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/.�PPLICATIO►. FOR CONS'TRUCTI..�N PERNAIT `'`'`'"'" <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ciivn,- � <br /> ev�?rett HEATING SYSTEM: U GAS J ELECTRIC ❑ _— � <br /> BUILDING DEPARTMENT <br /> ?_Ci9-8810 <br /> DEMOLITION COMBINATION BUII.DING ,�A7ECHANICAL PLUMBING SIGN <br /> �����i�� MA�LA��REoS L�iY Zi�' PMONE <br /> 1 � i� � � ' � � _j1�1.�I / <br /> �- ����,�-� �_�.��(� � �'�� �—�ii�'�� '�f.�� ' ✓c'rr�� '1— <br /> illln4i <br /> MARADDPE55 CIr� ZiN PNONE <br /> � � N —— <br /> �tl <br /> •] n��[�ut[G10ROESIGNER MAhRDDRESS CITV 21P PNONE <br /> iO Q� <br /> M <br /> � tl1 CIT' 21P P110NE LICENSE� <br /> � GENERAI.CONTFACTOR h1AR�D�RESS ' � -,; <br /> � (� '�rrt; i ' � 'lr{� ��p..� ' ��l',� Il'lr. l�n„na�( /i i `'�t�,�� ''�1k '01 �;`7-S�I��2 V�rll I F��� ( LI <br /> O F] 'p �dEGHI.NiCpLCONTRRCTOR MAiLA00RE55 �� CITV 21P PHONC LILENSE� <br /> 0� <br /> � N I�1 QTY 21P PHONE UCENSE• <br /> F] � � PLUMOiNGCONiR�CIOR �1�ILAODRE55 <br /> �a o <br /> O `f+� cussorwonK <br /> r�i etl � NEW � ADDITION �ALTERATION REPAIR DEMOLITION WOODSTOV6FRPL INSERT BUILDING REIOCATION <br /> M • CONiAri PERSON�ND PNONE NO <br /> M 5/ � <br /> y CONTPGCf PPiCE 06 WOPN <br /> y DE CPIBF ORN SE]UARE FO i ' iNV tVEO <br /> �py c d� , ;2� <br /> (1 O N ' <br /> � C � rnoroseous�oFem�oin I HEREBY CERTIFY THAT I HAVE READ AND EXAMINE� THIS <br /> W �� � APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT.ALL <br /> y tn PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> O N iecnioescaianouocaacreaTvtsHowNeeiowoAnnacNFouacovies� yJORH WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �pT e�ccK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE ON CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR iHE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AN:1 I CO'.1PLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIG./'UREOFCONiP�CTOAORAVi110q12EDAGENT OATE <br /> i � ) / <br /> ��-I i �1 /i ( � "l I�� ���� �/�J �� ( .'�IC <br /> a�OJ'EC;AODRE55 / �/ � � �_ pppLiC4NiSGITVFIU5WE55UCEN5ENO.RNDBUSWE55NAME <br /> .i ' .�'1' ��,�1 .-� <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> �C� WATER CLOSET(TOILET) A,C—A�HNDLG UNITS—H.P. <br /> . BATfiTUB FORCED AIR SYSTEM1IS—B.T.U. M E.A. <br /> � • _ LAVATCHY(WASHBASW) UNITHEATERS—B.T.U. M <br /> �� SHOWEfi CLOTHES DRYERS <br /> ' � IT HEN SINK 8 DISP <br /> , VENTILATION FAN <br /> T <br /> � K C , <br /> � �� RANGEHOOD <br /> DISHWASHER <br /> LAUNDRY TRAY .WATER HEATER <br /> CLOTHES WASHEF WOOD STOVE T_ <br /> � METAL FIREPLACE 8 CHIMNEY <br /> I I ! . URINAL �— <br /> DRINKING FOUNTAIN FIREPU�CE INSEAT <br /> FLOOR DRAIIJ HEAT PUMP <br /> BACKFLOW PREVENTERS �_ GAS PIPING <br /> RDOF DRAINS—RAINLE.4DERS EXHAUST FAN — <br /> �. _�' SINK(SERVICE—BAR.ETC.) ` � <br /> —�— <br /> • � _— , <br /> '01 . SUB TOTAL 5 SUB TOTAL 3 � � <br /> �� PERMIT 5 PERMIT 5 ~ � <br /> — TOTAL FEE S TOTAI FEE 5 O' — <br /> ��. <br /> FOR OFFICE USE ONLY: <br /> - FeO�ITSETpACM BGRSE7�/CN SiUES[TOACN PI�NG�ECNNUMBER �EE RECEiPTNO. <br /> use zoH� iot naen VACRNT SITE FEES VALUATION FEE <br /> �UILOING <br /> hPEOiCONiSALIOWABIE IYPE�%LONSC�C1U�l �q�pr NONOn[uixcwrtS <br /> PLUhIBING <br /> 512E OF BLOG NOAF STOFIES BnSEMENT MECHANICAL VD � <br /> CCCUPANC�LOAD �IlIESPRNNIENSRE00 HEIGHTIIMITAiiON <br /> ADDITIONAL PLAN CHECK <br /> OTIiER � <br /> R[450NFORSPNNNLFB3 <br /> STATE BUILDING SUFCHARGE <br /> �r,.nKrev r�n�+snPr�vovconv CITY OF EVERETT PUBUC WORKS <br /> LOCAL SALES <br /> TAX COOE IS 3105 7oTA� �n � <br />