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APPLICATItrN FOR CONSTRUC►�.ON PERMIT ��`'`�'" <br /> moEverpieen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everet# HEATING SYSTEM: O GAS ❑ ELECTRIC ❑ <br /> BUILDING DEPARTMENT — <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING IMECHANICAL 1�PLUMBING SIGN <br /> �OwNER 1 MAILApDAESS . , Cltt, LP'�� � o�ONE � � _ - �. <br /> �il . � � I' 1� �' � � l ' � � . 1 �1 � i � � 11 . 5��• � _ � , . .� _!i � � � .� �'_,, �. . <br /> 1ENANT ,� MAllA0�RE55 CITY 21P PHONE <br /> ♦RCMRECTOHDESIGNER MARADDRE55 CITv 2iP PNONE <br /> ��� OENCPA�COHTR�GIOR M�IIADDPE55 CITV Ho PHONE LICENSEI <br /> >H <br /> �.�1 H - Cltt . � ar�ONE � .. WG E• .�' <br /> � . N6G�IANICMCONTMGTON � MAIIAD�flE55 P , . <br /> � ',:'_ � I v . � ' '. I .' . 1 � �. r I � .: I �. �' �l �, � . , i' ' - �. � i ��i ' ^ � �. � � >< < <br /> ayw .f\�1 � I'1 �1 1 f, � i � •• � 't �� � i �, t ,. .�j �, � , � ,�,�;1 f7'li, I � �'�. ,Z <br /> H 9�i -pWMBING CONTR�CTOA M�IL AOOAESS C�Tv 21P oMOHE UCENSE� <br /> y LH <br /> ft C] <br /> H=h '.. c�•ssocwoAK <br /> � yN � NEW - ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE'FRPIINSERT .� BUILDINGPELOCATION <br /> y x,., , . , COIILeGioER50NARp>wONEHO <br /> .e. � /�( i �, <br /> C O C 7 CONTRACTPBICEOF WORR � ' r ` � <br /> `•, y d <br /> DESCRiBE WORK N1D SW�AE FppTAGE iNVOIVED � <br /> t7 _'1 �����i� '� ' 1� 1 '�� ' �� �� � ��� ��- '1 �� <br /> � LT+�O,� oaolo5eou5¢oceutid�+c , I HEFEBV CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br /> � '1 i' APPUCATION AND HNOW THE SAME TO BE TFUE AND CORRECT.ALL <br /> H C� _ i� ,5� 1 �i`�. , '��, 1'� � <br /> Z H 3 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> ay�,y .EG�LOESCA��TrpryO�PAOVEerrt5J0�'NBELOWOA�ii��woW4�O>�ESi <br /> YlORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> r H y �or e�ocK oF NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �y W " ,� � i ,,. i � - � ,,. � /- .. , AUTHGRITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> nd� � � � �. •. �I� ' . '7 � ; �_)�. �.: ��� � 1 l �� � ' i OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br /> q PERFORMANCE OFCONSTRUCTION.THATIAM AUTHORRED BYTHE <br /> 3, �t" OWNER OF THIS PROPEfiTV TO PERFORM THE WOFK FOR WHICH <br /> t�� � APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> Z y N CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> H O fp <br /> SN'iHRUAEOFCONTNA�TOAOA�U'wOAQEDAOENT p�TE <br /> X 11 - 1 , . <br /> � <br /> , � , , , � �. � ; . I C'7'C `i/ <br /> oAQIECTADOFE55 . , - � �' - �' � • <br /> '.y . � I � - i ;�' 1 ��� ' �I � r � ' ! � � / APPLM.ANiSGITYBUSWfSSL4ENSEMO �HDBOYHESS 4E <br /> I <br /> PLUMBING MECHANICAL <br /> � N0. TYPE OF FI%TUFE OR ITEM FEE NO. TYPE OF EOUIPMEIIT FEE <br /> I � WATER CIOSET�701LET1 0.C—AHNDLG CNiTS—H P <br /> � BATHTUB FORCED AIR 5"STEMS—B TU. M E A. ' <br /> LAVATORV(WASH BASIN) UNIT HEATEFS--B T U. ti� <br /> s SHOWER CIOTHES DRVEAS <br /> ` � KITCHEN SINK 8 OISP ' VENTILA7ION FAN <br /> DISHWASHER � RANGE MOOD <br /> LAUNDRV TRAV ' WATER HEATER <br /> -.� ,� <br /> CLOTMES WASHER WOOD STOVE <br /> URINAL b1ETAl FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> "" � FLOOR DRAIN ' HEAT PUMP ' <br /> !'� BACKFIOw PREVENTERS ' .".( G�S PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK ISERVICE—BAR.ETC I � <br /> � I � <br /> � � /S <br /> !'! SUBTOTAL S SUBTOTAL S <br /> PER6117 S PERMIT S �.�'� <br /> TOTAL FEE 5 TOTAL FEE 5 ������ �- <br /> � FOR OFFICE USE ONLY: '�� <br /> FPONTSEiBA�R PEARSEiBACN S��ESETBACN PUHGkCKNUMBEA �EE AEGEIGTNO <br /> use Ea+¢ LOt�qEA VACANT SRE FEES VALUATION FEE <br /> BU�IDiNG <br /> t��E 0�CONfS A��OW�B:[ irv{Of[pNSf/.CNR a[V�x� r0 V h1c�+G.���s <br /> ���AO PIUMBING <br /> SIZEOFBLW NOOFSTOHiES BASEMENT MELHANICAL ' <br /> i� � � <br /> OGGUPANCv�OAD FIRESPRNKLERSREOD HEKrMTLIMITATION ADDITIONALPLANCMECN <br /> OTMER <br /> AE�SOMfORSppiNNLEAS <br /> STA7E BUILDiNG SURLHARGE <br /> iH*��EBY Pl�NS�VFROVEDBV CITYOFEVERETT PUBLICWORKS <br /> ' LOCALSALES <br /> i TAX CODE IS 3105 rore� ���� ;a <br />