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� � <br /> f.�PLICATION FOR everetl <br /> :".E"'°`"" CONSTRUCTION e <br /> GTY OF <br /> everett PERMIT <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br /> 259•8810 <br /> ❑ DEMOLITION ❑ COMBINATION 19 BUILDING ❑ MECHANICAL 'E4PLUMBING ❑ SIGN <br /> p O�}�.`J �V. �L 0 RE55_ Cltt 21P PNOHF <br /> �",�s� - �--�C �sb, �,,n�oiu�7s ���ozu 77q-�7� z <br /> �171'T,U'/`Sl�n' PI�C Fovt�y d k�iv Hrh.nL- . <br /> nRLNIiECI UR OES�GNER � MnIL ADDRE55 C T ONC <br /> jt:,�Jc�l�;�/-1�ccNY7�t� l�/Z �=��7rA� ��<r_'� `i�zo1 Zsz -�d�� <br /> GEN[R�LCONtRAG10R M��LaODR[55 Cirv IiP n��pNE �J4�C�SE1� <br /> (r W <br /> �'u��- ul£Sj-C4lL/? InG c�.�ly7av C�7/i�J�u/Jj 9.��0 "77�- �7 �'L /a7Y-��- <br /> M51L R�OR 55 CIIY 21P PIIONE ��GShQ � <br /> MECM�NICALGONiHACTOfl �.� 7 7n �SJj.J C ! <br /> ���'�/f1 r �� ���C R���,��orva .✓.� <br /> � oo s z b e� - �ti;�v c z a�� t-N <br /> VWMBMOCONIR>C10R M41LAD�PESS Ct� ZP P ONE LiCENSE • <br /> CLA55OF WORN <br /> � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEA70LI710N ❑ WOODSTOVE/FRPL.INSERT ❑ BU�LDING RELOCATION <br /> V�LU/��� OiWOHniLO510�lAAiERIAl5PLU5L/BOAi <br /> /� (ila��c r��v �U ' w cvv� D'lJ�T�} �6L?C <br /> D[SGP18E WORK <br /> �J S ° � -UJ�- �L ftP7r <br /> US[OF BL'ROiNG I HEREBY CERTIFY THAT I HAVE READ AND EXAMWED THIS AP� <br /> Lt � �JJ� �I� P�ICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.4LL <br /> l WLOESCHIPiIONOFPFOPERiY15MOWNBELOWORN�TA����OU�COP�E$I PROVISIONSOFLAWSANDORD�NANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BECOMPLETED WITH WHETHER SPECIFIED HERE� <br /> �o�—a�ocn—or IN OR NOT.THE GRANTING OF A PERMITDOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOIA'.E OR CANCEL THE PROVISIONS bF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> 5�/� 5�� � SI�NATURE FCONiRACiOROPAUiHOFl2[DAGENT I14TE <br /> '/ X � � � 'Z 2- O� <br /> uc � — <br /> PROJECT�DORESS APPUG�NTSGTY9US�NESSLiCFN ENO <br /> b�"�� ' , . z s I i e P/ r- "�"IN�-� `� /�Iw��-� �. C°r� � <br /> PLUMBING MECHANICAL <br /> NO. T'PE GF FIXTUNE OR ITEM FEE NO. TYPE OF EQUIPMENT �E <br /> WATER CLOSET�TOILET) A/C—A/HNOLG UNITS—MP. <br /> FEFRIGERATION UN�TS—H P.EA. <br /> BATMTUB <br /> � UVATORVIWASMBIISIN� � BOILEPS—B.T.U./N.P. <br /> SHOWER /� GAS FIRED A.C.UNITS—B.T.U. <br /> KITCMEN SINK d DISP. fORCED A�A SYSTEMS—B T.U. M EA. <br /> OISHW�SNER WALLHEATERS—BT.U. M <br /> LAUNDRY TRAV UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOIERS <br /> CLOTHESORYERS <br /> URINAL <br /> ORINKING FOUNTAIN VENTILATION FAN <br /> RANGEHOOD <br /> FLOOR DRAIN <br /> BACKFLOW PREVENTERS WATER HEATER <br /> ROOF DRAINS—RA�NLEADERS WO00 STOVE <br /> SINK�SERVIGE—BAR.ETC 1 METAL FlHEPIACE 6 CNIMNEV <br /> FIREPLACE INSERT <br /> HEAT PUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br /> SUSTOT�L f SUBTOTAI <br /> PERMIT f PERMIT <br /> TOTALfEE S TOTALfEE <br /> �t�ONT SEiBACh AE>'�SETBACM SIDE$ETBACn / <br /> ;�AN CM CK NUMBER FEE RECEIPT NO. <br /> Zn� �n� � �O � `�� ��2L1 � �` <br /> us�zuHe �or naen vncnr�i siTc FEES YALUATION FEE <br /> � 2 NJ��.� �YES �]NO g I _ _ " � <br /> J BU�LOING <br /> r��'�g pF CONS* � OCCUPGNCY GBOUP NO OF�W� ING UHIiS <br /> Z'_ l J,r� � � /,� PLUMBING J I I �0• �1'�� _ <br /> l <br /> s¢E Or o�nc No Of STOeiES M<. o G loaD MECHANICAL <br /> (' > <br /> �', � � <br /> , OTHER /� <br /> FIPE SPRINKLERS REQUIRED ❑ YES ❑ NO $TATE BUIIDING SURCHAFGE � �v <br /> $7AT@ENEPGVSURCHARGE � . <br /> 4Pi'1 rt:4110N PGC I3• 1�LAVSI;MECMED BY AVpP !'�P ISSUANGE BV pUBUC WORKS �'� - , � <br /> � . 1- _ 1 <br /> � rern� <br /> � - � PROPERTY OWNERS ARE RESPONSIOLE P0�7 DETERMINING ALL <br /> PROPERTY LINE LOCATIONS AND REL�TED EASEMENTS. <br />