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.1� �.-_ <br /> APPLICATIOI:?FOR CONSTRUCTI,uN PERMIT everett <br /> I/M F�M�Q/f�Cl1 TO BE COMPLETED IN INK—PLEASE PRINT � <br /> C��Y�� <br /> everett HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT � <br /> 259-8810 <br /> ! DEMOLITION i I COMBINATION � i �i�ILDING � �MECHANICAL L7 PLUMBING ❑ SIGN <br /> rnvr�rn unnnoonrss I/ p cnv zm ruoNe <br /> -�k4,/�fi,�'r f'�� 433�//�Ai�a.� AA, - F� �1�ZG3 '33�-•S/y�� <br /> i nnur unn nooness crtr zm riroNe <br /> nncimecionocs�r,Nr.n ranunooness cirv � �m m�os: <br /> cRIfRALCIX1iR4CTOR MNL�ODI1E55 CIiV 21P PIIONE LICENSEI <br /> IA[LIUNICALCONIMCIOR Mdlt DORESS �ItY ZiP PIIONF. LICE�I <br /> �t ns�_�F���'�y��57 ����v� zs5—�'�I1�c 9Si �� _�z r 753s-' �f e sse�' �4�� <br /> wraninccorvmnc�on rananonness cirv zm ri�orue LICENSE� <br /> anss or wonK '�( <br /> ' ! NEW I I qDDITION Y��ALTERATION I 1 qEPAIR I I DEMOLITION I.I WOODS70VE/FRPL INSEflT ❑ BUILDING R[LOCATION <br /> �2�� � cautncrrEnsoNallov��or+=No. � <br /> cor�rnncr rnice on vronK <br /> q6,ccnine ORN�NU$W f1E fbOi�GG INVOLVED — �-� <br /> 6'�� �G(/Vfs.�— �7'c��/{ <br /> rn ro5EUU5EoroVi�on�o I IIEREBY GERTIF'�' THAT I HAVE READ AND EXAMINED THIS <br /> =�l 2 APPLICATION AND KIJOW THE SAME TO BE TRUE ANU CORRECL ALL <br /> ier.ntocscmvirouorraoarnrvisuoNmoeiowonniTnr,��Founcorics� PROVISIONSOFLAN'SANDO�DINANCESGOVEHNINGTHISTVPEOF <br /> WORK WIIL BE COMPLETED WITH Wh'EiHEti SPECIFIED HEREIN OR <br /> ior o�ocK or NOT. THE GRANTING OF A FERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFUCI'I�N OR THE <br /> PERFORMANCE OF CONSTRUCT�ON.THAT I AM AUTHORIZED BY THE <br /> QWNER OF TNIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> — APPLICA'fION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 NCW AND 296200 WAC. <br /> SIGNRTUREO�CONTR�CiORORnUfIqRRE��GENT O�TE �/ —/F—y / <br /> ' , /�ry <br /> ❑ROJPCT�DDRE55 /�� <br /> �� G/� APPII@Ni5C17YBU5ME55UCENSENO.ANO8V51NE55N�ME <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> _ WATER CLOSET�TOILET) A/C--NHNDIG UNITS—Ii.P. � <br /> _ BATIiTUB _' FORCED AIR 5`.'STEMS—B.T.U. M E.A. Q � <br /> LAVATORV(WASH BASIN) � UNIT HEATERS�—B.T.Ii. M � <br /> SHOWER � CLOTHES DRYFRS i <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD �—T <br /> LAUNDRV TRAY � WhTER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL ; M[TAL FIREPLA.CE 8 CHIMNEY � <br /> DRINKINC FOUNTAIN ; FIREALACE INSEFT � <br /> FLOOR DRAIN NEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF DRP.INS—RAINLEAD[RS � EXHAUST FAN � <br /> SINK(SERVIC[—BAR,ETC.) � � <br /> i � <br /> — � <br /> T <br /> 1 <br /> I <br /> � ; <br /> _ suo rorn� 5 � sus Torn� s .�,fa �� <br /> __ PEfiM1T $ --�— PERMIT S /J' i <br /> TC�TAL ftE 5 ' TOTAL FEE $ L � <br /> FOR OFFICE USE ONLY: <br /> II1pNi51:t0�CN fi[�RSETO�CK SiD[5[iPAf.K PlAHC11EC1(NUMp[R FEE qECEIPTNO. <br /> us�zrn+[ iot�nen vncnNt snc FEES VpLUATION FEE <br /> T <br /> OUILDING � <br /> i <br /> i�r�nrcomsnumvnei[ trrtorcorisr.ncmai occu�.m-. rmamnu�,r,u.��s — -- <br /> �"`""' rwMowc � <br /> � <br /> — �— <br /> �-.VrorntDc. HooFsloNES Aps[M[Nr �aFCHANICAI ' <br /> �S� � ou <br /> a;CurM�cvLonn flnESrnr�elEnsn[on nEiG�rtu6�rtnitON � �DDITIONALPLANCHECK � <br /> _ � <br /> _. O1NER � <br /> ntneor+ronsrmr�Kicns — _ _ �_ <br /> SiNE BUILDING SURCNARGE ' <br /> �ui��rnv nnr�snrrnoveoer CITY[1FEVEREIT runucwonks � <br /> LOCALSALES ' <br /> iAX CODE IS 31G5 rorni ; <br /> —�—— --- -- <br />