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APPLICATI�.N FOR COIdSTRUC'► �ON PERMIT <br /> �����« <br /> ,,�,� ,�., � e <br /> CIiY OL <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK-PLEASE PRINT <br /> Z59�88�� BUILDING MECtiAMICAL PLUMBING SIGN <br /> DEMOLITION COMBINATION __ __- <br /> aiv rP� rr�oue <br /> crr�+eq ua�noo�[ss � _ L� • �' �/A .'7 � `5`�\� <br /> 1.! � GTV 21P PHO ' " <br /> ��Ha�J MFhA0�RE55 <br /> ��n, ZiP PMONE <br /> pnCNitELTOR0E51GNER MRRPDDRE55 <br /> d'Y 21P PNONE 4CENS/E�• <br /> Glf�LRALCONTRACTOR MRILPODRE55 � , � ` / ���� . �//C �(tC��"'%� \�S�` <br /> ) <br /> 7 � /` ' / <br /> . /F GLV .� PHONE LiCENSE• <br /> VtLNANILALLONTRAGTON MA ADDR[SS •//���.� �.� J///S ��(2 <br /> /Y�� �a <br /> y�� — LITY ZIV PNONE �ICENSE• <br /> C] <br /> I+LUId01AGLONTRACTOR MPILROUHE55 <br /> ay <br /> � �x <br /> L�. y y r�nssoFw�aK <br /> C i NEW � ADDITION - ALTERATION REPAIR DEMOLITION WOODSTOVE'FRPL INSER7 ' BUILDING RELOCATION <br /> ^7 CONTACi P[RSON AND PNONE NO <br /> yH 1[1lANT11APPOVEh1ENi0RIHLEHiO�yP�REMO�ELONL� <br /> K y� f.0'liPAGTPNICEOFWORM: 7� • . <br /> UESCBIBEWOPRRNDSOWRE�OOUGEIN�LVEO' l ' <br /> 'i1 H �i1 ^ % <br /> V1 H v <br /> �x r r�oaroseouseocew�ort+c I HEREBY CERTIFY THAT I HAVF FlEAD AND EXAMINED THI_ <br /> APPLICATION AND IWOW THE SAME 10 BE TRUE AND CORRECT ALL <br /> p 3 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> � H d iEcn�oescaivnor+oFPaovERrr�sHowuec�owoan*ucHvouncoaies� yyORK WILL BE COAIPLETED WITH WHETHER SPEGFIED HER'cIN OR <br /> NOT. THE GRANTING O� � PERMIT DOES NOT PRESUME TO GIVE <br /> �-'�j [�rJ g LOT ���� �F AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> �" n OTHER SiATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � y� PERFORMANCE Of CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROFERTY TO PERFORM THE WORK FOR WNICH <br /> H y APPLICATION IS IdADE AND i COMPLV WITH THE STATC- <br /> � � CONTRACTORS LAW 1827 RCW��JD 296200 VJAC. <br /> �..� SIGNATUREOFWNiPALtOROFAUIN���REDAGEM �AiE <br /> n b� <br /> c�r X � y <br /> r� ' � �— <br /> zym — <br /> H O V] PPOJEGT�O�RE55 pPpuCP ISCI V SINESSOCENSENO./ND�USiNE55�lAlAE <br /> � �� 7 M6CHANICAL <br /> �� PLUMBING ' <br /> � NO. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF� FEE <br /> � WATERCLCSET(TOILET) A.C—A�HNDLGUNITS—H�P� <br /> � BATHTUB FORCE�AIR S�S7EMS—B T��� M E.A. <br /> I '_� LAVATORY(WASN BASINI UNIT HEATERS—B.T.U. M �_ <br /> CLOTHES DPVERS <br /> L� SHOW ER V ENTILATION FAN <br /> KITCHEN SINK B�ISP RANGE HOOD <br /> , DI5IWASHER WATER NEATER <br /> • '�� LAUNDRV TRAY WOOD 3TOVE _ <br /> i _� CLOTHES WASH[R METAL FIREPLACE 8 CHIMNEY <br /> URINAL FIREPIACEINSERT <br /> DRINKING FOUNTAIN HEAT PUMP <br /> '_ PLOOR DRAIN GAS PIPING <br /> __ BACKFLOW PR[VENTERS EXHAUST FAN <br /> ROOF ORAINS—RAINLEADERS <br /> SINK(SERVICE-6AR,ETC.) <br /> '�� <br /> �� <br /> SUB TOTAI S <br /> SUB TOTAL S pERM1T 5 <br /> PERMIT S TOTALFEE 3 <br /> ~�� TOTALFEE 5 <br /> PEARSETOACH S��ESEI�ACH <br /> PV.NCNECHNUMBER F[E AECEIPLNO <br /> -- FRONTSETORCN <br /> USCZONE IOiANE� <br /> vAcnrvTsrte FEES VALUATION FEE <br /> � - VES N� BUILDING <br /> acumw�r Noaow�u�+�ue�,is -- <br /> ivf[OfLONSTAIIOWABIF iYGEOFCONSt.ALNQ ceouo p�UMBING <br /> g��i_nr pL�('i. NOAF STOPIES 9ASEMENT MECHANICAL <br /> �. : VES �. NO <br /> ^CC'�IDANCYLOR� FlRESPRNNlER5RE0D NEIGHiLIMIiRTION <br /> OTHER <br /> I I yEg : �� NO STATL BUILDING SURCHAflGE � <br /> —�_ <br /> P.!nt1CN POP SPRINKLERS SiATE ENERGY SURCHAfiGE _ <br /> n�i•uCnTiONAGC.BY PLRNSNPPROVEDBY CITYOFEVERETT PUBLICWORKS <br /> LOCALSRLES <br /> TAX COUE IS�105 TOTAL <br />