <br /> VALUATION � <br /> ��pryE l0T�REA V�CANT SITE �ES � <br /> BUILDING � <br /> i <br /> TTEOiCONi9,/dLOWABIE 1YPEOfCONSi.ACfUAL omi�r �qaox[unGuntt � <br /> PLUMBINO ' _ <br /> i <br /> �pp9�pp, . NO.OFSTp11ES 9A5EMENT MECHIINICAL � <br /> i <br /> i <br /> ADDITION�L PLAN CHECN � <br /> OCCUPANCYLOAD FIRESPRNI(IERSPEO'D XEIGHTLMITAiION � <br /> UTHER � <br /> RE�BON FOfl SPPINNLERS � <br /> STATE BUILDIN6 SURCH�RGE <br /> nnu�er vuws�vraoveoer CIiYOFEVERETT PUBLICWORNS � <br /> LOCAL SALES � <br /> TAX CODE IS 3105 �r�� ; <br /> -- <br /> ,.:, .. tr.,•.. <br /> ___,.,,. ..., .._ . . .. . _ . <br /> .. . . .. . . <br /> -„� .. -._. . . ,. . ..:::...,..... .,:,.�. .. •- <br /> .�.•.. - <br />