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! APPLICATI�rI FOR CONSTRUCTrc�N PERMIT everett <br /> ' fM Everg�een TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OF } <br /> ' ever���l HEATING SYSTEM: GAS ❑FLECTRIC U <br /> � BUILDING DEPARTMENT <br /> ! 259-8810 1 / <br /> ❑ DEMOLITION I I COMBINATION I i BUILDING pCN1ECHANICAL I i PLUMBING I I SIGN <br /> ' �;o�,t� m c��°��v - � ia ► � '�cr��- ���PN�E �� - ��� <br /> �f,NANT����y�J�� MAILADDNESS ' CIIY 2�^ PHONE — <br /> ARCHITECTORDESIONEB � MARAOORESS CITV ZIP PIIONE <br /> 1 iER�LCONTR 01( M�ILA���Y NATURAL GAS� INC. CIIY 21P PIIONE LIGENSEI <br /> �eo uoe _ <br /> � MECHNIICALCONTR�CTJR MAILADDPE55 �cc���^ � � P H NE ICENSEI <br /> ,.j 2605 McDougall v,��_L'���� �13�,' <br /> i PLUMBINGCONTR�CTOR MMIADDfliESS��$20 CITY 21P PIIC'�t LICENSEI <br /> � CLASSOFMIORK A� � � , <br /> . ,� ❑ NEW I J ADDITION �D�A�TEFATION I 1 REPAIF I I DEMOLITION I I WpODSTOVE/FRPL INSERT f 1 BUILDING RELOCATION <br /> � � I . r•�J�) CONT�CT PENSON AND PNONE NO. <br /> : GONTq�CTPRICEOFW0i1K —`� <br /> ; �,' OEBCRI� SOU HEFOOTAOEIN;OLVED � �/ �r� <br /> l� <br /> I ' PROVOSCOUSEOFBUILOINO ��/ I HEREBV CdRTIFY THAT I HAVE REAO AND EXAMINED THIS <br /> ,I; APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> ;� IEOAL DESCH�PTION OF Pf10PERTY ISNOWN BEIOW O(1 ATt�CR FWO LOPIES� PROVISION�OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> �� WORK WILI BE COMPLETED WITN WHETHER SPECIFIED HEREIN OH <br /> ��A �or e�ocrc or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> -;'{ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTqUCTION OR THE <br /> .I�� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2E�BV THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> i — <br /> I CONTRACTORS LAW 1827 flCW AND 296200 WAC. <br /> � <br /> SqN�TU OFCONTRACTOROR� THORIZEDA�ENT OATE <br /> ' � // X U� 3�� ql <br /> :, <br /> ���� PROJECTMDI7ESS I I I � V <br /> APPLICANTS CITY BUSME S l E NO.AND BUSMESS NAME <br /> ,•j PLUMBINO MECMANICAL <br /> ��,{ NO. TYPE OF fl%TURE OA ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> .I WATER CLOSET(TOILET) � A/C—NHNDLG UNITS—H.P. , <br /> �'� BATHTUB ; FORCED AIR SYSTEMS—B.T.U. E.A. � <br /> � LAVATORY(WASH BASIN)� � UNIT HEATERS—B.T.U. M � <br /> �7 SHOWER � CLOTHESDRYERS � <br /> -j� KITCHEN SINK d DISP VENTILATION FAN ; <br /> �;� DISHWASHER 1 RANGE HOOD � <br /> � 7 I.AUNDRYTRAY WATERHEATER � <br /> ��j CLOTHES WASHER � WOOD S70VE � <br /> j` URINAL ' METAL FIREPLACE 8 CHIMNEV � <br /> DRINKINQ FOUNTAIN i FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> .' BACKFLOW PqEVENTERS � GAS PIPING ' <br /> ROOF DRAINS—RAINLEADERS � ExHAUST FAN � <br /> � SINK(SERVICE—BAR,ETCJ ; ' <br /> �1 i i <br /> I <br /> � � <br /> i i <br /> � � � <br /> � SUB TOTAL S � SUB TOTAL S O ' <br /> � PERMIT $ � PERMIT S / ; <br /> � TOTAL FEE $ ' TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> 1 FIIONTSETBACK REARSETBACN SIDESETBRCK PLANCHECKNUMBER FEE NECEIPTNO. <br /> i <br /> ; <br /> 9 usexot+e 10111PEA VAC�NtSIIE FEES VALUATION FEE <br /> f BUILDING i <br /> ��� IYPEOFLONTS.ALIOW�BIE lYPEOlCONS1.ACIU�L octureqa rroamrttUecuxns - ' <br /> '! �"0°" PLUMBING ' <br /> --�— <br /> SREOFPL�6. NO.OFSiOP1ES A45EI.IENT � <br /> i MECHANICAL S�� — <br /> � <br /> � OGCUPANCYLOAD fIf1E5P(1NNLERSIlE00 IIEICIIILIAIIIAIION �UDITIONALPLANCHECK � <br /> 'j OTHER � <br /> �� PEASONFONSPRINNLEnS � <br /> �� STATE BUILDING SURCHARGE � <br /> INiAKEBY PLANSAPPROVEDBY CITYOFEVERETT PUBLICWORKS � <br /> LOCALSALES ' <br /> TAl(CODE IS 3105 TOTAL � ;— <br /> � <br /> i <br /> nro . ; �a. ��::e . r .�._ . . .. . . .. . . .: �. .. . � ..• . - . .. .. .. , . .. <br />