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APPLICATIO"-' FOR CONSTRUCT�;.1N PERMIT e�erett <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> the Evergreen <br /> CITV OF <br /> everett IIEATING SYSTEM: IJ G�S IJ ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I I DEMOLITION i COMBINATION BUILDING i 'MECHANICAL I �PLUMBING ' SIGN <br /> Mnu nnnness rtr /I vm ruoNe <br /> �ownEA �� F�40.(.Ai�U� yJ�:�� � �� c5' L77�� � <br /> y��p '�80� a�U-ie�u��Ua• � r�wNe <br /> TENRN{� MI11L�U�PES$ ���Y ��r <br /> J2 <br /> CIIV 21P PIIONE <br /> ARCNIiECTOPDE51GNE0 ldMlA0Df1E55 <br /> GENER�LGONiR�C10R MAII�ODRESS <br /> C�IY 71P PIIDNE �IGENSE■ <br /> i CIIY ZIP PIIpNF LICENSE• <br /> MEClIANIC�LCDNiR�C1011 M�II.I.UUfiESS <br /> �� CIfY 21P PIIONE UCENSEI <br /> PWMBINGCONLI14C7011 MAllf����FSS <br /> CLASS OF WORN <br /> I I NEW I i ADDITION � � ALTERATION ' REPAIR � � DEMOLITION �l WOOUSTOVE/FRPL INSERT ! I BUILDING RELOCATION <br /> r,or+�nci rensor+neo rnoNE uo <br /> CONTRACT PRICE OF WORN <br /> DESCRIBEWORNANDSOWf1EF007�f.EINVOLVED • <br /> PROPOSEDUSEOFBUIIUI , 1 IIEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW TtiE SAME TO BE TRUE AND CORRECT'.ALL <br /> �eaai oescnmrror+or rraorcmr isiwwrveeiowon nT�nci�rouncoriesi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETFD WITH WHETHER SPECIFIED HEREIN OR <br /> wr e�ocK oF NOT. THE GRANtWC OF A PERMIT COES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> L� ,L7 �f-,� ~p ' I� QQl �Q u) «J�qpp, OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br /> _���.�- ) r PERFORMANCE OF CONSTFlUCTION.THAT I AM AUTHORIZED BY THE <br /> n . n yr OWNER OP THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> �{�/�.CLi7�p� �,,yr UQ_Ql�M4._� ].i�._I�`'�`��� APplICA710N IS MADE AND 1 COMPLY WITH THE STATE <br /> �-r� .1 p I CONI RAC10R5 LAW IP27 RCW ANU 296200 WAC.O�l; a S� I7�0 <br /> �yA A: ��X_u'u(Ul'_�4cb7l.lb�±��-111.�� sicwn�uncorcoi+nmctrnwnnun�oimeoncem nme <br /> � �}SS_ C��_r-{. '_ <br /> c� , X�� �Il_ ��o��,�.,Y,--�------- <br /> raaecrnnrn�ess -----_--- --� — -- —. .. (�,`� <br /> 1 J • � � AI'PIIC�NISI:IIYiIII �JISSIICENSfNO �N�AUSINE55NAMF <br /> eZ�O � � �CW . 1A. ( P ` r <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) �_ NC—A+HNDLG UNITS—H.P. ' <br /> � BATHTUB ' FORCED AIR 5`!STEMS—B.T.U. M E.A. �_ <br /> I LAVATORY(WASH BASIN) �_ _ UNIT HEATERS—B.T.U. M � <br /> � CLOTHESORYERS ' <br /> SHOWEfl � — <br /> KITCHEN SINK 8 DISP ; VENTILA7�ON FAN � <br /> --T— RANGE HOOD <br /> _ OISHWASHER � — WqTEfi HEA7ER � <br /> LAUN�RY TRAY .�__ — � <br /> CLOTNES WASHER � WOOD STOVE <br /> � METAL FIREPLACE&CHIMNEY <br /> URINAL -----�-- —�- ----- ' <br /> -- --- ----- —_ <br /> DRINKING FOUNTAM � FIREPLACE INS ' <br /> . .______,_—.. -__—_. ._._'__..___.—____ —� <br /> -- -----------`----� --------- HEAI�PUMP ' <br /> FLOOR DRAIN —'--- -- ---- � <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS —� EXHAUST FAN ' <br /> �— _ � <br /> SINK(SERVICE—BAR.ETC.) � <br /> -- -- -----�— — <br /> 1 T <br /> � � <br /> 1 <br /> 1 I <br /> 1 ��- <br /> ��T�. <br /> suo rorn� g l —-.- - .--- --- sue rorn� � !} ,— _ <br /> --- <br /> — ------------------- _.__- -- .. ...- —�-— -- — rer�Mir a <br /> — -----".----- PERMII� $- ----;---- -- -------- TOTAL FEE $ ' � <br /> IOIAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> �ecemr r+o. <br /> FOONTSEIP�CN OP�IISf10ACN SIUf5C1p�CN PLANGIIECNNlIMOE❑ «< <br /> USE20NE �otnnen wcnNrsnc FEES VALUATION FEE <br /> i <br /> �UILD�NG � <br /> 1YCEOfCONISALIOWA�IF ImEofcurlSi.nCIUpL acur�nn xoanxuun,unns ' <br /> i <br /> anam PLUMBING ' <br /> SiZE or�toa uo or sionms DASEMhNI MECHANICAL � <br /> � <br /> nnomoNni r�nN cFiecK � <br /> OGCUP�NCY LO�U fiOF$PONKLEfI511E00 IIFIGII7 LR.III�TION - <br /> � <br /> OTIIEIi � <br /> REASON FOR SPRINNLEIIS � <br /> SfA1F.BUILDING SURCIIMCE ' <br /> _ I - <br /> iN�nKenv �inrvsn��nov�nnv CITYOFEVERETT rumicwonks � <br /> LOCAL SALES � <br /> TAX CODE IS 3105 T�TI1L � � <br />