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y11.1- <br />lsL'l� <br />N x <br />9HCH/� <br />FC�C'i <br />0 0 <br />CA H <br />x <br />a. OH <br />yH <br />t'y <br />HH <br />N <br />i <br />1 C:) <br />r , <br />FROM:CITY OF EVERETT DLDG OPT TO: 206 867 Sill FED 9. 1°J93 A:4PPM m302 P.02 <br />APPLICATIuN FOR CCNSTRUCI ION PERNUT <br />TO BE OOf!PLETED IN BLACK INK —PLEASE PRINT <br />HEATING SYSTEM: U GAS IJ ELECTRIC ❑ — <br />13UILDINO DEPARTMENT <br />269.8610 <br />b4 DEMOLITION n COMBINATION I'I BUILDING L) MECHANICAL LJ PLUMBING Li SIGN <br />MAZER MAILAOVKE6S CRT— 21p FHONF <br />TENA14T <br />MIIIAAD_Dnns CITY <br />n <br />LIP <br />PKtINL <br />� <br />AnCNRCCTCIIDEsiou 0 <br />LU0. ADDRESS CITY <br />ZIP <br />PHONE <br />.vy ...... <br />il.-. <br />_'Me <br />fa@ <br />���s[rL_ <br />I—._. .. <br />II AICLCCNLC <br />GLNEFAI WW"TOR <br />MAR AOOpPR6 CITY <br />�S :S0VF.�st` �� A�,�h.�. <br />Mr[:HANICAI CONTRAC4YR <br />MAIL AEDnE9L[�// CITY <br />ZP <br />PHONE <br />"ATE LICEIISEI <br />PI VIONNO CONI RAP•IOR <br />MAR ADORCSS CITY <br />Ilr <br />YNVNL <br />LTAIC LICEIILCI <br />CONTRA(:T PnICE OF WONK <br />nrFrplpr WnRK NID SONAn�WOUk <br />NFD CONTAr,T P[R.•.nN AND rI InN[ 110 <br />86 7 <br />rnnFneRr USp Or Ron OUZO <br />t[nnE D[rr. rTKlNa rnCx'L/n^1Y�y{%01.:NUW BELOW OR TACH TWO CONE <br />I Di._ .— DI oc,16, _� OF <br />PARCH IWO NIIMnCn <br />_Ucfo�— <br />nu'ito" LOP, I FNOCR, MDOE 1-6, 1LIE PHONFN MRFR <br />PR JEC ADDRESS (1 <br />I THEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO DE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME 70 GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PFRPORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH T14E STATE <br />CONTRACTORS LAW 10.27 RCW AND 296 200 WAC, �Ac,, .-. <br />61 -Y-S3 <br />Z _. DINT <br />_ <br />PLUMBING <br />_ <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT _ <br />FEE <br />- <br />WATER CLOSED (101LET) <br />-BATHTUB- -_ <br />A/C-- A'HNDLG UNITS-H. P. <br />I <br />FORCED AIR SYSTEMS-O.T 0. IA (I.A. <br />_ <br />LAVATORY(WASH BASIN) <br />--'---- <br />SHOWER _ - <br />UNIT HEATERS-B:T.U�M <br />CLOTHES DRYERS <br />_ <br />' <br />-I— <br />I <br />_ <br />_.-_._. <br />KII CHEN SINK d DISP <br />.. .- <br />__ .ISHTYASIIER <br />D <br />J <br />VENIILATIOFI FAN <br />RANGE HOOD <br />_-__—_- <br />�- <br />_.. <br />I <br />.. <br />...... <br />_._..-......_—...--__._I <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES <br />_ <br />J <br />WOODSTOVE <br />_WASHER <br />URINAL <br />bRINKING FOUNTAIN <br />•_ <br />FLOOR DRAIN <br />BACKFLOW PREVENTEFlS <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />' <br />•. <br />I <br />� <br />HEAT PUMP _ <br />._--......_.._ <br />GAS PIPING <br />....._ i <br />I <br />ROOF DRAINS-RAINLEADERS <br />_... ..._..— <br />SINK (SE—_—_RVICE-_ OAR. ETC.) <br />I <br />EXHAUST FAN _ _�__--•— <br />; <br />' <br />I <br />----- <br />_ SUBTOTAL >; <br />PERMIT b <br />_ SUB TOTAL <br />I <br />--... ... _) .- <br />PERMIT b <br />TOTAL FEE b <br />—. <br />-- TOTAL FEE b <br />FOR OFFICE USE <br />rnONT 6[TDADK <br />ONLY: <br />_ <br />nEAR SEI NAVK <br />Lot ARIA ---- <br />NO Op LICAIkS <br />rEnc ArnINALERS RBO'D <br />FIRE ALARM HLOI' <br />—• • <br />610E SFTRACK <br />VACANT SHE ---• <br />FT YES Fl NO <br />¢GrnA. AR au nuat u:n! <br />v W. <br />RA>EMFNT <br />LI YES L) NO <br />rIAN CHECK NVLIDEH fFF <br />to <br />Karl Ito. <br />USE ZONL <br />VALUATION---FE <br />,CBS <br />DVII DING <br />PLUMRINO <br />TIFF OI cwt <br />MECHANICAL <br />L¢E OF BLDO. <br />-- <br />ABI)ITIGNAL PLAN CHECK <br />OTHER <br />—'--_--- <br />OCC.oPANCV LOAD <br />--- <br />INTAKE PY <br />HEIOHi LIMIM10N <br />STATE BUILDII40 SURCHARGE <br />— <br />rWIL ArrPOVkUBY CITY OF [V&R[TT <br />�— XCOD SALES <br />r.PIE 1nCOD[ IS 313;, <br />O <br />PUBI IC WRKS <br />TOTAL <br />-T— <br />