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APPLICATIO`. FOR CONSTRUCTI,,N PERMIT eV1f1'" <br /> mee�r�nreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> GTV OF <br /> everett HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION �BUILDING MECHANICAL PLUMBING SIGN <br /> ON'NE(i MAILADDf1E55 LIiV ZIP PHONE <br /> Do �T�t-Y � MA�Ks •zw3 tic=�KE.Fc.��Erz E-vER�� �)&zo� as9-,��:�f <br /> TENRNT MAIL ApORE55 CITY 21P PHONE <br /> 1C Jk-ct-tY CLA2K s�� <br /> •RLMITEGTORDESIGNER MPILF�DRES$ CITY ZIP FuONE <br /> GENER�LCONTRACtOR MAILAODRE55 CIIY ZIP PNONE c��t03 LICENSE� GB°S'OC�3 <br /> S1LVA{',j� 0lcSlCaN � CcNSTRULT�o� INC 4026� 6U�2Kfc A-VE. N SEl+1TLE SAvAC�oc.o98JE <br /> MECIIRNICRL GONiRACTOR MAIL ADDRE55 piV 21P PHO UCENSE t <br /> N /A <br /> � (']� FLUM��NGCONiRALTOR M�ILRpDRE55 CITY 21P PNONE LiCENSE� <br /> r" N /A <br /> e� <br /> Q � � CLASSOF WORK . <br /> C, H . � NEW � ADDITION � ALTERATION x REPAIR � DEMOLITION . WOODSTOVE/FRPL INSERT �, BUILDING RELOCATION <br /> �y N CONtAGT PEPSON RND PNONE NO. <br /> � � � �' �� Goo.no u{ucu- rErz�ar,��� �33-c��� <br /> y H LONTRAGT PAICE OF WOPN <br /> /! C'l OESCRIBCWORNANDSOUAREFOOiRGEINVOLVEO ` <br /> oxo B��I�o (-ouN4ATiou �NokR ExST-G Fb�sE <br /> "'tlH '-0 aaoroseousEovemioi�+c S� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> H y~[+ I�10 GI�I'1�N E�E " RE51 DE N C.� APPUCATION AND KNOV!THE SAME TO BE TRUE AND CORRECT.ALL <br /> x SY,3 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �O � � LEGALOESGRIPt10NOfPROPERTYIS��OWNpEIOWOF4RACHFOUOGOPiES� y,IORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OF <br /> ior Z— oiceK -�� oF ���TT NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> N � Cy AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> N� n PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> � H� NOA� CCFdFGRMIAIC� L.OT H�S SC�N OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � y �, 1 CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> � �vtE�v�O BY �L���1�v� SiGNAI R OFCONTRACtORqRA ORREDRGENi �`[ <br /> C]l❑7(n � X ��i„Q��V ���(iVIE'LL81,�CC <br /> t�f � /�i � ..�? if-9� �,Avhf,E OFiS�Uf.1 ANDCcNSTRU��o/.I ,IN.C, <br /> cAaecr nooness p� � � [.n <br /> �-]Q [A 2 w 3 �`-��G�E��wi-}� A�P���ANTSCITYBUSiNE55LICENSE NO ANDBUSMESSNAME ����y/ <br /> � PLUMBING MECHANICAL <br /> NO. TYPE OF F17(TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A�HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR S`!STEIAS—B.T.U. M E.A. <br /> � LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> I �� SHOWER CLUTHESDRI'ERS <br /> '��I KITCHEN SINK 8 DISP � VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> ' ._� CLOTHES WASHER WOOD STOVE i <br /> i L�I URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> --� <br /> BACHFLOW PREVENTERS GAS PIPING � <br /> , '1� ROOF DRAINS-RAINLEADERS E%HAUST FAN --� <br /> SINK(SERVICE—BAR,ETC.) — <br /> / <br /> / <br /> � _ <br /> ��1 <br /> / SUB TOTAL 5 SUB TOTAL S _ <br /> PERMIT $ PERMIT 5 <br /> �_1_1 TOTAL FEE S TOTAL FEE 5 —^— <br /> � <br /> FOR OFFICE USE ONLY: U e � � <br /> IRCNiS[iBACF R[R95EIBACN SIDESETBACN PLANCHECHNWAOER �EE AECEIPTNO. <br /> Zf>' Zv' S' v/ /���ia i, ii7v � s"aGv< <br /> us�zoN� �ornRen vncnNrsire FEES ' VALUATION FEE <br /> �Z �i�O n OUILDING'� !7��JL'1-z� d� YG� i�f <br /> �i r 7 6 <br /> lYC[0{LONiSAIIOWhBIF �VP[O�CONSiPL7lIRL KLUPAN[r NOO��efuisLUNnS <br /> �P"P / PLUMBING <br /> I •� <br /> SIZE Jf BLOG. NO OF STORiES BRSEMENT MECHANICAL <br /> 6YC S� fxarti [u <br /> OCCUPpNCV l0�i FlRE SPRNKlERS RLOD MEiGHt LIMITATIOY ADDITIONAL PLAN CHECK <br /> p/ � <br /> �fL1 /��/' 2 o OTHEfl <br /> R[A WN FON SPflINKlERS � <br /> SiATE BUILOING SURCHARGE r� � �y� <br /> INiPKEBY PUNSAPPPOVEDOv CITYOFEVERE7T PUBLICWORNS <br /> LOCAL SALES <br /> 9'U ,,,y;� 7AX CODE IS 3105 rorn� ,�p ,y� I <br /> J <br />