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J <br /> r» y-�+ <br /> APPLICATION wOR CONSTRUCTIG.�1 PERMIT `'`'"P" <br /> mc e�cig�cw� TO BE COMPI�TED IN INK—PLEASE PRINT � � <br /> ��� everett <br /> HEATING SYSTEM• ❑GAS U ELECTRIC ❑ <br /> � H BUILDING DEPARTMENT <br /> y y y - 259-8810 <br /> ��� DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER FIAtLAODRE(^pf Litt ZIP P4pNE <br /> H70 �� �� ARh�. c K � �..,�,< < E� e � �r7� 3�i � - aS�� <br /> �H � TENRNT MAlLA0�RE55 Cltt 2iP PHONE <br /> � <br /> H <br /> �xp qqCNIiECTORDESIGNEF AIARPDDPE55 LrtY ZIP PMONE � <br /> HC i� ' , .' % 07 ti 3 1 <br />� � �"� rypq�qpGipq M/RR�DRE55 Cltt ZiP PNONE LIGENSE• <br /> � �g . ��s������ <br /> 'i I LO ,�U � .'�. r� 6 <br /> H� n � <br /> II MECNANiCALCON1RRGiQ MAILPDOPE55 LrtV ZIP PNONE LICENSER <br /> [" y� <br /> I PWMB�NGCONTRRGtOR MAILADDPE55 CITY ZIP PHONE IIGENSE� <br /> V�i y <br /> ��y GLASS OF WORK <br />� � ✓NEW ADDITI�N ALTERATION REPAIR � OEMOLITION WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br />� CONTACT PERSON fu4D PNONE NO. <br />� y 0 y CONTRRCTPRILEOFWORK // �✓� e^ � � � � ( � <br />( � DESCPiBE WOFK ANO SOUARE FOOTRGE iNVOLVE� <br />, � q� � . <br /> aaoaoseouseoFew�oir+c I HEREBY CERTIFY ThIAT I HAVE READ AND EXAMINED 7HIS <br />'� � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> i PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALDESGRIVIONOFPPOPERtY�SHOWNBELOWORATTALMF7O�URCOP�ES� yyORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHEREINOR <br /> i �oT I9 D ' BLOCK � oF � C, NOT. THE GRANTMG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> I^ , � f � ' , ,, OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> I lal�L�l� y _ PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> � � (� �,� � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> ��1���� `./ I � �`�R — � _ APPUCATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> � � �.- O.� -7-U' -0 SIGNPTUREOPCONTPACTORORRUTIIOHREDRGENT DRTE <br /> ' '�' PRQILCiADORESS —f�.. '�-"'Lti--1 , "_L�� � <br /> 1 � ^ � A�PUCANTSCiiVBU5NE55UCEN5ENO.AND0U5MES5NAME <br /> ' ' PLUMBING ' MECHANICAL <br />� N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> '�1 WATER CLOSET(TOILET) A/C—�VHNDLG UNITS—H.P. _ <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> I ' LAVATORY(WASH BASIN) UNIT NEATERS—B.T.U. M <br /> SHOWER CLOTNES DRYERS <br /> 1 _ KITCHEN SINK 8 DISP VENTILAi I(1N fAN <br /> ' _ DISHWASHER RANGF HOOD <br /> LAUNDRY TRAV WATER hIEATER <br /> CLOTHES WASHER _ WOOD STOVE <br />� ' ' URINAL __ METAL FIREPLACE 8 CHIMNEY <br />' DRINKING fOUNTAIN FIREPLACE INSERT <br /> t�' FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br />, '_1 ROOF DFil11NS—RAINLEADEflS _ EXHAUST F�N <br /> ' SINK(SERVICE—DAR,ET0.) <br /> � <br /> '�' SUBTOTAL S <br /> SUB TOTAL S . <br /> - PERMIT S PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> FqONL$El00CK �EFRS[1BACK SIDESETBACK PLANCHE./Nl1M� N FEE <br /> RECEIPt NO <br /> - � � � �-�'a� Cvy '�-1 �� <br /> � <br /> WE ONE IOTAREN �ACRNTSITE FEES VALUATION <br /> � � r' p .V BUILDING � � w __,�j�iL� <br /> iYPE 0!LONiS AILOWABIE iYPE f CONSi.An� oGcp�p6 xa a�uNcubits <br /> � � PLUM�MG <br /> h <br /> SIZEOFBL�G. NO.OFSTORIES BRSEM[NT MECHANICAL i <br /> Z / � (�� <br /> OLCUPANCYIOAD FIRESPRNNIERSRE00 HEIGHTLIAlIT7T10N � DITIONALPLANCHECK p��'�\/ <br /> �v� ��f OTHEfI �_� <br /> HEASONfORSPRINNlERS � iC� <br /> STATE�UILJING SURCHARGE ��J <br /> ir�rnKe ev PLANSAraaAvEo ov CITY OF EVERETT PUBLIG WORKS � <br /> �/ LOCAL SALES <br /> 1c� TAXCODEIS3105 T�Tp� c���1� <br />