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APPLICATIG � FOR CONSTRUCT►.�N PERMIT evefP1t <br /> ��E��9��� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CIT�OF <br /> everett N/�EATING SYSTEM: iJ GAS ❑ ELECTRIC U __ � <br /> BUILDING DEPARTMENT � — <br /> 259-8810 <br /> I i DEMOLITION ' COMBINATION BUILDING ' ' MECHANICAL � PLUMBING i SIGN <br /> OWNER M�ILnpLlfiFSS CIIY ]II• PIIJNE <br /> , at� U�l�n�i,n�1�l�c�y� . C..r��� _I`_R�����c.o���__`iy`C:3i5�s�o� sSi-Kalb <br /> TEN�Ni AI�IL�DUf1FSti ' � CIIY P 711 PIIONE <br /> C v��Ru,�,��—��3�t�nke.s e����L2Y�1 �5- 1 �30 <br /> nncm�ecronuFsic;�mn n�nm m � ss cnv nr PI�ONE <br /> RONA_�_�(`r��•$ SA(TtQ.��_UW N �Lf <br /> Al1Al1lCONiMG70R f� M41L�OORF55 CIIY ZII' P110t1E LICF.NSEt <br /> MECIIANIC�I. �'NIfNCiMi ���nW Ao�55`�.�V�1��_f_V—GNf.li�`•f 1=L�21f' C� ��J,N PII� C� � r�ICENS[I��'�_'���' <br /> AR��SDr-d3a�cs <br /> Pl11MBMC NifinClO(1 Id�I1.nDDtiF.SS CIIV 71P PIIONE LICENSEt <br /> q ------- -----_ _ __----- - -- <br /> cussor oi�K <br /> I I NEW I ! ADDITION '� � ALTERIII ION ' f7EPAIR �� DFMOL1110N � WOODS70VF�PFlPL INSERT I � BUILDING RELOCATION <br /> _----_..—..—�--__�'—�---�"-- I:Otll4f.l1`IIISn11�NI�P1iONf:110 -- p7 <br /> coNmnct rnir.E or Wonn v� �—�J d LU :�—��7�J`(,� �5 a,� '� D�p� <br /> 1 L,,S��f------ - — -��---- =- -�- <br /> OESCRIBE WqnK nNn sounnr n>oincc irvvaven <br /> Ra,lw�e 9� R..pl.ace. RGT��u�;t�� [=R;s►'�+y Plasl� <br /> Cn, .+�y w� ���,��,,�1� <br /> PROPOSEDUSEOFBWIDING �--��`��—J��;3 00 I HEREBV CERTIFY THAT I HAVE RFAD AND E%AMINED THIS <br /> � � r"�� SI" APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> ! <br /> �ew�oescmnnon norEmvis�owNne�owonnrracnrouncoriesi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OP <br /> WORK WILL BE COMPL�TED WITH WHETHER SPECIFIED HEREIN OR <br /> tot BLOCN ar NOT. Tl1E GRANTING UF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOL.ATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY 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 FjCW AND 296200 WAC. <br /> SIGN�IUREOF or�mnc�ononn)/SFIONIZEDAGENt �ATE <br /> li�/wI / �/ Y� / <br /> X�- /✓' /�'�: /. � ��II: � 17 <br /> vaaecT�oonFss ��C�-�4--1�C��•�n�l '�¢_X'��i�a '. �Z���_ <br /> 1-- <br /> �I'PLIC�NI S CIIV IIIISINF.55lIGENSF NO �Np plI5ME5S NARIE <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WAiER CLOSET(TOILET) A/C—NFINDLG UNITS—H.P. <br /> — .—_—__. _ — �_ <br /> BATHiUB ; FORCED Alfl S`.'SiEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> -- —+— <br /> SHOWEH CLOTHESDRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> —� <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER �— WOOD STOVE � <br /> URINAL � M[TALfIREPLACE R CHIMNEY � <br /> DflINKING FOUNTAIN FIFlEPLACE INSERT <br /> FLOOR ORAIN HEAi PUMP —� <br /> BACKFLOW PREVENTERS � GAS PIPING <br /> ROOF DRAINS--RAINLEADERS �— EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> '— — — <br /> — — ------ —f— --- ---- — — <br /> — -- --- �-- - ---- — --+— <br /> - — ----�--- -- -------- - — <br /> — — � — — <br /> -- —'— — ---------- —r— <br /> � <br /> SUB TOTAL ? SUB 1 OTAL $ <br /> — ----- — ----� - - -- ------�— -—�-- --�--- — <br /> PF�411! $ � PERMIi S <br /> � <br /> ---- - — -----'— -- --- -- ---_..-- --- . .. ----- �-- <br /> TOIALFEE 5 TOIALfEE $ <br /> FOR OFFICE USE OP1LY: <br /> ----- — ----___ --- . <br /> rnorasemncK I11�IIS�IP�t'K smrsrmnrr. rinnnmr.nr�m.mrn in� nrcrinrun <br /> ----�--- -- ----�-- �--- ---- � ---'-- ---- <br /> use zoNr un nnrn vncnm wr� FEES VALUATION FEE <br /> .T <br /> --- --- - --- --- - nun niNc; � ��1 ' �>�� <br /> nrrnrcuxisnunwami in•,nrrnnvncmn� � ����. . I u����e���� -�� �� --� - � -� - � -- --'-- <br /> � nm PIUh1BW(1 � <br /> _— _.__ . ._—_. .— . .. ._ _. _ ' _. ._— ._"" _ . --_�_ <br /> SIlE01'FlUtG NOOf511)NFS PnSflJiql I,Ip.CIIANICAI <br /> _ . ..____— ___ ... .____ __—_ _—_ ___ <br /> OCCIII'A11CY10411--_— flfiESPpNNIPfi511[�70 IIF.IGIItU1.U1�1101! —_"_ AUDIIIONAI.PLA�ICIILCK � <br /> _" __ ' <br /> - --- ----- omr:r� —��;— <br /> ❑EASONlpI15PIiMnIP11S ---- --- - — <br /> stnienui�oiricsunci�nnce (� ; <br /> � 'r� <br /> iN�nxr m rinii, r�ovei;n. CITY OP EVERETT runi ic wonns � <br /> ���� ��� LOCAL SALES ' <br /> / TAX CODE IS 3105 ioTA� / ?� L� <br />