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.n-. r k . <br /> APPLICATI�.N FOR CONSTRUCI �ON PERMIT <br /> everete <br /> �ne E�rergree� � <br /> CIiV Of <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> �DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> ' MMIR��RE55 GTY ZIP PHO4E <br /> ow���;�y o� Ec�P�el� -3'c�C'P�/a. Ei-P�el� 2s9f��c-y.�Ziz� <br /> IENANi <br /> � IAAIL4DPR[55 CrtV 1iP PHONE <br /> pRCNRECTOFOCS�GNEN MAIL�DDRESS CITY ZIP PHONE <br /> GCNLFI.ICONTR�f,iOR MMLRODPE55 CITY 21P �// f'HOKE UCENSE• <br /> yt�"n~9 - �� C!jil'"J'! UD''/4» 7��7" �) V/ ��9��� JC�(///le ��J"'JS.��J <br /> �� IdCCHAN�LFL 6p�i�iRALtOP„� MAIL RDOPES� CIiY 21P �NONE L GE�SE <br /> ��� �',�lA '�T'r(��,'�=5���j- <br /> '�1-3V7 4'WMOINGCONiRRC10H MAIL�D�P[55 GITY 21P Cd06E LICENSE� <br /> � LLRSS OF WORN <br /> � y',�b � NEW ADDITION ALTERA?ION REPAIR �DEMOLITION . . WOODSTOVE/FRPL INSERT BWLDING RELOCATICN <br /> 9 JANT IMPROVEMCNI OP IHiER10R REMOpEL ONIY G0111AGT F[PSON AN�P110NE NO <br /> ° y� - �t�p, g - < o� �� ��_ GsC1, 2�z_4 <br /> C�INTNACTPRICEOFWORN: - � <br /> 'y' Zp.� D[SGNIBEWORnANO500AR[fOOiRGE�NVOtVED �J - � <br /> �s� y p ��H�L'�S L �� z Sf�Yv/(t�S�O 9 ��i i <br /> O H vnovoseouseoFe�weiu�-S NP / - I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �H C�q S � �iPriE'iin �O7' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7,ALL <br /> �` � iecn�oescaianouoF�noPEar �sHowrvaEwwoaettncHrou oviesi PROVISIONSOFLAWSANDORDINANGESGOVERNINGTHISTYPEOF <br /> H � WORK WILL BE CUMPLETE7 NIT.`I WF'ETHER SPEGFILD HEREIN OR <br /> z y �pr �� BLOCK ov NOT THE GRANTING Of n °ERk.IT DOES NOT PRESUME TO GIVE <br /> C AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> N y � OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> C y PERFORMANCE OF CONSTRUCTION.iHAT I AM AUTHORIZED BV THE <br /> n d y OWNER OF 7HIS PROPER7V TO PERFORM THE WOFK FOR WHICH <br /> � G'� APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> �T� CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> Zyy SIGNRtURE NTPnCiOROBPIItNOAIZEDPGENT D<i[ <br /> H O f/r ____�F��9�� <br /> X ,,� � 1 <br /> PP0.IECTADORE55 APPIIC CITYBUSMESSUCE ENO BUEMESSNPME <br /> 2 p �4c e�' <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—lUHNDLG UNITS—H.P <br /> � � BATHTUB FORCED AIR SYSTEMS—B.T.U. �d E.A. <br /> �' UNIT NEATERS—B.T.U. M <br /> LAVATORY(WASH BASIN) <br /> SHOWLH CLOTHES DRVERS <br /> "� � KITCHEN SINK 8 DISP VENTILATION FAN <br /> —� <br /> ! � DISHWASHER RANGEHOOD <br /> LAUNDRYTPAY WATER HEATER <br /> GLOTHES WASHER �^100D STOVE <br /> ' + METAL FIH�PLACE 8 CHIMNEY <br /> Iw � UPINAL <br /> �.� FIREPLACE INSERi <br /> DRINKINC FOUiITAIN <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> �. ..,� ROOF DFAINS—RAINLEADERS EXHAUST FAN <br /> SINK�J'ERVICE—BAR.ETC.) <br /> ��)� ' <br /> --T—- <br /> .� SUB TOTAL $ SUB TOTAL S <br /> �I� PERMIT $ PERMIT 5 _ <br /> TOTALFEE $ TOTALFEE S ^— <br /> fROtR5Ei8nCe RERRS['�ALN 9DESEi9RCN <br /> i'LAN�VELNNUMBEF FEE RECEIPiNO <br /> • ' USEZONE LOThRCI VALANTSITE FEES VALUATION FEE <br /> G ves No euaoiNc <br /> ivRO{CONSI�LLOW�BIf TYPEOftONSL�LtUR� a��°�'�`' xopwlfwxcuu'��5 — <br /> �9�� PWMBING <br /> SREDFBLDG NOOFSTORIES BRSEMENi MGCHANICAL <br /> I '. YES � �. NG � <br /> OCCl1P�NC�IOAD FlRESPRNKIERSRWD NE1GNTlIMIi�T1pN <br /> OTliER <br /> . 1 YES � . NO $TATE BNLDINfi SURGHARGE � <br /> � <br /> RUSON FOP S�RINKLER6 <br /> STATEENEPGYSURCHARGE <br /> ai�rv�c�non�cc or vuNs�vraoveo er CITY OF EVERETT PllBl IC WOPNS <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL _ <br />