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.. t <br /> ; <br /> AF`PLICATIOt��e FOR CONSTRUCTC�N PERMIT QVe`e" 4' <br /> ' TO BE COMPLETED IN INK—PLEASE PR�NT � <br /> me E�eryroan <br /> ��� everett � :,, ' <br /> HEATWG'SYSTEM• GAS ❑ELECTFIC O <br /> BUILDING DEPARTMENT I <br /> � � 259•8810 <br /> y�� U DEMOLITION f � COMBINATION � BUILDING ❑MECHANICA�o�� _�PLUMBING ❑ SIGN <br /> �yq- MAIL�UORE55 �'l�ll // UI�TM�• �YV/N�/� //lA //J(U� ��� �� —� I <br /> 14 tC[YY'��IJOk�/7� �_. ci �--�—"l I�� PNONE <br /> '+tl�� �.ua�ooness cin <br /> TElJ,VlT <br /> y M PMONE <br /> /�,��r�. j Z�P ��-J7a y <br /> �_� �RCHITtE�GTOR�ESIGNEN 14AIL D,�ESyS�y� /�/� `rYW7/L! /�✓/ ' <br /> Otl �1 `) �pC� E �/"1/NII/M � PHUNE LCENSE <br /> �.��- C iV 21P <br /> n ii GE CONiRALTOH MAIL�OORE55����� � ��U�//��� � <br /> � L7g /n,,��r�' .��'uc• — ZIP PNONE UGENSE� <br /> p� n cm <br /> MECH/J11LAL ONTAACTOR MAR��DFE55 <br /> I <br /> yy an, 2iP PHONE 4CENSE� � <br /> PLUMBW9GONTMCTOR M��LADDR[SS Ii <br /> 5~L H <br /> rh� H <br /> ��N ocwwH <br /> �� �EW ❑ ADDITION ❑ ALTER4TION ❑ REPAIR ❑ DEMOLITION LI WOODSTOVFJFRPL INSEHT ❑ BUIL�ING RELOCATION <br /> � LONiRCT FEPSON�WO PHO��E N0. <br /> ��� CONTRAGTPRICEOFWORK ' ` ` <br /> pESCNiBE�v}ppN�N�AN,DLSOUAREFOOTAGEINVOLVEO � • —7 �' y3 (J7 <br /> COnS�'�"�-( I HEREBY CERTI�Y THAT I HAVE FEAD AND EX�MI�ED THIS <br /> vnoao5E0 USEI or Bu�i n/G1n qppLICATION AND KNOW THE SAME TO BE TRUE AN7 COFRECT.ALL <br /> �SI CCr /'n'�� �E`�,�x� PROVISIONS OF LAWS AND ORDINANCES COVEFNIkG THIS TYPE OF <br /> ��es nivn� ioFPAo�EAttl ��BEIOWOR rrecN ouncOviE5l,iy�. WORK WILL BE COMPLETED WITH H'HETHfR SPEGFIED HEREIN OR <br /> BLOCH � a NOT.THE GRANTING UF A PERMIT D'J�S .VOT PRESUME TO GIVE <br /> � — AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF C01�STFUCTION.THAT I AM AUTHORI2ED BY THE �, <br /> ��, � t/�� OWNER OF THIS PROPEFiTY TO PERFORId THE WORK FOR WHICH <br /> � pPPLICATION IS NADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 78.27 RGW AND 296200 WAC. <br /> $IGNANNEOFGONIRACTORORAUiNOflREDAGENT OALE <br /> rI/ 1 PPQIEGTMDRE55 /ST / �� �PLIGANTSpTYUU51NE5S4CEN5ENOAN00U5ME55NAME <br /> f ��'� MECHANICAL <br /> � � � PLUMBING 7YpEOFE�UIPMENT FEE <br /> NO. T!'PE OF FIXTURE OR ITEM FEE NO. <br /> ,-WATEH CLOSET(TOILEn A/C—A/HNDLG UNITS—H.P. <br /> 1 ��' FORCED AIR SYSTEMS—B T U M E A � <br /> �I ��� �BATHTUB h �_ <br /> -LAVATORY(WASH BASIN). U�IT HEATERS—B.T.U. M �;_— <br /> SHOWER O '� CLOTIIES D�YERS <br /> � I �KITCHEN SINK 8 OISP __ ��- VENTILATION FAN — <br /> ._� :� i— RANGEHOOD <br /> t_� �DISHWASHER WpTERHEATER <br /> LAUNDfiY 1'RAY ,i r WOOD STOVE <br /> -CLOTHES WASHER i META:FIREPLACE 8 CHIMNEY �- <br /> �_ URINAL --� FIREPLAGEINSERT <br /> I == DRINKINGFOUNTAIN �� HEATPUMP <br /> FLOOR DRAIN � GAS PIPING <br /> BACKFLOW PREVENTERS ' <br /> EXH,:USi FAN ' <br /> ROOFDRAINS—RAINLEADERS J ` �j�� / � i <br /> � �_,=1 SINK(SERVICE—BAR,ETC.) � <br /> ----r— <br /> i . i <br /> I 1' <br /> � SUBTOTAL 5 � � � <br /> ��1�1 = '� SUBTOTAL S " � pERMIT 5 � <br /> _ PERMIT S TOTAL FEE 5 —T— <br /> — TOTALFEE S . <br /> FOROFFICEUSEONLY: cuHa�eckr+uuaen FFE/ RECEIPTNO. <br /> FPONTSETBrGN RE�RSEIDACN SiDE5ET0ACN > `3L� /.3�7�J3 <br /> � F,qn 'ITf'cF i �-7 i�� <br /> � � � 's VALUATION FEE <br /> � VACANTSITL FEES <br /> USEZONE LOtAREA ��J — �/9, �, <br /> 2'Z g SU s [5 BUILOWG � � )_� <br /> IYPEOFCONIS.ALIOWABLF T1'FEOfCONSTAGiWI O[cu��xa ^oi P^�«�°�urn5 � �— <br /> 1 acar- PLUMOING <br /> � <br /> 512E OF BLOG. PlSEMENT <br /> � No.OF StOniEs 1 h1ECHTNICAL <br /> � �� ` A�DITIONAL FLAN GHECK <br /> IOLCUPANCYLDAD FiqhSPPNNLER5RE0'D NEiGHTLIA11tATION i <br /> �uG 1 OTHER ���— <br /> PEA50 FORSPRINKLEPF $TATEBUILDINGSURCMARGE �I ���� <br /> IHiArcE9Y PUNSAPPROVEDOY CITYOFEVERETT P��UCWORK$ --�I �'�� <br /> LOCAL SALES -r� ;,;� <br /> TAX COOE IS 3105 TOTAL i � � <br /> - � <br />