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� <br /> ARPLICATI '1°� FOR CONSTRUCT�<'i7N PERMIT everett <br /> n�e E��p�ee� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cnr o= <br /> everett HEATING SYSTEM: U GAS CI ELECTRIC U � <br /> BUILDINf DEPARTMENT <br /> 259-8910 ' <br /> � DEMOLITION I I COMBINATION ' I BUILDING I i MECHANICAL f]PLUMBING O SiGN <br /> ' ��/GD v MAl1.A0DRE5S ��TY Z�P P�� �yT�/�� <br /> DEZ(_e1L `�D�G .S�79i//E!✓�'✓�_���T � . �'r <br /> iFrvnNr �nanooness crtr zir �rarve <br /> � �Rf.NIlEC1011DE51GNEN MAIL�DDRESS Ci�Y 21t' PMONE <br /> rf nnicor�in�ct 4NLADDf1E55 dTv 1�P PNONE ICENSE� <br /> ��ozc �'Kh,v� G��� �zsz cr�wn�c�ri�cf ��� 9r�>> ��u�,� �ca��� <br /> MECi��NICALCd17MClOP M�M1�IX1NE55 GTY 2�P P�E ���� <br /> 1 <br /> riuMamcca+mncton unknooncss � cnv nr rrar+e ��NSEi <br /> j CLASS OF WOPM <br /> ' � NEW I I AC iTION I I ALTERATION y1 REPAIR I I DEMOLITION I 1 WOODSTOVE/FRPL INSERT ❑ BUILDING REI.00ATION <br /> p`' � j� �j CONTAGT PERSON AND PIIONE N0. <br /> Gd/TR11CT PRICE GF WdM " � 7G'Q� <br /> � pEg�qlgE Wpilt ANO SOU�RE FOOTAGE INVOLVED <br /> �41'fdS �fi7a iFWI��ot+t L/h�►i.Mvt-�(v9�i.t. <br /> ; rnoroseouseaeuKos+a 1 HEREBY CEHTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TG BE TRUF AND CORFECT.ALL <br /> � LEO�LDESCRIVTqNOF PNIX'ERTY�SIIONTIBE�OM'OR�lUC1VOURG01'I[51 PROVISIONS OF LAWS AND ORDINANCES GOVERNINQ THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED FiEREIN CiR <br /> �o� piaK or NOT. THE GHANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISION$ OF ANY <br /> OTHER STATE OR LOCIIL I.RW REGUUTINO CONSTHUC?ION OR THE <br /> ��� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOR!ZED BV TME <br /> ` OWNER OF THIS PROPERTY TO PERFORM THE WORK FOH WHICH <br /> C 1PPLICATION I MAD ND I COMPLY WITH THE STATE <br /> CONTRACTORS 1B. H W AN0296.200 WAC. <br /> SiGN11NP ca+ ron w izeo�aerrt o�re <br /> t <br /> �b.�0 S�/t-'✓�✓�Nj , <br /> , <br /> , 1'fpJEC�A00i1E55 AP0.1LAN75 ITYBUSINESSIICEN5EN0.ANOBUSME55NAME <br /> PLUMBIN4 MECMAN(C11L <br /> � NO. TYPE OF Flf(TUNE OR ITEM FF.E NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET) � /U�AMNDLG UNITS—Ii.P. � <br /> . BATHTUB ' FORCED AIR SYSTLMS—B.T.U. M E.A. ' <br /> � LAVATOFY(WASH BASIN) UNIT HEATEHS—B.T.U. M � <br /> SHOWER <br /> � CLOTHES DRVERS ' <br /> ' KITCNEN SINK 6 DISP VENTILATION FAN � <br /> ; DlSHWASHER � RAN6E HOOD � <br /> LAUNDRV TRAY ; WATER HEATER <br /> � CI.OTHES WASNER � WOOD STOVE � <br /> �-- <br /> � METAL FIREPLACE d CHIMNEY ' <br /> URINAL _ i <br /> � DRINKING FOUNTAIN I FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP _ � <br /> BACKFLOW PREVENlERS ; GAS PIPING <br /> ROOF DFnINS—RAINLEADERS � EXHAUS7 FAM ' <br /> � � <br /> SINK(SERVICE—BAR,ETC.) i � <br /> � <br /> _ _— r— <br /> i � <br /> .� � <br /> — i i <br /> ��' <br /> i <br /> SUB TOTAL S ' SUB TOTAL S � <br /> — PERMIT 3 _ PERMIT f � <br /> -- — TCTALFEE $ TOTAIFEE f ' <br /> FOR OFFICE USE ONLY: <br /> RECEIPT NO. <br /> ffInNIS[iB�GK P[�RS[iO�CR Slp[SEIMGN PUNCNECItNU1A�[R FEE <br /> us�zone LOIAREA vncnNtsne FEES VALU�TION FEE � <br /> i�/� <br /> BUILDING �)�V( �_ <br /> IYMOtCONI5Al10WAfl11 1Yi'EOICONSI.ACiUAI M[u�'�M:r NnAlrMnnwlMitS � <br /> r.nmr PLUMBING � <br /> ---'�'�''— <br /> i <br /> snE or eiCG. No.oF SioniEs enSFrn[Nr MECHnNICAL � <br /> � <br /> i <br /> OCCUPnNCY LonD Hn[Sr'RNKLERS nW'D �iEIGHT llMitnll(NI ADDITIONAL PLAN CNECK _ � <br /> i <br /> 1 <br /> OTHER __�_ <br /> RE4SON fOf15P11111R1ERS � <br /> 57ATE BUiLDIN,SURCHnRGE <br /> mu.r nv n�ns errnoven ov CITY Df EVERETT PUBLIC WOIiNS � <br /> LOCIILSALES �2 ;�D <br /> TAX CODEIS 3105 ror�� J <br />