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i <br />�I pppL�CpT�(�,'�1 FOR C�TISTRUC7�.�N PERMIT <br /> everett <br /> ,�, �Ere�..� e <br /> ��r� <br /> ;. everett <br /> � BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLE�A E PRINT <br /> 7' 259•BB10 Ll BUILDING WYMECHANICAL ❑PLUMBINO ❑ SIQN <br /> i� ❑ DEMOLITION U COMBINATION c1TV z� P,�,E <br /> Mu��ooRess [7��y �/y� ����r R � ^yL)D11� Q�2�� 355•�Sa23 <br /> ','� � R� � 1 Z-1 V I � `."' ^^�`.`„_ l!I VP ` PNONE � <br /> ifNNlT <br /> ' MMLADORE58 CITY <br /> �p�H11ECTONDEB�ONER M�ILADDRESS <br /> CIIY 21P PIqNE <br /> � Z r p�E LIGENSE/ <br /> 7, MAR ADDRESS GI(Y <br /> pEry�q/��pNTMCTqi <br /> 1 (� CITY, � 1 (� P110NE LICENS SUNLOWIWRI�/ <br /> �1� MECHMlICALCONSMCTOII M�R�OOPESS �� �L �/ ��, 1�IW' Z�y •$��' H 82l •N5y?.� <br /> ' �wr11.QK Il�llg . 124 �^`""' � <br /> M�R�ODRE53 CIIY <br /> 21P PI/ONE LICEN / <br /> LUMlRqCOMTRACTOA <br /> :� <br /> ,� CU940F WONIf <br /> L7 NEW f_I ADDITION (XhL7ERATION I I PEPAIR I I DEMOC��CTPEp50IN�noOvHor+er+o�RPLINSERT ❑ BUILDINORELOCATI <br /> ��i TENANT�MPIIO�'EMENT di MiERIOR NE i OOEL�O• QT <br /> �'�1 V <br /> ' CONTP�CTPRICE�FMIOPNf <br /> i I �q�p��ypry(�Iq 6W�AE FOOT�OE INYOIVED <br /> 1� ��� I HEREBY CERTIFY T�HAT I HAVE READ AND EXAMINED THIS <br /> i� r�Eo us�o�eu�� qppLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> •I� SL��_��' PROVISIONS OF LAWS AND ORDINANCES GOVERNINO TMIS TYPE OF <br /> i� lEW�0E5GRIVTqNOFpR TY�SNdM�BELOWON� �CNFW�COCiES� ydORK WILL BE COMPLE?ED WITH WHEtHER SPECIFIED IIEREIN OR <br /> �� Bi�K op NOL THE GRANTINQ OF A PERMIT DOES NOT ?RESUME?D OIVE <br /> ��� �or AUTNORI7Y t0 VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> ; OTHER STATE OR LOCAL LAW REOULATIN6 CONSTRUCtION OR THE <br /> �+ PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> 'i — OWNER OF THIS PHOPERTY TO PERFORM THE WORK FOR WHICN <br /> � APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> �; CONTRAC�ORS LAW 1827 PCW AND 298•200 WMC. <br /> SION�IDREO��TAA��O�R^uT����QENT DAIE <br /> # h�3 i�,: <br /> �;', X S��K. 4nC `� <br /> , - <br /> � }�WE�TMO�E89 �^�A /�/� /] �M 1A �pp�ICAN7gCItYBU51NE5SUCENSENO.IWOBUSINESSN/�ME <br /> j .l(a/�f Yf. wlJ �•G•�lJ l/C. <br /> I MECHANICIIL FEE <br /> 'i� PLUMBINO FEE NO. TYPE OF EOUIPMENT <br /> 'I N� 7YPE OF FIXTURE OA 11EM q�C—q�HNDLO UNITS—H.P. � <br /> '� WATER GLOSET(TOII'cT) � FORCED AIR SYSTEMS—B.T.U. I�A E.A. � <br /> :i I gATHTUB UNIT HEATERS—B.T.U. M ' <br /> LAVATORY(WASH BASIN) , CLOTHES DRYERS '— <br /> � <br /> SHOWER � VENTILATION FAN <br /> ���,� � KITCHEN SINK 6 DISP ' � <br /> �� I DISITYYASHER � RANGE HOOD , <br /> � WATER HEATER i <br /> � � � IAUNDFY TRAV � yypOD STOVE --T—' <br /> ����I CLOTHES WASHER � <br /> � METAL FIREPLACE&CHIMNEY � <br /> ' �� URINAL FIREPIACE INSERT � <br /> � � DRINKIN6 FOUNTAIN � � <br /> i HEATPUMP � <br /> FLOOR DRAIN � GAS PIPING <br /> BACKFLOW PREVENTERS ' — ' <br /> ' � , , E%HAUST FAN � <br /> ROOF ORAINS—RAINLEADERS � <br /> SINK(SERVICE—BAP,ETC.) ' ' <br /> � , , <br /> � � i <br /> � <br /> � <br /> i � <br /> ; � O�OD <br /> SUBTOTAL S <br /> �! � SUB TOTAL E � — pERMIT S I ' <br /> .j PERMIT S ' TOTALFEE E � <br /> ! TOTALFEE $ � FEE RELEIPTNO. <br /> � SIDESEtBACN PLANCNECKNUMBEP <br /> FRONT6ET&1CK REARSEIBACN <br /> '� VALUATION FEE <br /> '' VACANT SITE FEES ; <br /> _,; � U6E ZONE LOT�RE� <br /> i , I�_I YES U NO Bq��DINO , <br /> , , ocaroxcr rro.dwrtun�auxn� � <br /> �� rn[acoxsr.uiow�eie ttr�orcansc�c�u�i �aW� ' <br /> PLUMB�NO � <br /> �' � NO.OF SIORIES OASEMENT MECHANICAL � <br /> BQEOFBLO�. I.I 1'ES 17 NO � <br /> � <br /> OTHER � <br /> OCCUPANCYLO�D FIRF^PPNKLEliSREOD NE�ONTLIMIiATION � <br /> ❑ YES U NO STATE BUILPINO SURCHARGE 1 <br /> I ' � <br /> HEASONFaRSPRwKLER9 ' STATEENERQYSURCHARGE <br /> � <br /> i <br /> .� �pp�ICATIONACC.BY M�NSAPPBOVEDBY CITYOFEVERETf PUOLICWOR�(S T <br /> LOCIIL SIILES � <br /> I <br /> TAl(CODE IS 3105 iOtAl <br /> '-;::,.,z;`'_: , ,_. . <br />