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_ :� <br /> � � =.', �-.,.�,. � \ f� �°" <br />� ` • pppLICATION FOR CONSTRUCTIJN PERMIT everett � <br /> rn.e�.a��^ ^.BE COMPLETED IN IYK—PL�ASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: GAS l�ELECTRIC U � <br /> ' � � BUILDING DEPARTMENT <br /> e,.. <br /> s <br /> 59-8810 <br /> � <br /> 2 � <br /> O _ r <br /> ��p { ❑ DEMOUTiON ' COMBINATION '_' BUILDING �]MECHANICAL u PLUMBING ❑ SI aN � <br /> � <br /> MAIIADDHE55 C{TV IP �MOME <br /> ��� ' �lb�e� � �vzo rr��n s� �,x� �,�r� �a�a � 53i�D��L <br /> J h� ��Eu cm zw <br /> �y� � ARGNREGT011DESRINER G4ML E55 CIiY Zil' PMONE <br /> �rc� ' DA�=S�'l�'ch £ 1�,ann��j �rt'/�r�,p l�9 ��a�-�7�y — <br /> G/�11�r� •�US PESS l dT+'//C �(�V Ilh.. � ZIP PI10NE /��!lE�I(�/�V .�/ <br /> Y��� L•!6L"���' <br /> �1 yEpW��t TM':TfNI MAILM�AESS Litt 21P PMONE IIGENSE• : <br /> ro. <br /> '� ' CIiY ZIP VHJNE UGENSE� <br /> . �y� ! 0.UMBiMG C MA�LTOR AUk MDRE55 — <br /> �y OF WORK <br /> 8�Fy �ryEW ❑ A D D I T I C W ❑ A L T E R A T I O N ❑ R E P A I R ❑ D E M O L I T I O N ❑ W O O D S T OVFJFRPL INSERT ❑ BWLDING RELOC.�TION <br /> Z5 0o i CONTAGTPERSONNIDPNONENJ. <br /> ���p cprtw�cr vn�ov wowc - . <br /> a pES�pIBE KMlDSOUNIEFOOTAG MVOIVED � �] ' `r�_ A <br /> — C'Q�S�i` �C,(� � � r�iFn .lYl.r�� `�� '5���7 <br /> ' PpOPOSEDUSEOFBUII ' I HEREH'i CEFTIFV THAT I HAVE READ AND EXAMINED TNIS <br /> . 5���,�� ��S/[;�"/�'� APPLICATION AND KNOW TiE SAMF TO BE TRUE AND CORRECT.ALL <br /> kpE qivrqnocvnoreanf �+��+'oA n�cN WRCAP�ES� PRCVISIONS'JFIAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> A �4 WORK WILL BE COMPLETED WITH WHE?HEH SPECIFIED HEREIN OR <br /> . �_� e�oac oF `��V _ NOT. THE GRANTING UF A PERMIT DOES NOT PRESUME TO GIVE � , <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY . I <br /> OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE � I <br /> — — PERFORMANCE OF CONSTRUCTIOIJ.THAT I AM i.7THOR�ZED BY THE � <br /> OWNER OF THIS PRGPEHTV TO PERFORM THE k ?RK FOF WHICH � <br /> / � _�__ APPLICATION IS MADE AND I COMPIY �� 'IT,' TNE STA'fE ' <br /> CONTRACTORS LAW 18.27 RCW AND 296200 W!' . ! <br /> SKaN�NR�CONTN�GTCROR�UTNORIZFD�GENT �QE � I <br /> � I � <br /> / �_ _ : <br /> �c= , � �- � <br /> �� <br /> ��� PROJECTAD�RE55 <br /> APPLIL�NiSCIttBUSINE55UG NSENO.ANDBOSINESSNMIE i <br /> � MECHANICAL <br /> 1 � '� ( PLUM81N0 <br /> I NO. TYPE OF FlXTURE OR�TEM FEE NO. R'PE OF EOUIPMENT FEE <br /> ( WATER CLOSET(TOILEn r ' N�NHNDLC UNITS—H.P. I� <br /> 1 ��� BATHTUB _ FORCEDAIRSYSTEMS—BTU M EA � <br /> LAVATOFY(WASH BAS�N�� � UNIT HEATERS—B.T.U. M I <br /> � CLOTHES DRYE(iS <br /> , SHOHEN SINK 8 DISP 'r — VENTILATION FAN I <br /> f / DISHWASHER � RANGE HOOD <br /> i <br /> � LAUNDRY TRAY I WATER HEATEN <br /> � � CLOTHES WASHER WOOD STOVE ' <br /> ' URINAL ' METAL FIREPIACE 8 CHIMNEY �� � — <br /> � DRINKIN6 FOUNTAIN i FIREPLACE INSERT � <br /> FLOOfl DRAIN i� — HEAT PUMP ' <br /> I � - BACKFLOW PREVENTERS i GAS PIPING <br /> ROOF DRAINS--RAINIEADERS EXHAUST FAN � <br /> SINK(SERVICE--BAR,ETC.) � ��r�� <br /> I � <br /> ��� — SUB TOTAL E �;� SUB TOTAL $ = � <br /> PERMIT E PERMIT S <br /> TOTALFEE S TOTALFEE 5 � <br /> FOR OFFICE USE ONLY: /� .f' � �� <br /> fPONT SEIBACN REAH SETBpCN SIDE SETBA� PUN LHECK NUMBER FEE a,; RECEIPT NO. <br /> ,o ' � ' -� 3s r � 30 — ��0 9 i <br /> USE 20NE lOT AREA VACANT SIiE FEES VALUATION FEE . <br /> �Z BUILDING JL,� �n �� ' . <br /> IYPEOfGOM6AlOW/9lE iYPEOFLON5I.�CLUAI OCcuwHcr xuIXDw[u�rGuxns 1 <br /> �AON / PLUMBIN i ' <br /> ' '/✓ /� � <br /> SQE OF BLDG. NO.OF STORIES B�SE:AENT MECHANICAL � (f ' ^ I <br /> � 'c,� C 1 � <br /> I OCCUPANGY LOAD FIRE E VKlERS REO'� HEIOMT LIMITATION� ADDITIONAL PLAN CHECN I <br /> y �� <br /> �J Q �/J OTHER i <br /> REASON FOR SFPINKlERS �—/� <br /> STATE BUILDIIJG SURCNARGE i h / � <br /> INTAKEBV PUNS�:PPROVEOBY CITY OF EVERETT PUBUC WORKS �� �J� � <br /> LOCALSALES � <br /> J� 3�y�9L T11X CODE IS 3105 Tor�� / %;' ;,S(J <br /> � <br />