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I <br /> APPLICATIO.i FOR CONSTRUCTIJN PERMIT ��`'�`'�` <br /> fnoEvergreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CIN OF <br /> y H everett HEATING SYSTEM: � GAS f]ELECTRIC ❑ <br /> �,y �31 BUILDING DEPARTMENT <br /> p x , 259-8610 <br /> s y y DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING 1 SIGN <br /> y �� �� ry�I/ � � h��p��� � �l CITV 21P PMONE <br /> � �7 (�fll<B� l.Ut;���' Cva (�00� c� � C i'�S <br /> k'y� IENANi MRILAODR[55 CIN 21P PHONE <br /> ��� <br /> VJ pRCHITECT OR�ESIGNEfi M�IL AD�FE55 CITY 21P PMONE <br /> 7^' 21P PHONE LICENSE� <br /> H <br /> ,!T']� GE LCONTRACTOR MRILAO�RESS ��T� <br /> QM F'I ��y �A.� ��� <br /> �'!��( MeCHRNICRLGONTRACTCR MRILAD�RESS CITY ZIP PNONE LICENSE <br /> I"1 V <br /> (7Y (] <br /> �y� PLUI.IBMGCONTRACtOR M�II pODFE55 CITY ZIP PNONE LICENSE t <br /> �y CLASS OF WORK <br /> H . � NEW : . ADDITION �. �. ALTERATION � REPAIR , � DEMOLITION � WOODSTOVFJFRPL INSERT . �. BUILDING RELOCATION <br /> Q rJ�/J CO/N���1CT PERSON ANO PMONE NO. <br /> �Z L CONTRACTPRICEOFWORN ^ K�J 'IW'�"�"�i wl� �5" � 9�3-3(0 <br /> oyW O[SCRiBE WORK RND SOURRE FOO GE INVOLYED <br /> b �- C`A c r t�� F o u nd��on M� 5a ' <br /> P SEDUSEOF�ui�oirvc I HEREBY CERTIFV THAT I HAVE FEAD AND EXAMINED THIS <br /> � � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL <br /> IEGRLUESGRIPTiONOFPHOPERttISHOWNBELOWOHATTAC11F0URCOPIESI PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISNPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> i6N gip�K �� oc NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ; �z� •a� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. � �� / <br /> SIGNATUREOFCONTRACTORORRUTHORREDRGENT ORTE <br /> X �/�'��«� ��_E�,- <br /> oA ss <br /> C qPPLIGRNTSCITV0U5ME55lIGEN$ENOANDOUSINESSNAME <br /> �_� �"� oQke� +.=v�..�-- �,A r�a� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> 1�' WATER ClOSET(TOILET) � NC—A/HNOLG UNITS—H.P. <br /> '�' BATHTUB FORCED AIR S`.'STEM17S—B.T.U. M E.A. <br /> LAVATORV(WASHBASIN) UNITHEATERS--B.T.U. M <br /> SHOWER CLOTHESORYEPS <br /> '�f KITCHEN SINK 8 DISP V[NTILATION FAN <br /> 1 _ DISHWASHER RANGE HOOD <br /> LAUNDPY TRAY WATER HEATER <br /> ' CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREFLACE 8 CHIMNEV <br /> � DRINKING FOUNTAIN FIREPLACE INSERT <br /> '�' FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PReVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> t SINK(SERVICE—BAR,ETC.) � <br /> 1 ' <br /> 1�; SU8 TOTAL 5 SUB TOTAL $ <br /> � PERMIT S PERMIT S <br /> . . TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: ��° �S <br /> FqONiSETORCK RERRSET�FCK SIOESETBAGN PIANLNECNNUM EN FEE NECEIFTNO. <br /> -8' ��'� �9 aS ,53at�i <br /> usezone IOtAPE� VACANTSITE FEES VALUATION FEE <br /> �J�Z BUIL[1ING ��Q� �7 ' .� <br /> fYPE Of COt115 AIlOWABIF 1YFE Of CON51 AL700.1 OCCq�aMv NO p Uv:LL�'�N+uvaS � <br /> �-/J -rJ .} f PWMBING � <br /> 5¢EOFBLDG. NO.OFSTORIES B45EMENT MECHANICAL n <br /> ia�3 s e��srb 2 � ,// � �y n <br /> OCCUPANGVIOAD FlRESPRNNLERSFEO'D MEIGNTUMITATION AODITIONN�PLANCHECK _7(,J� �U✓ <br /> N� OTHER <br /> REASONiORSPPiNKLERS � <br /> STATE BUILOING SURCHARGE L�-, <br /> INtAnEBY PLANSFPPROVE�OY CITYOFEVERETT PUBLICWORKS <br /> LOCAL SALES <br /> � R�� TAR CODE IS 3105 TOTAL /��•,� ;�' <br />