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�- <br /> ,.,,, ," , ,,,e,.:a I <br /> AF�PLICATION FOEi CONSTRUCTION PERMIT everett <br /> rnee�re.qr�o� TO BE COMPLETEU IN INK—PLEASE PRINT � <br /> c�n oF <br /> everett HEATING SYSTEM: GAS ❑ELECTRIC ❑ _ � � <br /> BUILDING DEPARTMENT � <br /> ��� ; <br /> zss-ea,o <br /> OEMOLITION J�COMBINATIOS� /�BUI_DING MECHANICAL _'PLUMBING l SIGN ` � <br /> O�Jf� ; --- - <br /> G i 01V MAIL�DDRE55 LILY I�P PHONE � <br /> y�� � ���''�� �uz, �ZG nn�-�� .l�z�u��e l� i9Z� �J-s��1-�d y�_ <br /> �"� TFNANf MML���OESS �� ��T� � Z�� ���ONF <br /> � � _ <br /> op NNLHITECTORpE51GNER IAMIRD7�DRE55 LITY ZIP p PHONE <br /> 'il 'il ��� �L'h E ✓'C-417n1hG Y/� n[1� �i� �OQ33 �22 - l72`f <br /> VJ N <br /> GENERMCOKiRALTOR tA�IlN00RE55 LIiY ZIP PHONE IILENSEI <br /> �'^s�� �-� ���a�� .�r�� �SN,�z� a��c ) -T�Um �I�`�'JA _ <br /> �]C MELHANiC�ICONTflACTOB MARADDRESS CRY iiP PHONE 4GEN5:/ <br /> OH <br /> � �� PWYflMGGON+NnCTOR M4RADDRESS CrtY Z�^ PHONE IICENSE• <br /> Q� O <br /> H] CUSSOFWOFN ( <br /> �M <br /> �Fy y �NEW !.� ADDITION ; ALTERATION . REPAIR � � DEMOLITION ._�. \VOODSTOVE/FRPLINSERT �] BUILDING RELOCATION <br /> �W H CONiACT_ERWNpNOPHONENO �,�y�� <br /> �W LONTR�LTPRICEOFWORN �L�£���(�f.wi7 I <br /> � DESLRIBEWORN�NDSWAR'cFOOiAGEINVOLVED <br /> �Yin�h'ucf- neu 7 /� , 3s3_ y p , <br /> p y PROPOSEOUSEOFBIIIL�ING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS I <br /> -� � APPLICATION AND KNOW THE SAME TO BE TRUE AND L'ORRECL ALL I <br /> LEWLDECRIPTIONOFPROPERiV�SHOWYBEIOWORAR�CHFOURCOPIES� PROVISIONSOFLAWSANDOR�INANCESGOVERNINGTHISTYPEOF i <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> wr o�ocK oF � f� G � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV j <br /> OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE � <br /> PERFORMANCE OF CONSTRUCTIOY.THAT I AM AUTHORIZED BY THE � <br /> OWNER OF THIS PROPERTV TO PERFOFiM THE WORK FOR WHICH <br /> APPUCATION IS lAADE AND I COMPLY WITH THE STATE �, <br /> CONTRACTORS LAW 1B.E7 RCW A1JD 296200 N'AC. <br /> SIGNATUREOFCONTRACTOROFAUi�.ORIZt'uAG[NT DRiE � <br /> rf3 /S l ST Dr .S� /Jy�/� l �, <br /> PqOJELT ADDR[55 ��'�-r l" �� � <br /> APPLP.qNTS CITY PUSM[55 LiLENSE NO.AND BUSi6F.55 NAME <br /> ��� PLUMBING MECHANICAL � <br /> (� NO. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE �. <br /> ��� WATER CLOSET(TOILET) A/C-NHNDLG UNITS-H B � <br /> � J BATHTUB FORCEDAIRSYSTEMS-B.LU. M E.A. _ � <br /> LAVATORY(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> �� SHOWER CLOTHES DFVERS <br /> i ���' KITCHEN SINK 8 DISP VFNTILATION FAN ' � <br /> OISHWASHER / H:�NGEHOOD - � <br /> �. ) LAUNDRYTRA� � / WATER HEATER <br /> � i ��"� CLGTHES WASHER WOOD STOVE <br /> I ��' URINAL METAL FIREPLACE 8 CHIMNEY . <br /> DRINI(ING FOUNTAIN FIREPLACE INSERT <br /> � FLOOR DRAIN HEAT PUMP <br /> �� �� BACKFLOW PFlEVENTERS GAS PIPING <br /> �, ���� ROOF DRA:NS-RAINLEADERS EXHAUST FAN , <br /> � SINK(SERVICE-BAR,ETC.) � � $ � <br /> �_� — <br /> i► <br /> SUB TOTAI $ SUB TOTAL S <br /> PEPMIT 5 PERMIT $ <br /> �,� TOTAL FEE 5 TOTAL FEE § <br /> FOR OFFICE USE ONLY: <br /> FROHTSETBRCK RE�RSETBACK SIOESETOACH PUNC EGNNUMBEN FEE RECEIPLNO. <br /> �� 3C�;c ,--, - <br /> , y— ��s <br /> usE�^r.t �ornqen vacnr�tsit[ FEES VHLUATION FEE <br /> BUILOING <br /> ttVEOiLONiSAIIOWRBL[ tYPEOiCON9ACNAt Ma�rur,v xopPniu�xcuvns — <br /> �"0�°° PLUM�ING <br /> 512EOFPLDG. NOAPSiORiES BRSEMENT MECHANICAL ' <br /> OCGUPANCYLORD FIPESPRNKLERSREOD NEIGMiLIM1i�T10N A�DITIONALPV.NCHECK <br /> O1HER <br /> PERSON FOP Sf 9mX�.�iPS -- --� <br /> STATE�UILDING SURCHARu'E <br /> INiRNE 0V PIANS APPROVEO BY CITY OF EVERETT PUBLIC WORK$ <br /> �t.�f LOCAL SALES <br /> 'T i�� TAX CODE�S 3105 I TOTAL <br />