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r;`�: � , ;�. <br /> APPLICATION'�FOR CONSTRUCTI h`�i�l PERMIT everett <br /> ����� <br /> �-�,�.Q��o� TO BE COMPLETED IN INK—PLEASE PRINT � K; , <br /> r; <br /> or ;;'i <br /> verett ;f,: <br /> �ILDING DEPARTMENT HEA7ING SYS7EM: U GAS ECTRIC U �;, ' <br /> �-8810 �'� <br /> �•� <br /> DEMOUTION I_I COMBINATION IG BUILDING I I MECHANICAL ❑ PLUMBING ❑ SIGN r%•:: <br /> Rfi • M�IL�DDPESS G7Y 21P PNONE ,�� ' <br /> ������ o �iaa- l2vc%.cFri/..� 6r��'�rl �b'zo , aJ�j- � S�zT �<:;: <br /> �ur Mn�nooness cirr zm r�ior+e f;' <br /> �/��..� '�. <br /> �IIIECTORDESIGNER MRILAOORESS C11Y ZIP pNONE <br /> I:�' <br /> %1' <br /> �If1�l'C,ONiRAC70R M�ILAODRE55 CtlY ZIP PIIONE IILEN5E1 I'�, <br /> i�� j 1�� <br /> n�NICALCON7R�ClOfi MRILADDFE55 QIV ZIP PHONE LICENSE� <br /> I. �. <br /> \ <br /> t1 <br /> '.'111NGCONIR�ClOf1 MAILAOORESS CI7V ZIP PHONE UCENSE� <br /> :SOfWOfiK �'�� � <br /> NEW I � ADDITION I1 ALTERATION ' � REPA�R I .I DEMOLITION LI WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION �i.,; <br /> �n CONTRCT PERSON AND PHONE NO. ��1• <br /> �i�(JQ ' <br /> IIOACT PRICE OF WOIiN ' �� <br /> �qfi18E�'�OFK AND SOUARE FOOTAGE I:lVOlVEO ���•� <br /> �'�]fSC �' v � ,�!<-o�v"e� c''. <br /> ���oseo EOFOU�LDING I HEREBY CERTIFY THAT • HAVE READ AND EXAMINED THIS �l.� <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL ij,��.. <br /> ��L U SCRIPTIONOF PROPERTY(SMOWNBELOW OR ATT4CHFOUR COPIES) PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THIS TYPE OF ��'�. <br /> WORK WILL BE COMPLETED WITH WHETHEF SPECIFIED HEREIN OR �' . <br /> l EA( 2��ocK ��oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE r'° <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ;��' <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE E�1,; <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE ��:( <br /> OWNER OF THIS PROPERTY TO FERFORM THE WORK FOR WHICH �,�. <br /> APPUCATtON IS MADE AND I COMPLY WITH THE STATE :'��� <br /> CONTRACTORS LA1V 18.27 RCW AND 296200 WAC. �•,' <br /> SIGNAiUREOFCONTRAf.TORONPUTHONIZE0A0ENT O�TE . <br /> X ,O �� <br /> / r' <br /> VECT�ODRE55 ( I �';.,� <br /> ���� �PYLICFNTSCITVBUSiNG55UGENSENO.ANOBUSIN NAME �I�� <br /> PLUMBING MECHANICAL ��� <br /> � 10. TVPE OF FIXTUflE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE �' <br /> WATER CLOSET(TOILET) � A/�AIHNDLG UNITS—H.P. � �'�� <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> f i�, <br /> LAVATORY(WASH BASIN) i UNIT HEA7ER5—B.T.U. M ' <br /> � � <br /> SHOWER � CLOTHES DRYERS � �'�;' <br /> KITCHEN SINK 8 DISP ; VENTIlATION FAN ; k� <br /> DISHWASHER � RANGE HOOD i ;�a, <br /> LAUNDRY TRAY ; WATER HEATER � I�; <br /> CLOTHES WASHER i WpOD STOVE � ;•! <br /> URINAL � METAL FIREPLACFB CHIMNEY � ���� <br /> DRINKING FOUNTAIN i FIREPLACE INSEflT ; i � <br /> FLOOR DPAIN �— HEAT PUMP � �� <br /> BACKFLOW PREVENTERS ; GAS PIPING ' �i�� <br /> ROOF DRNNS—RAINLEADERS � EXHAUST FAN � $ <br /> SINK(SERVICE—BAR,ETC.) ' � <br /> � <br /> , � �f <br /> i' <br /> � , . <br /> � , <br /> � �' <br /> — 1 <br /> SUB TOTAL $ ; SUB TOTAL $ ' ` <br /> PERMIT $ � PERMIT $ i ��� <br /> TOTAL FEE $ � TOTAL FEE $ � `��� <br /> )R OFFICE USE ONLY: , <br /> �NTSElOACK REARSEiO�CN SIDESEIDACN PIANCHEGKNUMOEP FEE REGEIPTNO. �� <br /> ��'zoNe ior nRen VqCANT SIiE FEES VALUATION FEE `��� <br /> BUILDING /�� <br /> ��y i�— <br /> �OfCONIS.RIIOWAPIE lYPFOlLON51.ALIU�L nccur�Nc+ nomrnvnunr,uVns �-'--l—� ',+ <br /> ����� PLUMUING � � <br /> � <br /> °Of OLDG. NO.OF STONIES pASEM[N� MECHANICAL �— � <br /> CUP�NCYLOr1D FIRESPRNNLERSREO'0 IIEIGNTlIMI7ATIDN ADDITIONALPLANCH[CK i <br /> O7HEti � �, <br /> �sor+wn srninKiens – <br /> i <br /> SiAiE�UILDING SURCHARGE ; <br /> i I� <br /> +nenr rinNsnrrnoveoer CITYOFEVERETT PUBUCWORNS � ' <br /> LOCALSALES ' <br /> TAX COOE IS 3105 TOTAL 3 � `�O i <br />