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APPLICATIO.J FAR CONSTRUCT..JN PERMIT e�e�e�' <br /> � TO BE COMPLETED IN INK—PLEASE PRINT � <br /> t�e Evorgreon ^I� I n <br /> E L� ✓ <br /> CITY OF <br /> everett �l HEATING SYSTEM: GAS ❑ELECTRIC C]_ <br /> BUILDING DEPARTMENT <br /> 259-Bu10 <br /> DEMOLITION COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br /> NER 1 � MAILAODFESS CITV _ 21P PHOI�E <br /> _C_I1C�"'J'� '� ��sr� �ti��, i��a t rnr,nn . v�e� D� - �e�-P-,� o oi ���1 - is 3 <br /> TENhNi MAILAOOPESS CITY 21P PHONE <br /> pCCHiiECTOfiDE51GNER MAILqDDRE55 CITV pIP PNONE <br /> GENERALCONIRFCTOR MFILA��RESS GITV 21P PNONE LICENSE• <br /> N[CMANICALCONiRACTOR �AAILA��RESS CITV 2�P PMONE UCENSEt <br /> SO`-`�e inerzi a� km`. �U.��ax 19?`,q Sor�t (La ���n Qc� ilq ��_–,< .-< � <br /> �t'� � � �' Ro:�.m i4c�.l'�P <br /> PLUdBMGCO4TRnCT0i1 MAILq�DRESS CITV ZIP pHONE LI�ENSE� ' <br /> LLFSS OF WORN <br /> � NEW �. � ADDITION X ALTERATION . I REPAIR � DEMOUTION WOODSTOVE/FRPL INSERT �. � BUILDING RELOCATION <br /> ��':�=T�— / ,.�� CONiACTPERI NANDPNONENO�<�� ^��� �� � � <br /> CONTRRCT PR�C[OF WORN �./�.J G` � <br /> DESCRIDE WOFKRNDSOUME FOOTAGE INVOLVEO <br /> U'��(SIE Q(1 !>�(ll�.f10-C.4 F \l�(��9 � o <br /> PROPOSEDUS FeuaoiNc ' I HEREBY CERT�FY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE A�D CORRECL ALL <br /> LEGAL DESCRIPpONOP PROPERTV ISNOWN BELOW ORATTACH FOUNCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNWG THIS TYPE OF <br /> WORK WIL_ BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> io* o�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. TFiAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNAiUREOFWNTRACTORORRU�^�O REDAGE�NT, ypTE � � <br /> X �ll/� l/��'z�!/l/i--� <br /> P/�ROJECTADDRESS ��JL� ' ��� ��`I�`f��,y!�`�I/1(�IJ/ <br /> \l�`3'� � •Ma�L�I�, J � ��� ������ C� � APPLICANTSCIiVBII WESSLICENSENO.ANDBUSINESSRAME / � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CIOSET(TOILET) ArC—A�HNDLG UNITS—H.P. I <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV WATER HEATER <br /> CLOTFiES WASHER � WOOD STOVE <br /> URINAL ; METAL FIREPLACE&CHIMNEV <br /> DRINKIPJG FOUNTAIN FIREPLACE INSERT <br /> FlOOR DRAIN HEAT PUMP <br /> BACKFLOW PHEVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS T EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; � (c���- <br /> � I ��C� kC� 16b?� �0�1 <br /> -- -0�3���i�t�0.� �(3=.6i% <br /> � <br /> SUB TOTAL 5 SUB TOTAL S <br /> PERMIT $ PERMIT 5 - �Ci� <br /> TOTALFEE 5 TOTALFEE S - <br /> FOR OFFICE USE ONLY: <br /> FRONTSETOAGN REOqSETpACK SIDESET6ACN PIANCHECKNI1MBEfi ;CEE PECEIPTNO. <br /> ' � 1317 <br /> usczoNe �ornaen VACANTSITE FEES � _VAUlAT10N FEE <br /> eui�oiNc <br /> IYCEOFCON75.AtlOWABIE IYPfOfWNS*.ACIOAt cccurev:v xoo�rnrtuix�u�rts <br /> �4�uc pLUMBING <br /> SIZEOFOLDG. NO.OFSTORIES BASEAtENT MECHANICAL <br /> OLCIIPdNCY LOAD FIRE SPRNKLERS REO'D HEIf.HT UMITATiON ADDITIONAL PLAN CHECK <br /> OTHER <br /> REh$ON FOH SPIiINKLEHS — �— <br /> STAT[BUILDING SUfiCHARGE <br /> INt�KEDY PLANSAPPROVEDBY CITI OFEVERETT PU�LICWORKS <br /> LOCAL SALES -�— <br /> TAR CODE IS 3105 roTn� <br />