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�� <br /> ,.,.....,m <br /> r � <br /> � � <br /> - • APPLICATION FOR CONSTR!l�T�ON PERMIT everett p <br /> IhnEcmgrnod TO BE COMF' tTED IN INK—PLEP.S[PRINT � <br /> GTY OF I <br /> . ��� everett HEATWG�SYSTEM: GAS ❑ELECTRIC 0 _ <br /> BUILDING DEPARTMENT <br /> p � 259-8810 <br /> C y �] DEMOLITION j� COMBINATION ' � BUILDING CI MECHANICAL ❑PLUMBlNG ❑ SIGN <br /> OY ! R <br /> �AnILA0DnE55 clrv Ir rNONE �� <br /> ���[[[�]] ° 'i b�'�kTi�. �2�Ln—f4+,t'—.���� `�'l� _ sd9 53 - ��L. <br /> ��� iEN�Ni MAM1��ORE55 QIY ZIP — PMONE — I <br /> � nnC��lIEC1011DE5iGNER ���1, D [SS CIIV 2iF PIIO4EC����� I <br /> �x� �I�1 Cl £ > n� �rf'�JD � <br /> G�UIDLWNil�CIO� MAR�DD�E�S CITY� ZIP f110�E LICENSE� ( <br /> o� � lnvrn�rK T,s2a'u�. (va�'�sa�x�c ��rm, ilo9%SJ�— i <br /> ,�,��g iAEC�UMPA�;GNiBAGt01i MAR4DORE55 GtY 21P PIIONE VGENSE� <br /> ��1r n — <br /> zy� � 1`lpMBMGCONiIUCLOR A1�I1�00RE5S GILY ZIP PIICN[ LILENSE� — <br /> � <br /> "� � $OF WORN <br /> Q�Hy i�NEW ❑ ADDITION ❑ ALTEf7ATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDIIJG RELOCATION <br /> cor+ucr rensor+mm r��a:F.r+o <br /> ►`yy� CON1IlACI PRIGE OF WOfiK � <br /> F]VJ � �[SLPiOE IINANDSOWNEFOOUG �NVOIVE� � �� ��� , //�,p. <br /> _ �� Cons�ece't l2 T ��Tcs%fn .tx7.��/7 �`no � <br /> rnoro5Eou5EOFel�a r+o • I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �� !� ��S/�/]C� APPLICATION AND KNOW THE b\ME TO BE TRUE AND CORRECL ALL <br /> . .. � �,�n��� <br /> ie .ioe NiF ONOF PROPERIY� awr+oc�owonppnnu�pppouncoricsl PROVISIONS OF LAWS AIJD OR�INANCES GOVERNING THIS TYPE OF <br /> �� ��„�y f�'y# I WORK WILI BE COMPLETED WITH WH:THER SPEC�FIED HEREIN OR <br /> i o�ocK or I L� �� NOT. THE GRANTWG OF A PERMIT DOFS N0T PRESUME TO GIVE <br /> AUTHORITY TO VIOL�TE OR CANCEL THE PROVISIONS OF ANY ; <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTf1UC:TION OR THE <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNOfiIZEO BY THE . <br /> �� � �9 C� OWNER OF TFIIS PROPERTY TO PERFORM THE W(7RK FOR WHICH <br /> J APPLICATION IS MADE AND I COMPLY \JITH THE STATE I <br /> CCNTRACTCRS LAW�827 RCW AND 296200 WAC. <br /> s�cr+etuneorcc�;ti�ncrononeunromzeonc[nt oer[ <br /> �6Gb l � Dr �� X ' <br /> PPOJECTAODRE55 <br /> %� \ ` APFLICANISCILYOUSINESSUC[HSENO.ANDOUSINE55lUME I <br /> I ��P , PLUMBIN6 MECHANICAL _ � <br /> ( I i NO. TYPE OF FIXTUflE OR ITEM FEE , — NO. TYPE OF EOUIPMENT FEE � <br /> WATER ClOSET(TOILET) A/CrNHNDLG UNITS—H.P. <br /> � �r BATHTUB FORCEDAIRSYSTEM1IS—B.T.U. M E.A. <br /> �I LqVATORY(WASH BASIN). UNIT HEATERS—B.T.U. M _� <br /> SHOWER '— CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP 'i— VENTIIATION FAN <br /> �� DISHWASHER �— RANGE HOOD � � <br /> � `�+ LAUNDRY TRAY ' WATER HEATER � ' <br /> CLOTHES WASHER �'" �— WOOD STOVF., � ., <br /> ', URINAL ' h1ETAL fIREPLACE 8 CHIMNEY �jD : — <br /> DRINKING FOUNTAIN i FIREPLACE INSERT __�_ <br /> i �� FLOOR DRAIN ' � H@AT PUMP � . <br /> l3ACKFLOW PREVENTERS � GAS PIPING <br /> � —i-- <br /> ROOF DRAINS—RAINLEADERS ! ExHAUST FAN ���� <br /> SINK(SERVICE—BAR,ETC.) � .1i�ISI�� U� ��2� G.::.� � <br /> � �I 1 — ' -— .J- � <br /> i � <br /> �— <br /> � � � <br /> ��'��� -- SUB TOTAL S ) i' — SUB TOTAL $ � �� <br /> PERIdIT 5 PEFlMIT 5 i <br /> - - TOTALFEE $ TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> f110�� 810�CN BGRSELOACN SIpESEIDnCN PLANGNECKNU�aC[n f[EJ �EC[iPR10. <br /> �Zo � zo' S' 35�. .� :3v (�3Uo3 <br /> �1 /I� <br /> ❑SE20NE �ornnen VACANTSIiI FEES VALUA�90N FEE <br /> ��Z � /8� y�s ouaoiNc ID7.P�� lLdi��l.�� <br /> IYfEOKONIS.�IIOWABIE lYPEOlLONSI.�LN0. aar�r¢r rmnttMW+auntt � <br /> cewr PLUMOING � i—" <br /> - SG-1J R.- � �! <br /> ;izeoFo�oc ea.orstomes onsna[�+r MECIInr�iCnL 9L" ' <br /> 2i9B 5�+ q _ <br /> 193 SL C ` u� — qD01TIONALPLANCHECK <br /> OCLU�ANCYLCRD FIPE SPRNHlEB511W 0 IICIGIIi Uhlll'IION � <br /> N` n�O _. OTHER <br /> � <br /> 11CASON FOq SPNNNI[f15 ' <br /> STATE DUILDING SURCHARGG i�) J <br /> �innkeor PUNSAI'PIIOVEOf1V CITYOFEVERETf puoucwonKs 2L� '— <br /> JH LOCALSALES �,yZ '� <br /> TAX COOE IS o105 TOTAL <br />