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F�.w� <br /> APPLdC�17'IOrI F6R CONSTRUCT�JN PERIV117' <br /> ����E�« <br /> ���,�,,..,«.��� e <br /> ��,�o� <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8870 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> L�YHER MAiLADDBESS CITY Zi' F��OI:C ; <br /> �V1A���'}oh u.�1_3 Mert+�owt PI �evr.'C_1�__`j�203 Zv2-`f33� i <br /> �TENFNt IAFiI AD��E55 Cliv liP �'HONE <br /> C'-,'�l L7G�vi5 �, . � <br /> ARCHILECTOFi�E51GNER M/IIADDPESS Cliv ZIP PHONE <br /> y n H CITY ZiP PHONE LICENSE� � <br /> Sr�TJ G[NERALCON1RACi0R MARAD�HESS <br /> t]>H � .l�� <br /> ��H MECNANICAL CONiRPCTOR IAAIL ADDRE55 CIiY ZiP PMONE UCENSE� <br /> aycn <br /> > PLlIMOiNGCONTRAGTOF A:AILA�ORE55 CrtV 21P PHONE LiGENSE� <br /> y z i-�+ <br /> �C C] <br /> F3 Lb CLASSOF WUFK <br /> y�.� H� NEW XADDITION ALTERATIO REPAIR DEMOLITION . WOODSTOVE/FRPL INSERT . �- BUILDING REIOCAT10N <br /> N~ TRIANT IMPROVEMENi OR iNTERiOF HP.IOOEL ONLY �� .y 'j,t� 1 GONTACT PERSON AND PHONE N0. <br /> r3 C oa / <br /> � y� C0�ITRNCTPPICEOFWORK: � ZU�UUa- <br /> �ESCRIBE 1YORK AND SOURRE fOOTAGE iNVGLVED <br /> z �g '-��d,. o� 3 c s �- b�. bac�«rr rrs <br /> hl [s7 PaoPoseouseorouaou+c I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> 4�� C� .D ` ' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � qi� PPOVISIONS OF LAWS AND OF�INANCES GOVERNING THIS T1'PE OF <br /> a y� �ccn�ocs�Pn�Ho�Qo�FaLr���m9E��°bt���l�oC�����s� WORH WILL BE COMPLETE�WITH WHETHER SPECIFIED HEREIN OR <br /> b Y' S <br /> C H� �or5�Nf1������xK �S ^' GP�.i"17tqI–�ai'ILL�'J.� • NOT. THE GRANTING OF A PERMIt DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLAfE OR CANCEL THE PPOVISIONS OF ANY <br /> N H OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br /> O �7(A - – PERFORMANCE OF CONSTRUCTION.THAT I Ah1 AUTHOFI7ED BY THE <br /> � C�{ C,�S y,�n' OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> sj "'��i7 � .,,un,B'., � _ APPUCATION IS MADE AND I GOMPLY WITH THE STATE <br /> Z H f/) CONTRACTORS lAW 1827 RCW AND 296.200 WAC. <br /> HO� _;;!�nii�qCO�CO�ltFACiORORAUTNORiZE�AGENT OAiF <br /> X /�L�-�C✓ �/ (� � ` <br /> —_ �. <br /> rao�eeTaooNess - � - <br /> --y. � 7.�;-, n �t.-'���:.fl�.i E ' i;El:gl r.- nhoEluse�L55unME <br /> 7 //t't7x!>st � <br /> PLUMBING 1dECHANICAL <br /> p _ NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF ECUIPMENT FEE <br /> � w Z WAT[R GLOSET ITOILET� _ . __ A�C-A:HNOLG UNITS-H.P. <br /> ( BATHTUB _ FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> Z LAV�TORV IWASH BASINI _ _ __ _ UNIT HEATERS-B.TU. M <br /> CLOTHES DRVERS <br /> `�� Z K TOHEN SINK 8 DISP '- _,�_ VENTILATION FAN <br /> DISHWASHEH RANGE HOOD <br /> LAUNDRV TRAY __� �_ WATER HEATER <br /> CLOTNES WASHER WOOD�TOVE <br /> +� URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRI�!KING FOUNTAIN FIREPLAGE INSERT <br /> � FLOOR DRAIN � HEAT PUMP __ <br /> a' � BACHPLOW PREVENTERS ; f_ GAS PIPING <br /> —' E%NAUSTFAN <br /> ROOF DRAINS-F1AINl.EADERS __ <br /> SINK ISERVIGE-BAFi.ETC.) ' <br /> '_� ' _ -- r—_ _ <br /> v <br /> ..�� SUB TOTAL 5 -- SUB TOTAL S I�� ^ <br /> PERMIT 5 �- PEHMIT S T- <br /> TOTALFEE S TOTALFEE 5 <br /> PPONTSCIDPCrc � �EARSEiBACN SIDESEiBrrc ^— PIANG�[[KNIiM9ER Itl' RGC[iPiY.O <br /> 20 i S � � p �30 33oyo <br /> usezo• wrnn�n2 vnenNrsne ' FEES VALUATION FEE <br /> ��I /fj / J 9� , '. YES � pUILDING _��Z <br /> LY{'fOFGONStAII�YlA�IC 7YPEOiCON51.AL1U�L �°��+ ManPhluiF�uM1'�5 — ---- <br /> tnao � <br /> / pLL'MOMG �_ <br /> SREOFotOG. NO.GFStOBIES OAS[MENi MECHANICAL �_ <br /> � VES . � NO — ' <br /> OCCUPANf.YLOAD FIPESPNNKL[RSRF011 I�FIGHTLIMIiAtqION� <br /> OTHER � <br /> '� ��. VES �. NO Z-V STATE UUILOING SUPCHARGE �� <br /> �_�� <br /> � PEASON FOR SPRINKLENS <br /> STATEENERGVSURCHAFGE <br /> APPLIGATIONACG.BV PLAN`i�Pl`P"A'I�!)v CITY OF EVERETT PULILIC WORKS <br /> LOCALSAIES � � <br /> TAX CODE IS 3105 fOTAL �, <br />