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APPLICATI4.J FOR CONSTRUCT�JN PERMIY °`'�'"'" <br /> , ::����, ,����, <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CIlY OFI <br /> everett HEATING SYSTEM: J�AS J ELECTRIC J _ -- � <br /> BUILDING DEPARTMENT � — <br /> 259-8870 <br /> DEMOLITION COM8INATION BUILDING MECHANICAL PLUMBING SIGN <br /> O�YNER 1141LADDR65 GtV ZIP PHONE <br /> ��n0 � l��t�Z �ZUG,•- �c,&Lr e �-- � UT ZS9 ^ ��-`l � <br /> ;u+nur uni�noonEss crtr zir rnoN[ <br /> ARLNIiECTO�DESIGNER MAi�nD�PC55 GIiV IiP PHONE <br /> GENERALCONit1AGtOR IdAILA00FE55 Cliv ZiP PNON[ UCENSEi <br /> 'S' ��iI l.�ECNANICRLGONiRAQq fV MAILApDRE55 CIiV ZIP VI10NE LICENSE� <br /> t� � y N •�.J. yl�.�.�l.�.�-T-,.� 3110 - I-�-i� A��y fzuT tiYZo) 2S"5•S'3)I /V�->-�wl, /U3 R� <br /> PLUMB'NGLONiRALiOR MNL��ORES$ ❑LY 21P PHONE LICENSE� <br /> � H!}! fHi� <br /> � ��ASSOFWORN <br /> �NEW ADDITION ALTERATION FEPAIR DEMOLITIpN . WOO�STOVEFRPLINSERT BUILDINGRELOCATION <br /> � CONTALi P[FSON AND PNONE NO <br /> OpCO / OO d <br /> � F"1 �I CONiRACI PRiGE OF WORK <br /> y �"� OESCRiOE 1YO��K AND SOIIA�[FIX tAGE INVOWED <br /> �o� �s R7� �s u�n � �'i✓N -- <br /> riaa•oseousEOFom oi�+c I HEREBY CERTIfY THAT I HAVE READ AND EXAMINED THIS <br /> p� � d �` /- �� • APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �7 J"'1�'� PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS TVPE OF <br /> � C� � LEGALDL�SCRiPt10NOFPPOPEliI� ISHOWNBELO\YORATTAqIFOURCOPiESI yyORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> z H q 1O� o�ocrc oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ` y� AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> � z OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> H y PERFORMANCE OF CONSTRUCTION.THAT I AM11 AUTHORIZED BY THE <br /> �i y OWNER OF THIS PROPERTY TO PERFOFiM THE WORK FOR WHICH <br /> n d� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �5 CONTRACTORS LAW 1827 RCW AND 296200 WAC. � <br /> L�]� SiGNRLU4[OFGONiNACTOROt1AUtMO111ZEDAGENT DAtE r/�9��/ <br /> xyw <br /> yov, X /J <br /> raaecr nooacss <br /> . /GCv�.h � <br /> �� _ �`r �� RPPIICANiSCIiV�OStiCS£LIpENSE NO ANp BUSI4CSS N4A�6 <br /> �� <br /> PLUMBING MECHANICAL <br /> i NO. TV'�E OF FIxTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> I �_ WATER CLOSET(TOILET) —T' A/C—A�HNDLG UNITS—H.P. _ <br /> BATHTUB 1 FORCED AI SYSI�EMS—B.T.U. M E.A. <br /> ��1 LAVATORY�WASHBASIN� UNITHEATERS—B.TU. M _ <br /> SHOWER CLOTHES DRYEFS _ <br /> , _ KITCHEN SINK 8 DISP _ VENTILATION FAN <br /> 7 '_ 1 DISHWASHER RANGEHOOD <br /> � � LAUNDRV TRAV WATER HEATER <br /> � CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUN?AIN FIREPLACE INSERT <br /> i �� FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS Z GAS PIPING <br /> ROOF DRAINS—RAINLEADEFS EXHAUST FAN <br /> '�t- SINK(SERVICE—BAR,ETC.) <br /> —T <br /> �t� ' <br /> � SUBTOTAL 3 SUBTOTAL 5 5!� '— <br /> PERMIT 5 PERMIT 5 /��� <br /> TOTAL FEE S TOTAL FEE 5 — ,s�'�_ <br /> FOR OFFICE USE ONLY: <br /> FRONiS[lOACK REARSLipACK Si�ESEiB�CK PIANCH[LNN�MOFR �F:F REGUPINO <br /> �sezor+e �ornnEn vacnNrsirE FEES VALUATION FEE <br /> BLJILDING <br /> rvPEOiCONtSAIIOWABIE tYPEOiCONStAGNAI aCCMexcv xnamvNivsuvns '— — <br /> cqour PLUM�ING <br /> SRE OF 81DG NO.OF STOPoES BASEMENT MECHANICAL � <br /> ��__ <br /> OCCUPANGYLOr1D FlRESPRNNLERSREOD IIEIGHTLIMITATION AODITIONALPLANCHECK <br /> OTHEH <br /> Iil A�.O'i FOR SPRINKtEHS � <br /> srqre n�m n�rir.sua�Nn�cr <br /> icrn..car vinrvs,�rrr�ovt.00r CITYOFEVERETT aUouCwoHKs <br /> LOCAL SALES � <br /> TAX CODE IS 3105 TOTAL S��M' <br />