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APPLICATIOt� FOR �ONSTRUC�'ION PERMIT `'``'`°" <br /> ,� ,, ._ ,, TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OP <br /> x r � everett f HEATING SYSTEM: UGAS U ELECTRIC ❑ _— <br /> rr� �a� BUILDING DEPARTMENT <br /> �l y <br /> 259-8810 <br /> �'� y DEMOLITION COMBINATION BUILDING f-1 MECHANICAL PLUMBING SIGN <br /> y� � ER� MAiL ApUqF.55 C�TV 21P PMONE <br /> s< d y o �Coo7 Pnn4v�eu Blva, t�r�+F- .3 % �- 2Z/S-/ <br /> H xl <br /> IENANT MAIIA�DRE55 GiV ZIP PHONE <br /> �H� _ <br /> N H — — <br /> N x � nOCHIT[CTORDEdIGNEri MA�I.ApOPE55 GITV ZiP P��ON[ <br /> ] <br /> CsJ <br /> d G[NEfiAICONiRAGiOB M�ILR�OFE55 ptY n2iP �'�- HON[ UCENSE• <br /> o r+ ���yyy ���[{��� „ ,,, � n,v to /(2 SE �c9°•/1"lmn0 C[� �i �j�('' � ( ��.SCr/� <br /> � � ��-n�-I�J-M1Ll-4�—�� r � ZiP PHONE IICENSE/ <br /> ��� AIECHANICAICONiHACTOR MRIIRDpRESS CITY <br /> H <br /> � y CITY 2iP PNONE LICENSE� <br /> CLNAOINGCONTRACTOii MAILADORE55 <br /> HH <br /> CJ CA C1A550F\YORK <br /> n ty y NEY! ADDITION ALTERATION REPAIR DEMOUTION . WOOOSTOVE/FRPL INSERT . �. BUILDING FELOCATION <br /> �aa-�!C �ty CONTACT PEBSON RND PHONE NO. <br /> L'! tr, W � ,r� <br /> CONTRACT PRIGE OF WORN I�`' � <br /> y0 (yq CESCRIBE\VORNANOSOUAREFCqTAGE1NVCWED <br /> �2hs�k,l/ 25' C74s �i in <br /> PROPG$[DlISLOFpUIL�INO I HEREBV CERTIFV THAT I HAVE READ AND EXAhIINED THIS <br /> S � APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> L[GALDESCRIFTIONOFi�FOPERiY15HOWNBElOW09ATTFCHFOIIRCOPiES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or atocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV[ <br /> AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIOVS OF ANV <br /> OTHER STATE OR LOCAL LAW flEGULATING CONSTRUCT�.ON OR THE <br /> PERFORMANCE OF CONSTP.UCTION.THAT I AM AUTHORI.?ED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK i"OR WHICH <br /> APPLICATION IS MADE AND I COMPIY WITH T4E STATE <br /> soAtsAov�o'+*acroacanuHoruzo�ncent200�WAE. ���/i/�/ <br /> ���J �/lis�v%E,�:u GY'Jv C[YP— XO �s ���� <br /> P4iOJEGT�DDPE55 <br /> f�' APPUC�Ni5C1iYPU5iNE55UCEN5EN0 A��DBl15ME55NAM1lE <br /> PLUMBING MECHANICAL <br /> 1�' NO. TVPE OF FI7(TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET�TOILET) lUC—NHNDLG UNITS—H.P. <br /> ' 1 BATHTUB FORCED AIR S`.'STEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASM) UNIT HEATERS—B.T.U. M <br /> '�' SHOWER CLOTHES DRYE(iS <br /> KITCHEN SINH 8 DISP VENTILATION FAN <br /> ' ' DI�HWASHER RANGE HOOD i <br /> L/1UNDRY TR�Y WATER HEATER �__ <br /> 1�� CLOTHES WASHER WOOD STOVE <br /> �' URINAL METAL FIREPLACE A CHIMNEV ; <br /> DRINKING FOUNTAIN FIREPLACE INSERT T_ <br /> ' FLOOR DFAIN HEAT PUMP <br /> � BACKFLOJJ PREVC-NTERS GAS PIPING __ <br /> �' ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> � SINK(SERVICE—BAR,ETC.) <br /> '� <br /> '—� — T— <br /> '_' SUB TOTAL � PER"OTAL 5 /�_. <br /> PERMIT 5 f � -- <br /> TOTAL FEE S TOTAL FEE 5 3U _ <br /> FOR OFFICE USE ONLY: — <br /> nr,i4t5[iOACn �EARSEiOALK SIDESETBRCK PIAtlCMECNNUMBER �EE RECPPLNO ' <br /> u�:.e;oue �orni�ea VACANTSITE FEES VALUATION FEE _ <br /> (3UILDING <br /> bvIUiLONiSAIL�WABIE iYFE�iCONSiALfWI at[ur�Mr hOornMu•.-.i.•.��'. — <br /> cnav PWM�ING <br /> SiiCOF9LW. NO.OFSTORIES PRSEMENT MECHANICAL 3�/ � <br /> OCCUPANCYLOAp FIRESPNNNlER5RE0D MEIGMTLIMITATION ADDITIONALPLANCHECN _ <br /> OTHER <br /> --i-- <br /> i:L n50N fOR SPHINNLEPS <br /> STATE DUIIDING Sl1PCHAflGE <br /> wrn�eov PLANSAPPHOVEDOY CITYOFEVERETT PUBLICWORKS <br /> LOCALSALES <br /> TAX CODE IS 3105 TOTAL ?�, I o�, <br />