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,_ �. <br /> . ..,. .� i <br /> �j � APPLICATIOr�i FOR CONSTRUCTI�N PERMIT everett ' <br /> �E a p� TO BE COMPLETED IN INK—PLEASE PRINT ! <br /> e <br /> ciTv or I <br /> t��� everett HEATING�SYSTEM: GAS O ELECTRIC ❑ <br /> �ij BUILDING DEPARTMENT � <br /> �p 259-8810 �L� ' <br /> � y� ❑ DEMOLITION j�' COMBINATION j� fiUILDING �MECHANICAL ❑PLUMBING ❑ SIGN � <br /> t� 0 q q WILADOPE55 Cltt IP PNONE <br /> ��� �br���'n� �'. �v�rrn�,��r� /+J���—�s���s3�/o�i�y ; <br /> � TENiWT MAIL�DOPE55 ��TM ziP <br /> ��� _ <br /> � �A H RRTCHITELTOROESIG/N�ET/N { AIL D ESSy � y1l/Q,�TNV ]� 2iP PI�ONE �I// <br /> ��i� �J� U�C� 1 � ���1I�iF�I il'rll�/'U lA.���T��— /��E'SE� — <br /> OQ� GiNFAN,CONTMCTOR MAIL�DDR[55 <br /> ��g l�rK �2a'us ��r,��s�x,c�---- 7"�'��ilGi'i SA <br /> MECHNIiCAL�ONTMGTOR MAIt�pDRE55 CItY 21P 1'NONB I.ICEHSE• � <br /> p���111• O <br /> �y� PLUMOINOCCNTP�GTOR M�I��DOflESS GI7Y 21P PHONE — ��CENSE• <br /> �y F"� oFwonK <br /> O�Hy �NEW C ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION L7 WOODSTOVFJFRPL IN3ERT ❑ BUILOING RELOCATION <br /> O CONTRCT PEFSON�ND PNONE NO, <br /> � ,� J <br /> � CONTRACTiRICEOFWWU( I <br /> - �]� ���y/p �,4W�RE Ff%1T�G INVOL�ED � � � —� � ���^ d/-� � <br /> � �^ . . � � <br /> 7�� <br /> PROPoSE�USEOiBII nc ' I HEREBY CERTIFY TNAT I HAVE READ AND EXAMINED 7HIS <br /> S�/'�/l� �AJI�/(�J �ES«�� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> l�uoe qip?�pFPFOVEPTY� ON?1BElOWOR iTAGH WRCOPiES) PROVISIONSOFLAWSANDORDINANCESGOVEFNINGTHISTYPEOF <br /> � �'� - e�oc�t oF ��y#/ NOT THELGRAN NG OF A ERMITJOOES NOT PRIESU EETO GNE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW NEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE � <br /> �y � 5 •�_{.- OWNER OF TIiIS PROPERTY TO PERFORM THE WORK FOR WHICH I <br /> �f� f APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOFiS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNATU(iEOFCQYTNA�jORG JYNORRE0�IGENT OAfE <br /> ��� ; <br /> -D� ls� ��r ��� X � l % �� <br /> , . , _ �� <br /> Pli0.1EGT AOORE55 � <br /> ���� APPIIC�NT9 ITYOUSIM1 SSUC �SENO.ANOBUStN 1AME <br /> � . PLUMBING MECHANICAL <br /> � i � NO. TYPE OF FIXTUHE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> 1 ' WATER CLOSET(TOILEn _ A/CrA/HNDLG UNITS—H P ' . I <br /> � � BATHTUB (.� ;- FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> I ��I _ LAVATORY(WASH BASIN�. �' UNIT HEATERS—B.T.U. M <br /> � SHOWER �j '' / CLOTHESDRVERS —T— <br /> KITCHEN SINK d DISP VENTILATION FAN <br /> DISHWASHER / �� / RANGEHOOD <br /> � ) `_� LAUNDRYTRAY WATER HEATER — ' <br /> CLOTHES WASHER Fj �- VdOOD STOVE <br /> 'i URINAL METAL FIREPLACE 8 CHIMNEY — <br /> � DRINKING FOUNTAIN FIREPLACE INSERT _�_ <br /> � �_ PLOORDRAIN �j '� HEATPUMP <br /> I �� <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—FAINLEADERS E%HAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) �'��' � � � I <br /> � ' 1�� <br /> � <br /> i <br /> ��� SUBTOTAL S L n � <br /> 1 l SUB TOTAL 5 ' � �� pERA11T 5 �14,i ', <br /> PEHMIT 5 — <br /> . TOTALFEE 5 TOTALFEE 5 —� <br /> FOR OFFICE USE ONLY: <br /> FRONTSETORCK REPRSETOACK Si0E5ET9PGK �L�ICNEGR t1M�EP FEE U RECFiPLNO. <br /> ;��; �, , - � rZ�n �— 5 �9�� <br /> usE zone LOTAREA vncnNi srt[ FEES VALUATION FEE <br /> ,�`L GUILDING ��U�,073 '7C� <br /> iVPEOfCONIS.AIIOWABIE TYPEOiCONSi,AGNAI Occu�v x00�P�Ruutu�rt5 ,/� <br /> '/ _3 P�UtdBING (Ji_ , <br /> SREOFBLW. NO.OFSTORiES BASEMENT �,�ECHANIChL �� � <br /> z,�e sF * , <br /> 3,7. s< c a Z lo .--1- , <br /> OCGUPeNGYLOAO iiqESPRNKlEP5RE0� NE�GNTLiAIITAiION AD�ITIONALPLANCHECH <br /> J 4 M� Z4J I ` O7HER � <br /> REA;ANF RSPflINNLEPS U <br /> STATE BUILDWG Sl1RCHARGE <br /> INTANEOY PUNSAPPHOVEDOV CITY OF EVERETT PI1pLIC WORK$ "./�I iG�� � <br /> LOCRLSALES � <br /> J�� z/s/SZ TAX COOE IS 3105 rorn� � <br />