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�� I <br /> `�J� �� A[?PLICATIO / FOR CONSTRUCT�JN PERMIT e,'e��'t <br /> mee�ap�Pe� TO BE COMPLETED IN INK—PLEASE PRINT� � <br /> GITV OF � � , • <br /> everett HEATWG SYSTEM: GAS J ELECTRIC :J <br /> '� n� BUILDING DEPARTMENT <br /> � 259-8810 <br /> � H DEMOLITION COMBINATION BUILDING �MECHANICAL PLUMBING SIGN <br /> � y y �q MAIL qpDflE55 CITY 21P PHON <br /> �..c�v�u�'� Il �-ti,c 146�s 11 � I�jo� *�107 l,�,r�c1���,��lle u7� 4$6�/�F.rs <br /> �"� �� vHor+[ <br /> H h'� iENRNT f� 1 AAIL RDDFE55 GTY 21P <br /> �y� �'VM�4 \0.\ 1� <br /> �N� �qCHRECTORDE5IGNER M�ILADDRE55 CITV ZiP P IONE <br /> y� <br /> y� �pur- .C�Tar�ipR MA�,�DDFE55 nr +�P �40NE llCcqSE/ <br /> Enp ? �' �GIS��.G %7o�"yr1o�_j,7c��,H��iIIE ���7z �/f'i;lv-Ss <br /> HC7 O�JrJ� ' . .JC.w <br /> M �� . ANICRLGOHtR O �^ MRIUC7AE55 � pT`-�\� ":�`/ I�N PNON[�/�('.bdJ UG NSEr <br /> \ + �H OUI <br /> C �` ' y �JI�t�, Y11 <br /> n� PLUMBIN GONT 4CTOR M4iLRDDRE55 � QTY IIP P ONE IICENS � <br /> H <br /> zN <br /> Cl 'SOGWOFK <br /> �y y NEW � ADDITION ALTERAT=ON REPAIR � - DEMOLITION . WOODSTOVE/FRPL INSERT � -. BUILDING FiELOCATION <br /> �y �(7 CONLACTORSpNANDPNONE <br /> �-1 � _ FwoA� - E��' r '� Zie( 77 � -�s��/( <br /> � Cw OESCRiBEWORKAND50WAF.F00 GEINVOLVED Tp 1 <br /> F�f�l � <br /> O v� �'As��{�o �,� r �,kl' Naa� -z c.,�✓iTJkt. �� � <br /> vaovosmuseorem on�� I HEREBV CERTIFV THA7 I HAVE READ AND ExAMINED THIS <br /> n _, � r APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL <br /> J1�m pRO�'�SIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> iEcn�oesc��vnorvovraoPeArv�sNownaeiowoe�rucnFouncowes� yyORK WILL BE COMPLETED WITH WHETHER SPEGFlED HEREIN OR <br /> tor etocK oF NOT. THE GRANTING OP A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHCRITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOGAL LAW REGULATING CONSTRUCTION OR TNE <br /> PERFORMANCE OF COi�STRUGTION.THAT I AM AUTHOR2E0 BV THE <br /> �11�`i r � � v�� OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WNICH <br /> i APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> c 1 1 CONTRACTORS LAW 78.27 RCW AND 296200 WAC. <br /> T ,1 C:.r !� �-{ G_ , SIGNwTUREOFCONTRICTOROR�UiMOR12E0PGENt DATE <br /> L.�V l V �'"" \ \ <br /> � �����—� .3�a.3� y3 <br /> PROJEGTPDDNE55 � <br /> qPPt I�NiS CITV�USINE55lICENSE NO RN�BUSiNE55 NAME <br /> � '�' PIUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET� N�NHNOLG UNITS—H.P. <br /> ' ' BATHTUB FORCEDAIRS`.'STEMS—B.T.U. M E.A. <br /> '�' LAVATORY IWASH BASIN) Z UNIT HEATE(�S—B.T.0 M 7,$� <br /> SHOWER CLOTHESORYERS ' <br /> 1 ' KITCHEN SINK&DISP VENTILATION FAN �_ <br /> DISHWASHER RANGE HOOD <br /> '�' LAUNDRY TRAY _ WATER HEATER <br /> ' ' CLOTHES WASHER WOOD S70VE <br /> � <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> DRINK,':G FOUNTAIN FIREPLACE INSERT _ __ <br /> ' �LOOR DRAIN HEAT PUMP = <br /> ' BACKFLON'PREVENTERS GAS PIPING — <br /> ROOF DRAINS—RAINLEAD[RS EXHAUST FAN <br /> � SINK(SEHVICE—BAR.ETC.) <br /> t_� ---r- <br /> SUBTOTAL $ SUBTOT.AL 5 '� <br /> �1 PERMIT $ PERMIT $ <br /> '� TOTAL FEE 5 TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: O S <br /> it10Ni5ETBACK AEARSEIB.V �' $IDESETB/�GK PlANC11E.Nq0�AB PEE HECEIPTNO. <br /> use7or+E �orr.Pen VRCRNTSITE PEES VALUATION FEE <br /> BUILDING <br /> tYFFOff 6.�LlOW4BLE 1YFEOiLONS1.�LiWI 0¢un'2'� NOnMrtuixcdx��s -- <br /> uuav p�UMPiNG � <br /> T. <br /> SREOFBL�G NO.OFSTOHIES BASEMENT M@CHANICAL <br /> OCGUPPNG`�ORD FlRESPRNKLEfl50.`.�'D MEIGHiIIMRRION ADDITIONALPLANCHECN _ <br /> I OTHER � <br /> ---�— <br /> aEA^x.N FON SPRINKLERS <br /> STATE BUILDING SURG;LflF[ _ <br /> iNiAKF.BY P S P OVF[l9Y C�iY OF EVERETT PII"'IC W�IRKS <br /> � �ocai.sr.�es <br /> 'pX COUEIS 3105 rorn� <br />