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APPLICATIVN FOR CONSTRUCYiON PERMIT everett <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> !�v Evergreen <br /> GTY OF _ � <br /> everett ( HE/1TING SYSTEM� GAS U ELECTfiIC IJ <br /> BUILDING DEPARTMENT ` — <br /> 259-8810 I I SIGN <br /> I I DEMOUTION i i COMBINATION � ' BUILDING i ECHANICAL i I PLUMBING <br /> ----- ruor,e t <br /> WNER \r�/ M�IL�UD11G55 ^ CIIY 7 ' , ,� `_�- C <br /> t' V i' I�.��� .. ��� l (.:�j l�) � ��� y�) �� I —S� � f I -� ) � " �� � l� <br /> ' ��1�IJ MnnnnonFss �irv zm viroNe <br /> i TEN� 1 nrvt � _ — <br /> ARGNIIECTORDE5ICNF.R MML�UUOE55 <br /> cirv zm w�oNe <br /> II <br /> PII NE �- LICENSE/ �/�f� 1 <br /> � G NER L ONTR�G700���� �.1AILAODOEaS ��'` �` �IIY � ����ZIPC�,C� f�� �') P_ ,�%;r L`�I /�X <br /> 1 , ��, � p � �J ) r_ k. - t_ <br /> � L ' �.` l. c rv p r�wn. . ,, J.I(,'E � <br /> MECN�NICAI.CO fiRC100 MAlli.[1f1f1E5S � /I ` � � J \I 11� � ,'�J !1 � "/� C� <br /> \ 1 1 1 !-� II 1 � <br /> V I"1'�� PII E UCE / <br /> PLUMBINGCON7A�C70R M�II.AODf1E5S CItV 21P <br /> GUSS OP WOfiK ` , . <br /> I I NEW I I ADDITION ��:%�ALTERATION '�_� REPAIR _ � '� DEMOL1710N ! � WOODSTOVE/FRPLINSERT ! i BUILD�NGRELOCAT�ON <br /> - ----'- �cONIM1i1'PfISON�NPI'IIONFND <br /> ca+rnncrrn�ceorwonK�'�JJ� �• �l�) <br /> OESCI110E tlNAN W fOOf/�QE�NVVLVED 11 (,�`I� � � <br /> �j����c� ,(.l—`� �, ) "�----�� 1 �'.I - — <br /> PROPOSCOUSFOfi11111b11 , � I hIFRFBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � , � I APPLICA�TION AND KNOW THE SAME TO BE TFUE AND CORRECT.AlL <br /> iea��oescAm�ror+or rnor�mv�siwwr+neiowon nrtncurouncoriesi PROVISIONS OF LAWS AND ORDINANCES GOVBRNINCa THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT p�p�N or NOT. 7HE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LALY REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICH <br /> AAPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNRIUREOFCOH�(i�CTOROii/l1iNONIZEDACENT D�TE . <br /> — X��1`l_.�?����-.-J7 r �-�\l (Yl��i�:��l��l�/7-1'` l �l'III <br /> PROlEC7�ODRE55/� � ' / / I�IL' I� �1 � qpp�IC�NiSQiYBU51NF9SUGENSENO.�NOBU51NE5SNAME <br /> r � � l �-� r. <br /> PLUMBING� MECHANICAL <br /> Np, TYPE OF FI%TURE OR ITEM <br /> FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) _ NC—NHNDLG UNITS—H.P. � � <br /> � FORCEDAIRfiYSTEMS—B.T.U=�- � <br /> BATHTUB � <br /> LAVATORY(WASH BASIN) T—_ UNIT HEATERS�—B.T.U. M � <br /> � CLOTHES DRYERS ' <br /> K TOCHEN SINK 8 OISP � VENTILATION FAPI � <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRY TRAY ; WATER hIEATE(i � <br /> --- --� WOOD STOVE ' <br /> CLOTHES WASHER — -- —'�— <br /> URINAL � ' _ METAL FIREPLACE 8 CHIMNEY _ ' <br /> DRINKING FOUNTAIN i __ FIREPLACE INSERT ___�__ <br /> FLOOFi DRAIN _ fiEAT PUMP � - <br /> ' — �j GAS PIPING � <br /> BACKFLOW PREVENTERS ___� �_ � <br /> ROOF DRAINS—RAINLE�DERS _ EXHAUST FAW ' <br /> � <br /> SINK(SERVICE—Bt.�l,E7J.) �— — � <br /> � <br /> �- 1 T <br /> 1 <br /> 1 <br /> _ � <br /> 1 <br /> 1 _ ��� <br /> ��-�� �� 1 <br /> 1 <br /> SUB TO7AL $ ' _______ SUB tOTAL 5 �/��f_ <br /> � <br /> -----�-- — — PERMIT $ _i 1 TM_ <br /> — PEFiM1T 5 ___— -- , <br /> IOTl1L FEE S ' TOTAL fcE $ I <br /> FOR OFFICE USE ONLY: ____ <br /> —_--- smr semncn� r�nri cin r.K rnn.mFn �Fe neeemt r+n. <br /> POONLSf10�f.H IIF�115fip\CN <br /> useza+e � i�������� <br /> --- vncn�rts�F FEES VALUATION FEE <br /> � <br /> f1UlU)R1C ' <br /> IYPfUff.ONISAIIIIWAPIf IYfllli[illlSI�LIIIAI ����nun rinnPntu��Kuvita ... - . _. - - _.._._- --- ----- -- i <br /> i <br /> �.mnx� .I PI.UI.IHIN(: __ _ __. " . _'__'__'_ -- � _ <br /> � <br /> SIiBOrP�INi t1��1�I51nlllf^ O�.f1.11�N1 Lif(:U4NIC/11 � <br /> "_ ' _._"___" _-_—_ ___— _�i <br /> � <br /> nuoi i io�in�r�nN ci iecK � <br /> occurnr+criono nnEsrnriniensneoo i�riairtin.mm�a+ � <br /> � <br /> --- — onien -------- '— <br /> nEnwe ron srmr��irns ' <br /> sinre ouuoiric suncnnnar: � <br /> � <br /> iNinnenv rinusnrrnovmm CITYOFEVERETT put7�iCwonKs � <br /> LOCAL SALES � � <br /> TAl(CODE IS 3105 70TA� SS �� <br />