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APPLICATII..N FOR CONS'Tl�UC7 .ON PERMIT ""`'" <br /> ,c ,, TO BE COMPLETED IN INK—PLEASE PRINT � <br /> urv oF <br /> everett HEATINGSYSTEM: �GAS ❑ELECTRIC J - <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING ECHANICAL PLUMBING SIGN <br /> fAPIL A�ORE55 CITY ZIP �'HONE <br /> �o,��ER y�3r rn��P� ��� zsz- �bs� <br /> � MARRDOPE55 Cltt 21P PNONE <br /> TENANi <br /> nRCNI1ECTOFO[SGNER MAILP�DR[SS <br /> CITY 21P PHONE <br /> GENCRPICONiRRCTOR AIR' enDBE55 CITv ZiP PNONE IICENSE• <br /> CIIY ZiP PNONE UCEp SE• <br /> � � � MEC11/NICRLCONTPr1C OR MAIL/���ES$ ��r � - � ^�/ i/,��'L��yM�� <br /> rPrpz► t�i�'�° �//D /��iu.ST V� J 3 /I/O p //M1i <br /> ��/ CiLY ZiP PHONE LICENSEa <br /> A � � PIUM�INGCONTRAGTOR M�ILA�DHESS <br /> F-1 <br /> -�y y y CLASSOFWORN � <br /> y � H NEW ADDITION ALTERATION AEPAIR � DEMOLITION . � WOODSTOVErFRPL INSERT ���, BUILDING RELOCATIG�. <br /> CONTRGT PERSON AND P110N[NO <br /> � y � �r�Q. �J <br /> Q� H Q� LONiRAGT PRiCE O�N'ORK <br /> yN 0[SCRIBEWORKANOSOORREFOOiAGEINVOlVEO <br /> y �'Y' vno�~ouseo,���rou��/u/ I HEREBY CERTIFY THAT i HAVE READ AND E%AMINED THIS <br /> O �� S � APPLICATION AND KWOW THE SAtdE TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> H � �y iecnioescnivuorvocvaovenrv�sNo oe�owonn*TacHvourvcoviesi �yORK WILL BE COMPLE7ED WITH WHETHER SPECIFIED HEREIN OR <br /> 4]� O tot BLOCC OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> H � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> Z H OTHER STATE OR LOCAL LAW REGULATING CONSTI7UC?ION OR TNE <br /> .�y y .x PERFORMANCE OF CONSTRUCTION.THAT I A�d AUINORIZED BY THE <br /> H H OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> gy H APPLICATION IS MADE AND I COMPIV WITH THE STATE <br /> n �y y CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> �`ar SI�NATUREOFCONiRACiORORRUiHORiZ[�AGENT OATE <br /> H� y X � <br /> FRQIEGIADDPES$ ,/ ��y/ pp{ i�AN15 JLVBUSi _SSIICENS[N NDBq5ME55NAME <br /> PLUMBING <br /> " ��/ "�G��- DC MEC ICAL <br /> ' � NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �� WATER CLOSET(TOILET) A�C—kHNDLG UNITS—H.P. <br /> � �� BATHTUB FORCED AIR SYSTEh1S—B.T.U. M E.A. <br /> � LAVATOHV(WASH BASIN) UNIT HEATERS—�.T.U. M <br /> � SHOWCR __ CLOTHESDRYBRS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> ' DISHWASHER RANGE HOOD <br /> � �+ L�UNDfiY TFAY � WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> ' URINAL MCTAL FlREPLACE 8 CHIMNEY <br /> DRINKING FOUN?AIN FIREPLACEINSERT <br /> � FLOOR DRAIN HEAT PUMP <br /> �� GAS PIP�NG <br /> I BP.CKFLOW PREVENTERS <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR.ETC.) <br /> �1_1 <br /> I ' <br /> I ._� — — SUB TOTAL 3 ';�� O <br /> SUBTOTAL S - <br /> � ��' PERMIT $ PERMIT 5 /t � <br /> � TOTAL FEE 5 TOTAL FEE S S ;�v <br /> FOR OFFICE USE OWLY: <br /> RECEIPi NO. <br /> Fl10Ni5ET�ACK OEARSET9ACK SiDES[TBRCN Pl4NC1�ECNNt1AN[R F[E <br /> usczor+e �ornRen VACMlTSITE FEES VALUATION FEE <br /> BUILDING <br /> IYPEOfCONiSALLOWABIE iYMOiLONSi.ACtUFt OLq�uCr NOo�RMlux4UMn5 <br /> PLUMOING <br /> SIZ[OiBIDG. NOOFSTORIES BASEMENT MECHANICAL S S 'L`� <br /> OCQIPANCVLOAD FifESPRNKlER5RE0'D HE�GHTUMrtAT10N <br /> ADDIiIONAL PLAN CHECK <br /> OTHER � <br /> ---t— <br /> PEASON FOR SPFiNrclERS <br /> STATE�WLDINGSURCHARGE � <br /> i,��nKFo�� r�nNsrrraoveoov CITYOFEVEHETT PU�uCwoaks <br /> LOCAL SALES TOTAL S S �I`� <br /> TAX CODE IS 3105 <br />