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; <br /> APPLICATION FAR CONSTRUCTIO(�! PERMIT ��tfe1t <br /> e��E�dig��r� TO BE COMPLETED IN INK—PLEASE PRiNT � <br /> cm oF <br /> x �-n, �j everett HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> �r� �yT� BUILDING CEPARTMENT <br /> �O ;u x 259-8810 <br /> � H ��i+ - DEMOUTION �,COMBINATION �,BUILDING ❑ MECHANICAL ❑ PLUMBING � ❑r T�S�IGN <br /> �„� �� p,yq MAI�AOOPESS CITY . ZiP FNONE F/ <br /> K � �v���zrK ..ri�us . �'. yUzv n�r.�� �u� �iXrl�a�ze,�H `��Z�L 53�-c��iy <br /> H� LEN�NT MAIL�DORESS ��TY ZiP � PN� E <br /> � H ��i1 <br /> y eqCMITECTONDE5IGNER • M�ILAOOPE55 CITY ZiP PIIONE <br /> y x Dll�-� Q�,E`�'arin�na Y�'�rt!ls�n!� GIH� �'��-l 7Z Sl <br /> � y d G[N QCONTRACiOP MAILAD�RE55 CITY 21P PNONE LICENS • <br /> �J �/'un��k �,dv� - � um ilv�J� <br /> H Cil V NECNANIC0.CONIRALTOfi AIAILADONE55 •'-CRY IIP PNONE ��CENSE� <br /> 4�� C1 <br /> x y� FWMBINGCONTRACTOR AIAILA�OHESS '�.CIjY 2iP PHONE LICENSE• <br /> C' L <br /> H H . <br /> (p C SOFWORK <br /> �"� " .�NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR � �'L� DEMOLITION ❑ WOODSTOVE/FRPLINSERT u BWIDINGfiELOCAT10N <br /> g� � , <br /> � CONiACT PERSON AND PHONE N0. /�r_ <br /> - CONTMLTPPIGEOFWORN G C � � �SJ _`"�+ <br /> �O � �?SCRiBEWORNANOS�UAREF00TAGE1HVqLVED � '. O� ��� 3S3-yg�)� <br /> �� l �1 � <br /> PROPOSEDUsgoveu:�oi^ . ' , � � I HEREBY CERTIFY THAT I HAVE READ AND EXAAIINED THIS <br /> S� � f? � ] APPLICATION AND KIJOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �ecu oe RiPn NOf PROPERTV�SNO N BELOW OR n�cH Fougtoviesl .. PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> a v�L �'�ORK WIIL 8E COh1PLETED\VITH WHETHER SPECIFIED HEREIN OR <br /> ior - e�ocK oF NOT. THE GRANTING OF A FERMIT DOES NOT PFESUME TO GIVE <br /> . AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LA\N REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> !�j _ _ ,� //� j� � OWNER OF THIS PROPERN TO PERFORh1 THE \YORK FOR WHICH <br /> _t}��r �7 APPUCATION IS MADE AND I COMPLY \41TH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 296200 5•lAC. <br /> SiGNATUREOFGONiMCTORQNAUTHO�ZEDAGENT OniE <br /> l/Sc`�S�[C <br /> � �S�O CC i�Y��ri.t� ,�.s4��e.. , �. ' %": " � — '.� � <br /> �OJEGTAD�RE55 �M��L /'. /.�jJ � <br /> — �P ICANTSCITV9USINE554GENSENO.AHDBUS�NESSNee�E <br /> ' I PLUMBING h1ECHANICAL <br /> ' ' NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) AIC—NHNDLG UNITS—H.P. <br /> '�' � BATHTUB FORCED AIR SYSTEh1S—B.T.U. A1 E.A. <br /> '_' � LAVATORY(WASH BASIN). UNIT HEATERS—B.T.U. A1 <br /> SHOWER f CLOTHES ORYERS <br /> / KITCHEN SINK 8 DISP VENTILATION FAN <br /> '�' DISHWASHER RANGE HOOD <br /> �LAUNDRYTRAY WATERHEATER <br /> '�I CLOTHES WASHER WOODSTOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> ' DRINKING FOUNTAIN FIREPLACE INSERT <br /> � FLOOF DRAIN HEAT PUh1P <br /> 1�I BACKFLOW PREVENTERS GAS PIPING ' <br /> ROOFDRAINS—RAINLEADERS EXHAUSTFAN _ T <br /> 1 SINK(SERVICE—BAR,ETC.) SI � <br /> _� � <br /> i <br /> � <br /> �~e SUBTOTAL $ "• SUBTOTAL 5 <br /> PERAIIT S PERMIT 5 <br /> TOTALF[E $ TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> FHONTSETBACK FEAflSTBACK � SiDE5Ei0ACK PUNCIIECRNUAIOEF FEE AECEIPTNO. , - ' <br /> o' Zo� o 'r�'rn�T`� S 3 7�// � 3a ' 7/a E S_ <br /> USEZONE LOTAREA v�cu�isiie FEES VALUATION FEE <br /> � Z- � S� 7 �S DUILDIRG 'J � � ' 'G� <br /> fYPEOfCONi5Al0'NilBIE iYCFOFCONSi.K1UAl Oauruitr r.opmuun:u+ui <br /> �I� �- �j"w / PLU1d01NG l/ <br /> �" <br /> SiZEOFBL NO.OFSTONiES BtiSEMENi AIECHANICAL C�G7 � <br /> �6�63�5* 2 0 <br /> OCCVPANCYLCaD • FIRESPRNKLEFSREO'D HE�GNTIIAUTATIpN AODITIONALPLANCHECK <br /> �� ��J OTHER <br /> qEA50HFOqSPPoNNLtNS <br /> STATE BUILDING SURCHAPGE ;� <br /> �NiRAEBY PW:SAPPROVEDUY CITYOFEVERETT PU�LICYJOPNS ,-/U �G�� <br /> LOCALSALES <br /> J!� L'�Z� �J2 TAX C00[IS 3105 Tora� <br />