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". e��erett <br /> APPLICATIOh fOR CONSTRUCTII..�1 PERMIT � <br /> TO BE COMPLETED IN INK-PLEASE PRINT <br /> ren eve.9ree� <br /> GITV OF � <br /> everett HEATWGSYSTEM 'JGAS i.�ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIG <br /> cirr ziv vHONe <br /> DWNCN MAILPODR65/5 � V��tf �f'2Jj <br /> Alu� � 3 �3 S� t�.>{ �- � <br /> A�2vQn[7CV' clir Zir � PHONE <br /> 1ENANr AIRI�ADURE55 3 SS_ y r.�y /3 y�-3 3�n <br /> qqLHRELTORDE5IGNEP MnII�DDFE55 <br /> cirv zir vHOHE <br /> C�JY ��o PNOHE L�CCNSE� <br /> GENEAA�COHiR�LTOR IAA�LADDRESS <br /> ��� GIiV ZIP PNONE UCENSE t — <br /> MfCll/JIICALCONiR�C10A MAIL�OOAE55 <br /> p�� LITY ZiP PHONE IIt.ENSE� <br /> PlU'ABiNGCONTRAGTOR MNLAD�AE55 <br /> � Ht~n <br /> LUSS OI wOAK <br /> f~.]�,�.�j NEW X�DDITION ALTERATION REPAIR DEMOLITION � WOODSTOVEPRPL INSERT BUILOING RELOCATI <br /> � � CONi�CT PEH50��AND PNOHE NO <br /> H�1 <br /> �M� GONLR�GTPR�CEOf WOPK <br /> [/J N DESLRiBE WOPx�nD WURRE FOOIAGE�NVOLVEO <br /> 7' I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> H <br /> o PflOPOSEO UI:E OF 811/1�yING <br /> H Y-n...,,�N YP S�����C� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> O M��y ! IC PPOVISIONS Of LAWS AND ORDINANCES GOVERNING 7HIS TVPE OF <br /> iecn�o mm�cnovraoPe��YISHOWNB[LOW09ATTALMFOURCOPi[5� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ~�� ^ �t rt � �P � NOT. THE GR�NTING OF H PERMIT DOES NOT PRESUME TO GIVE <br /> Q ��� ��- B��K �F AUTHORIiV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> y OTHLFi STATE OR LOCAL IAW REGULATING CONSTRUCTION OR THE <br /> .'x,' H <br /> t PERFORMANCE OF CONSTRUCTION.1HAT I AM AUTHORIZED BV THE <br /> M H OWNER OF THIS PROPERiV TO PERFORM THE ��ORK FOR WHICH <br /> �y APPLICATION IS' MADE AND I COMPLY WITH THE STATE <br /> N <br /> �y y CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> �a�� — SIGNATU9CO�CONiA4C10FORnUiHOR12EDPGENT DATE <br /> �� X �� �"-Ya--�___ <br /> � PRQIFGTU�]lDRE55 C A��PUUNiSCrtVPIISME55LICEYS[NORND�OSME55NAME <br /> S Jl r J l��l L�V/Y� <br /> PLUMBING MECHANICAL <br /> FEE NO. TYPE OFEOUIPMENT FEE <br /> �� NO. TYPE OF FI%TURE OR ITEM A�C-A!HNDLG UNITS-H.P. <br /> � � _ WATER CLOSET(TOILET) FORCED AIR S`.'STEAIS-B 7.U. M E.A. ' <br /> � DATHTUB <br /> LAVATOFiY(WASH BASIN) UNIT HEATERS-B.T.U. M �T <br /> � SHOWER CLOTHESDRYERS � - <br /> VENTILATION FAN �—� <br /> . KITCHEN SINK 8 DISP RANGE HOOD <br /> � IDISHWASHER WqTERHEATER <br /> �� LAUNDRV TRAV y�ppD STOVE <br /> � CLOTHES WASNER METAL FIREPLACE 8 CHIMNEV <br /> ' URINAL FIREPLACE INSERT <br /> ,I �1� DRINKING FOUNTAIN - HEAT PUMP <br /> FLOOR ORAIN GAS PIPING <br /> BACKFLOW PREVENTEFiS EXHAUSTFAN <br /> ROOF DRAINS-F7AINLEADERS <br /> � SINK�SERVICE-BAR.ETC.) <br /> � <br /> �� SU6TOTAL S � SUBTOTAL S <br /> PERMIT S � PERMIT S �_ <br /> TOTALFEE S <br /> � - � TOTALFEE 5 - <br /> FOR OFFICE USF ONLY: _ ��E n�ceict r+o <br /> (PONTSETBACe FGRSEiOPCK SIDESETFIACK PUNCH hNIIMBER <br /> �, 2D� S-/�' N- f� �/ a-�'L`� � VALUATION FEE <br /> Usf ZOrvE <br /> �otnnee vncnHr itE FEES <br /> �2_.� ♦ N✓ BUILDING _ <br /> tYvf oi i0N1 i ALLOwRPIE ���[Of CONSi AGtU�L accoo�'k� ti�n wnwv;ue��s PLUMBING �f� <br /> �� <br /> ✓-N I�'=3 / <br /> � 5�2E Of BL�('i /=T � � J�O Oi STOF�[5 BASEMENt MECNANICAL <br /> �o sF, ti..� lVv <br /> ADDITIONAL PLAN CHEGK ' <br /> OCCUPANC lOA IIR[SPFNHI[RSREO'� HEIGNLfii`A���M i <br /> � OTNER �T <br /> q6n Foa sPatHrcteas N� STATE BUILDING SUfiCHAPGE <br /> wra�eer rur+snvrr�oveoer CITYOFEVERETT rueuCwoaKs <br /> -T LOCAL SALES <br /> TAX COOE IS 3105 T�TA� <br />