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APPLICATI�1 FOR CONSTRUC�N PERMIT everett <br /> �E�� TC�BE COMPLETED IN INK—PLEASE PRINT � <br /> an oF } <br /> ' eVere l� ,HEATING SYSTEM: J�GAS O ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> � 259•8810 <br /> ❑ DEMOLITION I l COMBINATION f I BUILDING �MECHANICAL ❑PLUM�ING ❑ SI(iN <br /> S OWNE�M�� � �MLA�Df1E55�ZU �LY�CIQ`1([ 1��ZIP�vf-�£� �f"lE ('7a � I� �� �� <br /> I <br /> � 7E/UNT M1111 AD��E55 dfY Ii� PNONE <br /> ARCMRECT IXi DESIGN[N M�tL��DRE55 CIIY ZIP PNONE <br /> 6ENER/�LCd1TR�LTOR N.AILAODRE55 LIfY Z�P PHONE LICENSE/ ' <br /> MECHMIICQCONTHACTOR M�IlA00RE55 CIfV 21P PNONE UCENSEt <br /> � , � • �2�na A� o ti1 �-rr�6 ��/33 �4�0340 (,vA'TPffB�SMK <br /> ' W t� wi, �u�-r �..a-r i , <br /> � PLUMlIWJCONTRALIOR M�IL�DOAE55 dtt 21P PIIONE UCENSE� <br /> 1 � <br /> C1A850F WORK <br /> � ❑ NEW L7 ADDITION � pLTERATION I I REPAIR f I DEMOLITION I I WOODSTOVEIFRPL INSERT fl BUILDINO RELOCATION <br /> ' / � GO–N{i�GI PEf150N ND PNd1E NO. Z/^ <br /> � CONiR�CTPRICEOFWdilf ��O ��_ J�� �nrr�so,.l "V`Y -03�U <br /> OEBCRIBE WORK A/N�D�SOU�RE f00T�6E INVOLVEO <br /> ' �N�JlA(J t.�.4J UN�� N�4Tt/LS <br /> � rROPO5EDU5EOFBUnDnq I HEREBY CERTIPY THAT I HAVE READ AND EXAMINED THIS <br /> t ���� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECL ALL <br /> � �EpKpE$GRIPTqNO�PPC.'iM1Y�SNOWNBEIOWORATTACNFq1RCOP1E51 PROVISIONSOFLAWSANDORDINANCESGOVERNINaTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br /> �ar PLOCN � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME�TO OIVE <br /> i AUTHORITV TO VIOLATE OR CANCEL THE PROVISIUNS Of ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> ' PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIIED BY THE <br /> OWNER OF THIS PROPEHTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITM THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SI6NATUREOFCONTRAGTOROR�UTNORIZED�OENT D�iF <br /> �r,�,�u � A [' p^— x,�I9`�� w.a. a�-;N�- � . <br /> �7C.�{ /"' f"�U�IJUV CV� �p(J:/ �P �TSCIiYBU5ME5SlIGENSENO.MlOBUSINE&4NIJAE <br /> ���� MECHANICAL <br /> ►p, TYPE OF FlI(TURE OR fTEM FEE N0. TYPE OF EOUIPMENT �E <br /> WATER CL6SET(TOILET) � A/C—A/HNOLO UNITS—H.P. � <br /> �TM�B � 2 FORCEDAIRSYSTEMS—B.T.U. �E.A. ' <br /> • LAVATORY�,WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> . S��R � CLOTHES DRVERS � <br /> ' � KITCHEN SINK 8 DISP VENTIUTION FAN � <br /> DISHWASHER � RANGE HOOD ' <br /> � LAUNDRYTRAY ; WATER HEATER � <br /> � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAL ' METAI FIREPLACE 8 CHIMNEY ' <br /> � <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP _ ' <br /> � BACKFLOW PREVENTERS GAS PIPING � _ <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ' <br /> � <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � <br /> � <br /> � <br /> � <br /> � <br /> ; , <br /> � <br /> SUB TOTAL S ' SUB TOTAL b ' <br /> PERMIT S � PERMIT E <br /> � TOTALFEE $ ' TOTALFEE E ' <br /> i <br /> fOR OFFICE USE ONLY: <br /> FRONTSET&lCR HE�RSETBACK SIDESETB�CN PIANCHECKNUA�BER FEE HECEIPTNO. <br /> i VALUATION FEE <br /> U6ESONE LOT�REA V�C�NTS�TE FEES <br /> i <br /> j BUILDING � <br /> i <br /> TYPEOffANiS.�LLOWABLE tYPfOfCOHSL�CIUAI o[nm�icr xopu�twrzuM.rs � <br /> �^�° PLUMBING � <br /> i <br /> i <br /> 61ZE Qf B106. NO.OF STOPIES BASEMENT MECHANICAL � '— <br /> i <br /> i <br /> OCCUPrWCY LOAp FIRE SPRNRLENS NtOV HEIGIIi LIMIT�I!ON �DDITIONAL PLAN CHECN � <br /> I <br /> OTHER i <br /> i PE�SOIIFORSPPINKLERS � <br /> STATE BUILDING SUFCHARGE � <br /> � <br /> �� MN(E BY MNS APPROVEO BY ClTY OF EYERETT PUBLIC WORNS i <br /> LOCALSALES <br /> TAl(CODE IS 3105 roT�� �; � <br /> :+f,5�cccesonrvn�.l�r.e�r.�.rr,..n.r'✓cn-:.�sc-.r,G.wr..cr.:nc�nsck7l:t�.cL.;� ..�... " . t:� � :�..;..�.: '.t'..-1� ��v.pl'.ti+f.�.�4.;7� ,v�.�:f�6'iJi'i�.t^.�;+.- <br />