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pPPLICATIOt"�'FOR CONSTRUCTI'°�N PERMIT ���'��" <br /> TO BE COMPLETED IN INK—PIEASE PRINT � <br /> rn Everg�een <br /> GN OF <br /> everett HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL ' . PLUMBING - SIGN <br /> ER MAIL�DDRE55 GTV Z� PMONE <br /> �nnr �261 ��t-)K(v`��'r3 <br /> � _,� �� �) JIL'�t�;�� �I�PJC� <br /> TEN�NT M�ILADORE55 ��T�' Z�P PHONE <br /> �RCHITECT OR OES�GNER Mnll AODRE55 dtY zlo PHONE <br /> GENER�LCOHTR�CTON M�ILADDRESS <br /> pTV ZiP PNONE LIGENSE I <br /> M CHN! 0.CONTMCTUR MAIUDDPE55 CITV ZIP PHGVE UGENSE• <br /> i�OY�^c� ����b �i�' r�. �'.�IP.Ve,�-f 9�Z.�1 �>6G�331 iUov�G�u-� �I��►2? -- <br /> PLUMBING CONTRAGTOR MAIL�ODRE55 <br /> �iT� ZII' PNONE UGENSE• <br /> CLA55 OF WORK <br /> . NEW � �� ADDITION ALTERATION REPAIR DEMOUTION WOODSTOVE/FRPL INSERT i BUILDING RELOCA I N <br /> CONiACi PEASON�ND PHONE ND <br /> �j '�i.C� ` F �/ <br /> CONTP�CT PRICE OF WOHN CI <br /> OESCRIBEWONKANOSW�REFOOT�GEINVOLVEU � <br /> C I °+ <br /> PROPOSEDUSEO�BUiI G � I HEREBY CERIIFV TfiAT I HAVE READ AND E%AMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORflEC-.ALL <br /> E �L DE PTIONO AOPenrv iSHo 9ELOW OR�TTACMFOUFCOPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYFE OF <br /> WORK WILL BE COMPLETED WITII WHETHER SPECIFIEO HEREIN OR <br /> �ot e�ocK oc _ NOT. THE GRANTING OF A PERMIT DOES NOl PRESUME TO GIVE <br /> ,\/���� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> D� l���I ^��U� �O��:ScY-�l.l� OTHER STATE OF IOCAL LAW REGULATING CONSTRUCTION OR THE <br /> (� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY Th1E <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> ArPLICATION IS MADE AND I COIdPLY WITH THE STATE <br /> CONTFlACTORS LAW 182�RCW AND 296200 WAC. <br /> SiGNATUREOFCONTR�CTORO°IPUTMOR2ED�GENT DATE <br /> �d J ��IL�&Y �l � X � ���1 n �l �n�— <br /> ?ROJECT ADDRESS �pp�IGpNTS ITY BUSME55 UCENSE N�.PNO BUSINESS NAAIE <br /> MECHANICAL <br /> PLUMBINO <br /> NO. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A,'HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER FANGE HOOD <br /> LAUNORY TRAY WATER HEATER ' � <br /> CLOTHES WASHER WOOD STOVE <br /> METAL F:REPLACE 8 CHIMNEY . <br /> URINAL ' <br /> DRI4KING FOUNTAW FIREPLAGE INSERT ,�r— <br /> HEAT PUMP <br /> fIOOR DFAIN ' <br /> BACKFLOW PREVENTERS o,._ GAS PIPING <br /> ROOF DRAINS—FAINLEADERS ExHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> SUB TOTAL $ SUB TOTAL $ �G � <br /> PEFMIT 8 / <br /> PERMI7 S —_ - - -- TOTAL FEE $ 7 S�' � <br /> TOTAL FEE S <br /> FOR OFFICE USE ONLY: aeceiP*r+o <br /> P�ANLnECN NUMBER FEE <br /> PRONTSETB�CK REARSETBALK SIDESETBAGK �G� <br /> USE20NE LOTRRER <br /> vnc�r+tsiTe FEES VALUATION FEE <br /> BUiLDING _ _ <br /> IYGfO�GONT5.0.i0WRBlf ���FO�CONS7�GNAL ��pWp« �����E������ � P�UMBWIi <br /> cRE OF BLDG NO OF STORIES BRSEMENT MECHANICAI � � <br /> OGCUP�NGYLO�� FIRESPRNNIERSFEOD HEIGNTUMIT�TIOH <br /> ADDITIONAL FLAN CHECK �r._ <br /> OTHEF <br /> RE�SON FOR SPRINKLERS STATE BUILOING$URCHARGE <br /> __ � <br /> INTAHE BY PLANS APPRO�ED BY CITY OF EVERETT PUBLIC WORKS <br /> LOCRL SALES <br /> TAX CODE IS 3105 TOTAL �� Io G <br />