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i �� <br />APPLICATIO�.. FOR CONSTRUCTiJN PERMIT <br />^ E, a.,, TO BE COMPLETED IN INK—PLEASE PRINT <br />QTV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION <br />HEATING SYSTEAS: � GAS ❑ ELECTRIC ❑ <br />everett <br />e <br />COMBINATION BUILDING � MECHANICAL �.\,PLUMBING SIGN <br />RD�PE55 QTY 'IP PNONE <br />.,�.. G�/1[/ /�\ .Ll..inl_�nl.�i� �.J ��M✓co1L YIG.�i-1_—l�i <br />nFCHRELT OR OE9GNEP M�iL ApOPE55 Cljy/ 2iP PHONE <br />GENER�LCONTR�CTOR AIARAppRE55 CITY ZiP PHONE UCENSEt <br />MECMANIGRI ONiRACTOR MRIL�D�RE55 GITY ZIP PHONE LICENSE• <br />. �5 . ...... _ . � �.,�� l'.,_ __LL n.—�T�,-�i �,i.._U. J_ U17t�n <br />PW�IBINGC NiBAC10� MNIADORE55 <br />Nc.�-�l�wc�l- ?i �o � <br />C1R55 OF �`�ORK <br />�CNEW � ADDITION ALTERATION <br />LONiR�Ci PRIC[ O� WORn� I f l�' w <br />q[[�RipE WORe �NO 5(j�IM[ FOOUGE INVOLV[0 <br />IEGnL � SC iPtION OF Pf10oE�T1' ISII�VN DELOW O� �TinCM <br />lOT BLOCK _ _ �% <br />�� yya� -q�0-o�.�-oc <br />SIOr-r W. -I-h���ln �'Yl F?�l .. <br />PRQIEGT �DDNE55 l.J <br />REPAIR DEMOLITION <br />NO. TYPE OF FI7RURE OR ITEM FEE <br />WATER CLOSET �TOILET) _ <br />BATHTUB <br />LAVATORY (WASH BASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />� �: JOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS - RAMLEADERS <br />SINK (SERVICE—BAF, ETC.) <br />SUB TOTAL 5 <br />PEfiM1T $ <br />FOR OFFICE USE ONLY: <br />FqONTS[TORCK REABE <br />IYPE Oi CON15 I <br />52E OF BtDG. <br />PERSON:ORSvq�NnlERS <br />INiAKF 0� <br />IOTARE� <br />NO OF STORIES <br />PLAY.S APPROVEO BY <br />PHONE LiCENSE • <br />WOODS70VF1FRPL INSEFT . � BUILDING RELOCATION <br />RN��NON[NO . <br /><-r,�i - :� o � � <br />1 HEREBY CEHTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT. ALL <br />PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />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 LeW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CON? „UCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO P�RFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COIAPLY WITN THE STATE <br />CONTRACTORSlAW 18.2i RCWAND296200WAC. <br />SGNATU�[OFLONIMCTORORAl1iNONIZEDnGENi DAiE <br />(x 1�1�� z ti_�n�(�a� ��� — <br />�cPL�C�NtS 1 OUSM[SSUCENSENO�NDOUSMESSNnAiE �"' <br />NC—A�HNDLG I�NITS—H.P. <br />FORCED AIR S`.'SlE�.1S—B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DfiVERS <br />VENTILATION FAN <br />RANGEHOOD <br />8 CHIMNEY <br />HEAT PUNP <br />GAS PIPWG <br />E7CHAU5T FAN <br />S�OESETDALK �'IANC�iECKNUMOEN FFE <br />V�C�NT SITE FEES <br />BUILDWG <br />acuny�r noam�rtracuv.�s <br />�"0'° PLUMBING <br />Bn5En1ENT MECNANICAL <br />ME�GNT LIMIiATION AD�ITIONAL PLAN JHECK <br />OTHER <br />STATE BUILDING SIIRLHARGE <br />CITY OF EYERETT PUBLIC WORKS <br />LOCALSALES <br />TAX COUEIS 3105 rora� <br />TOTAL S <br />d1T $ � <br />�L FEE 5 .S.rJ: ' <br />