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. ... . .....:r�- . <br /> _ —, <br /> APPLIC.,:t'ION FOP� CONSTRV�TION ; <br /> PEI�MIT <br /> fh�Ewrproen everett ,� <br /> CITY OF � <br /> everett � <br /> BUILDINO DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> I ' ,,M�IL�DOPE55 I { n' CITY 21P P110NE � <br /> ENy��II�I IIlL�17'`�I/VfEZ I/II�!—��� � 1 ��1..� � �� PMONE�^���� � <br /> lENu1T <br /> AIiGMITECfORDE910NER MAlll1DDRE55 CITY 21P PMONE � <br /> � MAILADDRESS CITY 21P PHONE LICENSE• � <br /> OENEMLCONTR/�CTOP <br /> � y MECH�NICAL NTRACTOR MAILAODRE55 CITY 21P PMONE IICENSE• <br /> ' PLUM&NUCONTR�ICTOR M�IL�O�i?SS pTY 21P PMONE LILENSE� <br /> � G1A950FNORK cy i. <br /> � ❑ NEW ❑ ADDITION ALTER�TION ❑ REPAIR ❑ DEMOLITION W WOODSTOVE/FiiPL INSERT ❑ BUIL�ING RELOCATION '. <br /> � IENANTIMP110VEMENTOHINTERIORREM00ELONLY CONT�CTPERSONINOPNONENO. . <br /> ��CONTMCT MICE OF W�7RK .� <br /> D�Lp19E WORN AND SOU�NE FOOT�OE INVOL D (y� :� <br /> '� �` � E5� �� � C YV� � <br /> r�n{o`roeeDouaeoreuaoiNo IHEREBYCEPTIFV7HATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND f' <br /> � TD( S � KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVI910NSOFLAWSAND � <br /> �r ORDINANCES GOVERNINO THISNPE OF WORK WILL BE COMPLEiED WI7H ! <br /> ' �EMLOEBpiIPTIONOFPP01'ERTYISHOWNBELOWORARACMFOl1NCOPIE51 WHETHERSPECIFIEDHEREINORNOT.THE�RANTINOOFAPERMRDOEBNOT <br /> " PRESUME TO OIVE AUTNORIN TO VIOLATE OR CANCEL THE PROV1910N9 OF <br /> x �pT g�pcK or ANYOTHERSTATEORLOCALLAWREOULAT�N4CONSTRUCTIONORTHEPEFF <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE OWNER OF <br /> � THIS PROPERiV TO PERFORM THE WORK FOR WHICM APPLICATION I$MAOE ', <br /> AND I COMPLY �A'ITH THE STATE CONTRACTORS LAW 18.27 RCW AND � <br /> � 298200 WAQ i. <br /> � 5'3N�TUREOFCONTR�CiOHOFAIITMORREDAOENT UATE <br /> x ` nr��► �2-- 1 q-88 <br /> ����nnr�� <br /> PIqJECfADORE9S ' �PF_ TSCI BUSI 5 LIGENSENO.�NUBU51 SSN�ME <br /> ��l ; <br /> � PLUMlINO MECMANICAL ' <br /> �. <br /> NO. TYP!OF FIXTURE OP ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CL09ET(TOIlEi) AIC—A/HNDLG UNITS—H.P. ; <br /> �TM�B FORCED Alp SYSTEMS—B.T,U. M EA ; <br /> LAVATORV ryVASH BASIM UNIT HEATERS—flT.U. M <br /> $HOWER CLOTFIES DRYERS � <br /> KITCHEN$INKB DISP. VENTILATION FAN . <br /> DISHWASHEH RANGE HOOD �. <br /> � UUNORYTRAV WATERHEATER <br /> CIOTMES WA9MER WOOD STOVE � <br /> URINAL METAL FIREPLACE6 CHIMNEY ; <br /> DRINKINQ FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS _ _ GAS PIPING . <br /> ROOFDRAINS—RAINLEADERS _ _ EXHAUSTFAN � <br /> SINKI3ERVICE—BAR,ETG) <br /> _ i <br /> � <br /> SUBTOTAL S SUBTOTAL E <br /> PERMIT S PERMIT S _ <br /> TOTALFEE S TOTALfEE S �, <br /> SIDESEfBACK iUNCNECKNUMBER FEE RECEIPfNO. <br /> FRONiSEfB�CI( RFAP:ETB�CK ' <br /> usezowe �oru+� WC�NTSITE FEES VALUATION FEE . <br /> O YES ❑ NO <br /> BUIL�ING r <br /> TYPEOFCON9T. OGGUPANGYOROUP NO.OFOWELLINOUNITS — .. <br /> QIOWABLE/�CTUAL PLUMBING i <br /> 9REOFBLDQ NO.OFSTORIES &SMT. �����0 MECHANICAL � <br /> OY <br /> ❑N <br /> HEIGMTLIMIT�TION OTHER ` <br /> i, <br /> fIRESPRINKLEN5NE0UIRED ❑YES ❑NO STATEBU�LDINGSURCHARGE <br /> STATE ENERGY SURCHARGE • <br /> �PPLtGTON�CGBY MANSAPPR.BY PUBLICWORKS <br /> f <br /> TOTAL <br />