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� ��I <br />APPLICATIO.. FAR CONSTRUCT��N PEFiMIT `�"`'" <br />TO BE COfdPLETED fN INK—PLEASE PRINT � <br />!hfl EvPrQfev+a <br />cirv or <br />everett HEATING SYSTEM: �J GAS U ELECTRIC ❑ —� <br />dUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING ��CHANICAL PLUMBING SIGN <br />OWN[R M4ILAODRE5/5 ,./ �.� / // CIl J/ 21P PHONE <br />1//OI(q '/ n9T'/ /'s�//'J �/ / /lY ��G�G� ��Jilli %�%� 3�h�J <br />IEA�NT MA�LA pRE55 GIiV _� 21P PHONE <br />� �..,_. ..>h/% C i � .,. <br />AiICHIIELTOPDE�a'IGNER MAILA��RE55 "^• — <br />G[NCR4lCONTRnGTOR MAhADDNES$ CIiY ZIP PHONE IICENS[� <br />CITY 2iP PNONE LiCE1.5E • <br />ME NICALGONTRAGTOR MAILADDPE55 <br />PwMO� GCOHiRA� MMLA�DRE55 CIiY ZIP PNONE LIC[NSE• <br />CLASS O� WORN � <br />NEW ' ADDITION �. ALTERATION REPAIR DEMOLITION j/CNOODSTOVE/FRPLINSERT BUILDINGFELOCATiON <br />CGNiPGT PEfI50N RJp PNONE NO <br />CONTRRCi PRICE OF WJRK — <br />DESCA�OE WORK ANO SWRRE FOOTAGE iNVOLVE� <br />' (( ! � �i1'� : � (fi � <br />caoPoseo scuFouaowc I HEREDY CERTIFV THAT I HAVE READ AND EXAMWED THIS <br />�Eant oixr+ir i i�n �r r��.� <br />l01 6LOCN <br />� . N.1 �7 / — .� <br />�SNOWN B[LOW OR ATT�CN FOIIP LOPIES� <br />on _ <br />PriDJEGT�DDRE55 <br />i <br />r1- �D��- Y'���� s6 ��t,-� <br />PL MBING <br />NO. TVPE OF FIXTURE OR ITEM FEE <br />6YATER CLOSET (TOILET) : <br />BATNTUB _—r. <br />LAVATORV(WASH BASW) <br />SFiOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRVTR�Y ._� <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />FOR OFFICE USE ONLY: <br />1iiONiSHBACN AFAR'. <br />U',! 1011[ �UT A� <br />iw[pfCONiSRIIOW�BI[ ivPEOi <br />s�z� � e�oc. r+o. a <br />OCCUPANCVLOA� FlREE <br />REPSON FOR SPRINKLEOv <br />INinnCAv PLntY. <br />SUB TnTAL 5 <br />PERNIT $ <br />TOTALFEE $ <br />—� S�uE <br />AC1UAl <br />REO'� <br />BY <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COFiRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TNIS TYPE OF <br />WORK N9LL BE COMPLETED WITH WHETHER SPECIFlE� HEREIN OR <br />40T. THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PHOVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PePFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED HV THE <br />OWNER OF THIS PROPERTV TO PERPORM THE WOP�' FOR WHICH <br />APPLICATION IS MADE AND I C('MPLY WITH THE STATE <br />CONTRACTOP.S LAW 1827 FiCW AND 29G200 WAC. <br />9GNATIIR[O�COHiRACiOROR�UTHO�i4[DpGENi OALE // �r � / <br />X �� /�� / /% . . _ .� � � <br />UCFNSE NO 0.ND OUSINf 55 NAME <br />FORCED AIR 5"STEM; <br />UNIT HEN ERS—B.T.U. <br />CLOTHESORVERS <br />VENTILATION FAN_ <br />RANGEHCOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIR[PLACE 8 C <br />FIREPLACE INSERT <br />HEAT PUMP <br />GASPIPING __ <br />EXHAUSTFAN <br />aLnH <br />ouaniNc <br />p�YIIVIVGY HO OIpAIII�.:i:1��S <br />�w"�° PLUMBING <br />BASEMENi �,�ECNANICAL <br />HE�GNi uMI1nTION ADDITIONAL PLAN CHEGK <br />OTHER <br />STATE BWLOING SURGHARGF <br />CITY OF EVERETT Puouc woaKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAi <br />8 <br />> <br />FEE <br />T— <br />