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; <br /> APPLI�ATI�N FOR CONSTRU�C . I,ON PERMIT <br /> m�r,�.o,P�� everetl <br /> ��T�oF e <br /> y� � everett <br /> � �j BUILDING DEPART>AF�NT <br /> p �x 259-8810 ,, 1 O BE COMPLETED IN INK—PLEA E PRINT <br /> 9 y � fl DEMOLITION f I COMBINATION � I BUILDING t�CHANICAL IJ PLUMBING L I SIGN <br /> t•� v�rrza uni^ooness �. . .� cnr zia �. _ vnor+c / <br /> y �� IC?:'�� ��Af�ll�l� r�'�,��� Aiv<<viC�,u ����r� . �,l;i��e�-I� � I�Y-_�G� �y7-I�2C� 17U3� S�'���� <br /> k.y� iEN�NT / MAILR�Of1ES5 —�— ZIP PHON� <br /> ,� N � �tl,l�l�'� <br /> �f1LNItEGTORDE5IGNER AIAILPDOBESS GITY 21P PMONE <br /> x <br /> H <br /> p GENEMLCONIRRCIOR RI�IL�OORESS CIIY ZIP pHONE lIC N$�( <br /> H C1 �U1VI.OI�lq7.1b <br /> O H �t�i:T.n1']O1JII <br /> H � C M[C�IM�iCRLCON1R4L10R I.IAiUDDRESS CITV ZIP PI�JHE LICENSE� <br /> �i7r Q �.. . �. � . ;. . `. . . .� . <br /> � y5 PlUA10iNGCONiR�CtOR I.IAiI��ORE55 dTV ZiP PHONE UCENSE� <br /> 7 <br /> H H cussorwonK . <br /> �1 V� M I 1 NEW I I ADDITION I J ALTERATION ' 1 REPAIF I I DEMOIITION ' I WpODSTOVE/FRPL INSERT l I BUILDING RELOCATION <br /> �..� <br /> (']Cr�J' (p TEN�NfiM�ROYEMENiORINiER�pf1EF10D[rLONLY CONIACiCERSONANpCHONENO <br /> � (Ji r COt1tR�CLP0ICEOFYIOtlN: �` �^),�r(�(;�- <br /> T DESCRiBGWOBNAND5W�f1EfOO1pCEINVO�VED <br /> zyin <br /> HOp� '�,�il ;. � . , � <br /> vnoroseouseorem�oiNe I HGREBY CER7IFY THAT I HAVE READ AND E%AMIKED THIS <br /> �. � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IF.OALOE5GNP110NOFPROP[RTV�9�OWNpEIOWOfiRti�CNFOURCOPiES� FFOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISNPEOF <br /> WOFiK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> iot eiocK or _ NOT. THE GRANTIIJG OF A P[PMR DOES NOT PRESUME TO GIVE � <br /> /� (�� n ^^D�n�' ^M� AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> __`"_i (� "�� J( 1 �J ( 1LU OTHEP STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEf1FORAI�NCE OF CONSTRUCTION.THAI"I AM AUTHORIZED BV THE <br /> OWNER OF TNIS PFOPERTV TO PERFORM THE WORK FOR WHICN <br /> APPLIC�TION IS MADE AND I COMPLY WITH THE STATE <br /> CONTfi�CTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGIUtUREOFCONit1�CiORORr1UP10RR[p�GENi DRLE <br /> X � <br /> vna�creoone;s n I � � ' � � � <br /> C;1 '11� � /� /` /i II�!{If � p��UUNt5Ci1vBUS�NESSUCENSENO.AN�0U5ME55N�ME � <br /> , l Il vw l�l.l b <br /> '�1 PLUIdBING MECHANICAL ��i <br /> ' ' NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE I <br /> � WATER CLOSET(TOILET) 0.-C—NHNDLG UNITS—H.P. ' I <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A, � � <br /> '�1 _ LAVAIORY(WASH BASIN) �—_ UIJIT HEATERS—B.T.U. M ; � <br /> SHOWER � CLOTHES DRYERS � <br /> '�I KITCHEN SINK 8 DISP i VENTILATION FAN � <br /> DISHWASHER �— RANGE HOOD —� � <br /> , _ LAUNDRY TRAV _�= WA7ER HEAiEh ; <br /> ' _ CLOTHES WASHER � _ WOOD STOVE � <br /> UHINAL ; METAL FIREPLACE 8 CHIMNEY —�-- <br /> DRINKING FOUNTAIN FIREPLACE INSLRT i <br /> '_' FLOOR ORAIN _ �— I1EAT PUMP i <br /> ' _ BACKFLOW PREVENTERS _�_L GAS PIPING �_ <br /> ROOF DRAINS—RAINLEADERS � ExHAUST FAN <br /> 'o SINK(SEFVICE—BAR,ETC.) ' I— <br /> T— <br /> i <br /> 4� � <br /> � <br /> s' � � <br /> � SUBTOTAL 3 ' SUBTOiAL 5 /-(: 'f-��� <br /> ' _ PERMI� S —i—_ PERh11T 5 <br /> � TOTALFEE $ TOTALfEE $ �J � j <br /> fOpNTSEqIp�K REAPSETOACH SIDESETBRCK PIGNCNECNNUAI�EO FEE RECEIPTNO. � <br /> �3 7i <br /> use ia+e LOi AREA vaeaNt ste FEES VALUATION FEE � <br /> I 1 VES I 1 NO OUILDINO i <br /> IYPEOf;ONSt.AIIOWABIE LYF[OiLON51.Af.IUAL �uvwcr xOIXew�wNcu�nS <br /> f.OWO <br /> ewrneiNc <br /> —�— <br /> 512EOfBLDG NOA�SfOBiES OAS(.M[Ni h1ECHANICAL � <br /> I I VES I I NO — <br /> a:cuvnNcrioao rmesrnNKiEnsneo�o Heicr�rutimanor� OTIILR ; <br /> f I YES � � NO _ STATE�UIl01NG SUIiCHMG[ � <br /> ne�sor+ronsrnn+rciens • —r—� <br /> STAIE ENERGV SURCI7ARGE i <br /> nrai�cnnoHncc.ev vuNsnrrnovtoor CITYOFEVERETT PUALIC\VORNS � <br /> LOCRLSAIES � <br /> TAX CODEIS 3705 TOTAL � <br />