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APPLIGi ,TIQ.� Fl7R COI�iSTRUC'F, JN PERMIT ''"'" " <br /> rm�r��•�a��'��� TO BE COMPLETED IN INK—PLEASf_ PRINT � <br /> (IIiV Of � <br /> everett I HEATING SYSTEM U GAS lJ ELECTRIC ❑ ____ ____� I <br /> BUILDING DEPARTM[NT I <br /> 259-8810 { <br /> DEMOLITION COMBINATION BUILDING MECHANICAL xPLUM8ING ' SIGN <br /> ��r. �� �„o��E .��8-=�� 3-- 1 <br /> °'"s"M,i �^ �r ��A��,�o�v�ss 1' -}}- �1B2o1 �258 ' 182Y - <br /> � nran (zwe�htlerA ��4�1AGlSe.��VPrP <br /> U � � �Ai1.AUDNESS GLY TI1� f910NL <br /> lf��ANI J � <br /> h Q1�R- I <br /> n.�::Hn[C10PUE5':�:fq �.�nilAU0RE5S GITY Z�P FNON[ <br /> yr� Nn � <br /> x CITY ZIP PMONE LILENSE� � <br /> [i]�SJ :�.IbFRMCONtRA�iOR IAAIL400RE55 <br /> .��x N� PNONE LICENSE• <br /> 9Hy vfCN/.NIC�LGONTR�GiOF MAILAD�R[RS CI1Y 21P <br /> � <br /> 3 �iH �'LU�JdINGGONtRACTOR 1.!AILApDR[55 CRV 21P PHONE UCE�ISE� I <br /> � n <br /> H� — <br /> 4SI.SS OF WORH `/ <br /> � ~� NEW ADDITION h ALTERATION REPAIR DEtAOLITION WOODSTOVEiFRPL INSERT BUILOING RELOCATION <br /> V1 H <br /> y CONiPCT CERSCN ANO PHONE NO <br /> rpy z S% 7 }� <br /> l•J O� GONiRACiPRICEOFWORN aJOVO. _— — <br /> y ORGRI�EWORrcPND50UA�EPOOtAGERIVOLV[0 <br /> � �g clr wa � r�a2ir� <br /> p7. n❑ r�oroseousee�nr:�nwc I I HEREOY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> x Hg S��1D�I,E ,t�m� ` �•CC���•1� _ APPIICATION AND KNOW THE SAME TO DE TRUE AND CORRECT.ALL <br /> �--- PROVISIONS OF LAWS AN�OFDINANCES GOVERNING THIS TYPE OF <br /> � y[+7 i—i�;�,i��Ripri������noi•er�iris4�r.r:r<<.r,�+cnnrrn�cHr�ou(n�ccnc,� yyOFK WILL BE COMPLETED V�ITH WHETHER SPEGFIED HEREIN OFi <br /> H H ;;�.23 Y Z moca ��2,_ ��F �Id.?�J_4'�V_fJC NOT. THE GRANTING OF A PERMIT DOES NOT PRESUIdE TO GNE <br /> � y I � / AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> d� �fCOYCL�Gi I I��I � a� ���5� OTHER STATE OR LOCAL LAVJ REGULATING CONSTRUCTION OR THE � <br /> C. C r PERFOR1dANCE OF CONSTRUCTION.THAT I AM AUTHORIZED OY THE �' <br /> 3 �T1 OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> �� y y pq � 2 APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> �-3 O V� — J�— CONTRAGTORS LAW 1827 FCW AND 2 200 WAQ , <br /> — 5'GNAiU9[OFCON1RACiORORAl1iHOHIZE�P Nl DRi[ I <br /> \� � p• � <br /> � �W r <br /> cao.iFCi ADD _ . <br /> , ���� � ��r�. � nru^,nr�r�air ���iessu:t�+�er+aurmous�r,ess�+ni�� _ <br /> i <br /> PLUMBING MECHANICAL � <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> '+ � \VATER CLOSET ITOILET� _ ____� ' _ A'C—A�HNOLG UNITS—H.P. <br /> "�! Z OATHiU� FORCED AIR SYST[MS—B.T.U. M EA. _ <br /> � LP\'ATORY(WASH BASIN) UN;7 HEATERS—B T.U. M <br /> SHOW[R , CLOTHESDRYERS <br /> � + <br /> �„ I J KITCHEN SINK 8�ISP _ �EN fILATION FAN <br /> UISHWASf1ER fiANGE HOOD <br /> ` LAUNDRVTRAY WATER HEATER . <br /> 1 CLOTHESlNASHER WOODSTOVE <br /> � � 61ETAL PIREPLACE 8 CHIMNEY _ <br /> URINAL � <br /> DRINKING FOUNTAIN FIREPLAGE INSERT __� <br /> FLOOR DRAIN HEAT PUtdP <br /> I BACKFLOW PREVENTERS GAS PIPING _. <br /> FOOF DRAINS—RAINLEADERS EXH�UST FAN <br /> SINK(SERVICE—BAR,ETC.) _ <br /> �•. .,,�� _ � 4E-/Yl/1�G�72 — -- <br /> � ~� SUB TOTAL 5 SUB TOTAL 5 <br /> � .� _ — _— <br /> PERMIT $ PERMIT S _ <br /> � TOTALF[E 5 TOIALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> rii�rlrsc.onc� ncni�seio.�c,H sioEseroncK vinu�a�rc.r+m!ne� �a rsc�irri�n <br /> i��,-;n•,� �orni�en VACANiSrtE FEES VALUATION FEE <br /> �WICWG <br /> _ �,O�G"__ _ — 5`� �OU <br /> '":IOICONISAIlOWR01E iYP(OfCON51ACi0PL �LnOu�:r MOavnluu�i.�.'s ----- ��7 I <br /> PWIdf31NG <br /> '���:iO�BIDG NOAFSTORiES BPSEMENT MEQIANICAL _ <br /> _CurnNGvIOA� �InISPRNKlERSP[OD MEiGNiIIMItAiiON ��DITIUNALPLANCMECK —__ <br /> OTHEP <br /> – —� <br /> �+I nsON FOP SPp�NNtEHS <br /> SiATE�UIL�ING SURCHARGG _�j.�'� <br /> -,•n��.c in ainr�snan�iovi n m � CITY OF EVERETT ruouc wor+Ks <br /> LOCALSALES C <br /> TAX CODE IS 3105 T�TA� p I 5 6 <br />