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APPLICAT��'�1 FOR CONSTRUC'i°��ON PERIIAIT evere[t <br /> rne e�aqr�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OF <br /> everett �EATING SYSTEM: LJ GAS U ELEC'FiIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I 1 DEMOLITION l l COMBINATION I i BUILDING 1YMECHANICAL IJPLUMBING CJ SIGN <br /> OWNEIl2v Joh" N� MAILPDDIEO7�(J r IS��CI7�' l.. ��UI �A 'lUZ7 V (053- 103�— <br /> N <br /> N <br /> f@NANT M4ILADOPC55 CIIY IIP �IIONF <br /> •—Cj--��. <br /> �I1CMIiEC10R0E51GNEH MMLADDRESS CIIY ZIP PIIONE <br /> GENEiULGONiRnG10f1 MNI.�D��E55 CIIY 21P PI1011E UCENSE� <br /> Valleu Cansf �o9zz sl'T ,�ve. N� ,�Yl_sv�� � B27o �Acc�c-izt-�uD <br /> MEGHANICAI CONTP�C70R MAIL ADDRESS Cli� ZIP PIIONE LICENSE I <br /> PlUMOINGCON10�L10R M�ILAUOIlE55 f,llv ZIP PIIONE UCENSEI <br /> CLA55Of WORK <br /> I I NEW I.I ADDITION I .I ALTERATION I I REPAIR I I DEMOLITION � ' WOODSTOVE/FRPLINSERT I.-i BUILDINGRELOCAtION <br /> r,or+inc�rcnsoN nHo mioNe No. <br /> CONTR�CT PRICE OF WORK <br /> OESCRIOE WORN ANO SOU�RG fOOTAGE INVCVED <br /> PROPOSEDUSEOFBUILUING I HEREBY CERTIFY THAT 1 HAVE REAC AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> IECALDESCflIPiIONOFPROPE111Y�5110Wdf1ELOWOBNTACHfOUNCOP1G51 P,IOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WOHK WILL BE COMPLETED WITIi WHETHER SPECIFIED HEREIN OR <br /> iot ntocrc or __ — NOT. TH° GfiANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOhI7Y TO VIOIATE OR CANCEL THE PROVISIOI�S OF ANY <br /> OTHER STATE OH �OCAL LAW REGULATING CONSTRUCT!ON OR THE <br /> PER�ORMANCE OF CONSTRUCTIOiJ.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH <br /> ' APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIf.NATUIIEOPCONiRACiOiIORAUT110112EDAGENT DATE <br /> 36oy Ylor�on - �=uer�t�" �� ���� <br /> PROJECi�DDPESS <br /> ICANiSG BUSMESSU SENO.�NDBUSINESSNAME <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTUflE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER GLOSET(TOILET) � AIC—NHNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN)� � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ! <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � _ <br /> LAUNDRY TRAY �_ _ W�TER HEATER _ ; _ <br /> CLO?HES WASHER � WOOD STOVE � <br /> URINAL ' METkL FIREPI,PCE 8 CH�MNEY ; <br /> DRINKING FOUNTAIN t_ _�_ FIREI•LACE INSERT � <br /> FLOOR DtiAIN � f IEAT PUMP _ ' <br /> BACKFLOW PREVENTERS ; GAS PIPING T_ <br /> ROOF DRAINS—RA�NLEADEHS ! EXHAUST FAN �_ <br /> SINK(SERVICE—BAR,E?C.) � � <br /> _�— � <br /> � � <br /> --*— <br /> i � <br /> — , i <br /> � —_� <br /> T <br /> 1 � <br /> SUB TOTAL $ ; SUB Tc-AL $ �'� <br /> PERMIi $ � PERMIT 3 � <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FUR OFFICE USE ONLY: <br /> fRONTSE7BACR RE405ETOACN SIOESElO�CN PI.ANCHEf.KNUMOf:fl PEE REGEIPTNO. <br /> usezor+e `�TAREA vncnmsne FEES VALUATION FEE <br /> � <br /> �UILDI`1G ' <br /> IYPEO(CONiS.RIIOW�BIi AiCON57.RCIWL 0[LwiMv NOMpNIIUVGUNIIS — 1 <br /> r.nam PlUM01NG i <br /> ��J� _ _ �� <br /> SIZE OF OLDG. NO OF S70BIE5 OASEAICN� � <br /> MEC�IANIC�L _ _ ___ _�� i�U <br /> i <br /> OCCUP�NCVLO�D FIRESPf111NL.PSREOD ��EIGNILIMIlA7�ON ADDITIONALPLANCHGCK i <br /> I ' <br /> OTI ILfi � <br /> �E�SON FOR SPRINNtE05 � � <br /> STATE DUIL�W(i SURCNAf1GE � <br /> ir�iene�v P�nwsnrrnoveoor CITYOFEYERETT ��uoucwonks � <br /> LOCALSALES <br />