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APPLiCATlO.� FOR CONSTRUCTI./N PERMIT °``'"'" <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> rv,���.n.,;.,.,�.:, /. <br /> CRY Of' �y'/_ <br /> everett �HEATINGSYSTEM' lJ�iAS ❑ELECTRIC U — <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> owrirn wni�nooaEss urr� zm .. ���E r � <br /> �,/,,..�. - l��„�u�<<z� 9�?G-�f.��� �,/��. � s��z �ss�s43 <br /> �� MAIL�DDRE55 �CITV 21P " PHONE <br /> i[ti4Ni <br /> ��77/ � f� <br /> nPCHITEGTONDE9GNER �AiLRODRESS CiTY ZiF G ONE <br /> GENCt1/•LCOMPnCtOR MAILADDRE55 CIiV ZIP PMONE LIGENSE� <br /> I.�.EOI iCFLCONTPACTOR �y�AILRODRESSQ 1 piV / !IP `PN/ONE/ I�LENSE• /� <br /> 71� ,, /li /95�. f II �T li�i��VL !�1/ `IPG'7Z ��7/'Z���1'f�/f��lL/Q/I� <br /> ��� �/wl�vr�ri �� <br /> �P. Z�p PNONE LCENSE <br /> PWI/pINGWNTRACTUn MARA�DRE55 <br /> [t� � <br /> 9H <br /> ID .� rx GLh550F WORN � <br /> s y y NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT � BUILDING RELOCATICN <br /> � � � CONLACTPERSONANOPMONENO <br /> /) <br /> CONiflACTPRICEOFWORR . � ���C�I� ��/'� <br /> DESCRiOE WD ANO SOu:�E FOOinG[INVCk-VE� �Q l /Q(7 � <br /> o x o / � A/! . ll✓T �-r �t �x� <br /> � y H ('fZ7o��5 ��7rT��LUY�/s—� <br /> PnovoseouseoFouarvr.: � I HEREBY CERTIPY THAT I HAVE READ l+ND E7(AMINED THIS <br /> �.�7.�� APPLICATION AND KNOW THE SAME l0 BE TRUE AND CORRECT.ALL <br /> �'� iecnioescAivrwHOFVAovenTr�sHovrt+ee�owonnnnc�iFouncoP�es� PROVISIONSOFLAWSANDORDINANCESGOVF.RNINGTHISTVPEOF <br /> ty WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �at 9�x,c ov NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> H � g AUTHORITY TO VIOLATE OR CANCEL THE PROViSIJNS OF ANY <br /> 4]� O � _ — — OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THC- <br /> zp i <br /> H 3. PEHPOFMANCE OF CONSTPUCTION.THAT I AM AUTHORIZED BY THE <br /> y r] �:� OW�iL�i OF THIS PROPFRTY TO PERPORM THE WORK FOR WHICH <br /> t'� Z APPLIGt.TION IS MADE AND 1 COMPLV WITH THE STATE <br /> H y CONTFACTORSLAW1B27RCW AND296200WAC. <br /> g�' <br /> H S�GNATUPEOFCONiRAG'ORORAUiNORREDRGENi pAiE <br /> n b� <br /> �� � X -,:'� ���r� .�. <br /> y O y PRWECiRODRE55 /' J , <br /> pPPL nNiSCIiYBU5�NC55ULEN5EN0.AN001151NE55NAME <br /> ! �n L ) <br /> r��. PLUMBING MECHANICAL — <br /> � p0. TVPE OF FIXTURE OP ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) (1 A'C1A'HNDLG UNITS—H.P. ZS _ � <br /> , BATHTUB FORCED AIR SYSTEMS 8.T M E.A. <br /> LAVATORY(WASH BASW) UldlT HEATERS—B.T.U. M <br /> � � CLOTHES DNYERS <br /> � ' <br /> !� H TOCHEN SINK&DISP VENTILATION FAN �_ <br /> DISHWASHER RANGE HOOD <br /> LAUI�DRVTRAV L W�TERH[ATER <br /> I ~ _ CLOTHES WASHER WOODSTOVE <br /> !'1 URWAL IdE7AL FIREPLACE 8 CHIMNEV <br /> DRINKiNG FOUNTAIN FIREPLACEINSERT <br /> FLOOR DFAIN 'HEAT PUMP <br /> ' 1�1 — GAS PIPING :S� <br /> BACKFLOW PREVENTEFS <br /> ROOF ORAINS—RAINLEADERS E%HAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> B��) <br /> � SUBTOTAL 5 SUBTOTAL $ �r-'��' " <br /> ��s PERMIT S PERMR 5 i`--�-� <br /> i 1 �. TOTALFEE S 70TALFEE 5 � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�LN AEaR5ET0ACN Si�ESETpPCK PIANCNECKNOMBER fE[ ACCEiPiNO <br /> use zor�e io*naen VACANi SRE FEES VALUATION FEE <br /> BUILDING <br /> iVPE04C011L5FllOWF61E n'PEOFCONffi.ACLUAI oCC�MN[v NOIXPv[LUH4Uxit5 <br /> cnou> PLUMBING <br /> 9ZE OF DlIX'i NOAf StORIES B�SEMENT MECHANICAL %°� ' � � <br /> OCCUPRNGYLO�D F�RESPRNKLERSREO'� HE�GNTLIMIiRTqN ADDITIONALPLANLHECK <br /> O:HER <br /> FERSON fOR SPRiNNlERS <br /> ---� <br /> STATE�UILDING SURLHARGL <br /> wu�eev P�nHsnrrnovennr CITYOFEUERETT pUouCtvoRKS <br /> LOCALSALES <br /> TAX COOE IS 3105 rorn� <br />