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APPLICA►T.JN FOR CONSTRU�. �'ION RERMIT everett <br /> tne Evergreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-0810 <br /> DEMOLITION COMBINATION }�BUILDING }CMECHANICAL �LUMBING SIGN <br /> OWNER MAI DORES GIiV ZiP PHONE <br /> -�, .�. ; n�.. � � �o� �3og �� rE1 `��aa 6 33�-�So i�' <br /> iENRNT MA�LAUDRESS QTY 2�P PHONE <br /> pRCNITECTORDE5IGNER MRM1/COFE55 CITV ZiP PNpNE <br /> Gf„(,IEPRLCONTRILTOR MAIL�y DRE55 ITY // 21P PMONE UC NS[� <br /> Y�1I�Arc% o �.lJ J'o' �d� ��0� �:ti�H f�'cY�20G �s�-�ul,�' �cr�'„�d -�Gy,(U <br /> MECMRNICFLCONiR/GTOR MAILADJFE55 CITV ZIP PHONE LIGENvE <br /> f'LUMBING CONTRACTOR AUII ADDtiE55 GTV ZIP PHONE UCENSE� <br /> �CL SS OF WORH <br /> NEW � . ADDITION ALTEFATION � REPAIR � DEMOLITION . WOGDSTOVE/FRPL INSERT �_ BUILDING RELOCATION <br /> CON CT,PEFlSONANpPHONE / <br /> CONTRACTPRILEOFWORK �l '�� � �/ ��� S`,/� <br /> DESLR�BE WORK ANU SOUARE POOTAGE INVOWED �� fn' '� — <br /> Y <br /> aaoao5eouseoFeuitoiqc I HEREBY CERI�FY THAT I HAVE READ AND EKAMINED THIS <br /> � � � _� ' � APFUCATIG'I AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> L GFL DE NIPTIONOF PROPERTV ISHOWN�ELOW ORATTACH FOUR LOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> p WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT�� eioc< oc f���ri����l, NOT. THE GR�NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �—`� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW FEGU�ATING CONSTRUCTION OR THF <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTFIACTORS LAW 1827 RCW AND 296200 WAC. /-� q <br /> — SIGNATUR�I�FO�iH�AGENT DA7E �/_ o! S– /� <br /> X � � � <br /> PR0.iECT AODFESS n�� /�5 /VU/ N C'�i r+ LV <br /> RPPLICRNTS CITV 9USMESS LILE E N0.RND 9USINESS NAME � <br /> �1� - U�>P� <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPME;�T FEE _ <br /> WATER CLOSET(TOILET) 1 A/C—NHNDLG UNITS—H.P. <br /> / k3ATHTUB % FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAV^-JRY(WASH BASIM ( UNIT HEhTERS—B.T.U. M <br /> SHOVIF.R CLOTHES DRYERS <br /> � KITCF @N SINK 8 DISP _ VENTILATION F.W � <br /> / DISHIVASHER / RANGE HOOD � <br /> LAUN�RYTRAY WATER HEATFR <br /> CL�i H[5 WASHER / WOOD STO\E / 'rr� t <br /> URiPl4L METAL PiREPLACE 8 CHIPdNEY _ <br /> DRI\KING fOUfJTAIN FIREPLACE INSEfiT _ <br /> FLOOR DRAIN HEAT PUN.P _ <br /> BACKfLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—FAI�"_EADERS EXHAUST FAN <br /> SINK(SERVICE—�AR,ETC.) <br /> — ,� c k e�,,, z Co d� l� <br /> SUBTOTAL 5 SUB?OTAL 7 <br /> PEFMIT S PERMIT � <br /> TOTAL FEE 5 ;GG TOTAL FEE S (� ' <br /> FOR OFFICE USE ONLY: �' L <br /> FRONTSETBPCN REP95ETBALH� SIpESETBRCN / PLANGMECKNUN6E9 FEE RCLEIPTNO <br /> / � �I z(��'3� G �.���c <br /> —�-- �— �� <br /> use zoNe �or R�ra wcnnr sin FEES VALUATION FEE <br /> �=L__ -+� Y�' AUILDING (�G y d K �QG <br /> t�PfOiCONI5AlL0�YAB.F I\'PfOiCON4.FLIDAL acur�ya xoao-nuuvauvns PLUMBING <br /> v -n� v �i i`°��3 �+5 � � <br /> SREOFa'.DG"� NOAFLTORiES BASEMENi� � MECHANICAL CJ� �P(/ <br /> zP�'� "`=C�L ` ADDITIONAL PLAN CHECK ' <br /> OCLU^.1'iG�IOADJ FiRESORM4EF5FE0'� HEIGNTLAIITRTIQN <br /> � /� / <br /> N It�/ OTHER <br /> H[ASON FOR SPRINNIERS <br /> STATE BIIILOIIlG SURLHAPGE �,SD1 <br /> INiANE OV V11N�APPROVED BY CITY OF EVERETT PUBLIC WORKS /-V �W <br /> � �� �7� s��� TAX COOE SL3105 TOTAL �.' - SG ✓ ; <br /> j _ <br />