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APPLICATIo N FOR CONSTRUC'"""""'�ON PERMIT `'`�"`'" <br /> ,. _,, ,, TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cnv or <br /> everett HEATINGSYSTEM: ,�IG�S JELECTRIC U — - I <br /> BUILDING DEPARTMENT <br /> 259�6810 <br /> �t�+ �1 DEMOLITION COMBINATION_ BUILDING MECHANICAL PLUMBING SIGN i <br /> Cj7 cnv zi�� aHone <br /> y o�»+[n :. . nax ocsess � <br /> � <br /> G� H ���'�(`�T't'-E�JCIG`'iLIE("I�i!�.)! - ) C�)17- , /t,� �r"Yl.r �l'LCIAV <br /> y �tn �cNnnr ra nooncss cm zia rror�e <br /> � <br /> � � ARCHII(GTORDESIGNER MAllA0DPE55 GITV IIP PMONC <br /> o x o _ eS<< n Cpnswl�Ian� 731.Z"`�51. P��'� 1���13� M�Iki I Ic��t '��S "7`� S �SG��R <br /> 1� H � GENEf1AL ' TPACiOR INLADORl55 CItY SiP Pr10NE LICENSE� <br /> y`�'-' JH���SL=..IJG�(YTU�o�,U ��8�ns�fi/��e �drwnls q&�o 33Y-�53s �'/�Co�c lla�{�t< <br /> Z � ir.imuivacoHi cior� unannoa[ss arv ziP m�a�[ uce�+se� <br /> `�' yo �oriZeh ����„g 3601 1�2�w5.w, l-��nn� 980.57 ��•7%L(53�t3o <br /> nlUMu�N�corvtHnf.lon F�nilaonR 55 cliv ZiP rNONE IICENSE• <br /> �� g Pe<k;�is�F'S>n ���,,��u S�-,iiNNt. 14�p�, _(�}1�i1 `t8oll `188-s_'_� PFKK �� �o� 1 <br /> � LL4550FYIORK <br /> H <br /> x NEW � ADDITION ALTERATION REPAIR � DEMOLITION WOODSTOVEiPRPL INSERT � BUILDING RELOCATION <br /> CONiAGi PLRSON AND PMON[NO <br /> r ~y l'1 �I�� � I--��G �Sf�IlSSi.v 3��- IS� <br /> G V1 C04IIIACi PRIC[OF WONK <br /> ��� �ESCRIOE WO{iN AND SOOARE FOOTAGL INVOLVEO <br /> �� � 170o t�i le�el l��m� _ <br /> rnoroseouSEOFomioirvc (�� I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> y C N Re s;�encP �C�I S��e �1 Yhi�� APPUCATION ANO RNOW THE SAME TO BE TFUE AND CORRECT.ALL <br /> Lfi�Al�ESCRIP110NOrPROF[RIVISHO\VNBELO}yORAma�vouAcoa�[s PROVISIONSOFLAWSANDORDINANCESGOVERNWGIHISTYPEOF <br /> lA�e° Te G� ���RK WIIL BE CCMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> io� � 2 BLOCN or �� �_�[�_ � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUIHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LP.W REGULATING CONSTRUCTION OR T4iE <br /> — PERFORh1A�::E Of CONSTRUCTION.THAT I AM AUTHORIZED BY TfiE <br /> OWNER OF� THIS PROPEFiTV TO PERFORM THE WORK FOR WHICH <br /> APPLICNION IS MADE AND I COh1PLY WITH THE STATE <br /> CONTRACT�RS LAW 18.27 RC\N AND 296200 W�C. <br /> ;�cnnrur+[oFc�r+*enc*ononauiNon¢[oacerv* onrc <br /> X �ZrJ�.f — <br /> � q���/n���{. <br /> 'nO�ECL��DRE55 tLM/ V-�^' �\_ <br /> nPPli;,�lNiyr'I;Y61151NG>` V� �NSENO AN�BUS�Ntb�N�l._ <br /> F�231 ?nd Q S. - <br /> PLUMBING MECHANICAL <br /> � r�� FEE NO. TYPEOFEOU.PMENT FEE <br /> � t N0. TYPE OF FIXTURE OR ITEM <br /> a�� WATERCLOSET�iOILET) S� AC-NNNULGUNITS-H.P. <br /> 1 BATHTUB /O ; ( FORCED AIR SYSTE1.15-8 TU M E A. <br /> � UNIT HEATERS--B.T.U. M � <br /> LAVATORVIWASH BASIN) ,�D � <br /> �� � � SHOWER (�' I CLOTHESDRYERS ' <br /> I � VENTILATION FAN <br /> �� � KITCHEN SINK 8 DISP S �� --�-- <br /> � DISHWASHER RANGE HOOD <br /> LAUNDRVTRAY + WATERHEATER <br /> CLOTHES WASHEF WOOD STOVE ,; / <br /> I �� URINAL _ ME7AL FIPEPLACE 8 CHIMNEV <br /> � DRINKING FOUN7AM FIREPLACE INSERT _� <br /> FLOOR DRAIN HEAT PUMP <br /> ' BACKFLOW PREVENTERS GAS PIPING — <br /> �I�I �OOF DRAINS-RAWLEADERS 'i E%HAUST FAN <br /> SINK�SERVICE-BAR,ETCJ _ �, — <br /> ZLl�� �, �1 r! /.S�F •'� ,I( ' <br /> i� � <br /> .��` ---�-- <br /> SUB TOTAL S ..�; SUB TOTAL 5 9��' - <br /> PERh11T S PERMIT 5 <br /> I �_t i TOTAL FEE S .{ ' TOTAL FEE S �-' ' � <br /> � <br /> \ FOR OFFICE USE ONLY: �43 s z+ <br /> FRONTSETOPCN FURSqEtOACK Si0[$FiBAGN PtANO�Uk1ll1A1P11 _ FEE 7 �-� RECLPLNO) <br /> Z� � '!��� � � ���� � l •'l�/ (�� � ! �(/ <br /> usezor�E ^7 �ornqncA �J vncnN�r/s*E FEES VALUATION FEE �. <br /> 'C� J83 / (�S �UILDING '�'�C (U� �"%p' a�> <br /> �iw[orcaxtsuwwame tvriorcnr�stncrun� �... r+.����.s.�•.�s - —r--- <br /> - "'"`':1 �� � PLUMBING i �>c: <br /> ��1 —J _ <br /> 5¢EOFOIOG NDOFSiORiES [fRSEMLNi MECMANICAL %D '���'' <br /> (��6 Sf t a — - � <br /> 'f{�L Si GM1Q ADDITION�LPLANCHHGK '�(n �C� � <br /> OCCIIPANLYLOAD IIR[SPNNNLEPSREO� ��EIGMtL0�llAtiON <br /> N/A uO '__ o,�EA <br /> n[nSON FOR srn:NVL[�s <br /> STATE DUILDING SURCHARGE ��L� <br /> mo�ncnr riar�snrrrrveruY CITYOFEVEflETT PUBUCvroaKs _7�� Irn <br /> �i�a LOCAL SALES <br /> � �)/L TAX CO�E IS 3105 TOTAL ,y y�' �, i � <br />