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APPLICAYI(..� FOR CON:�TRUCTiO�I P�RMIT � "'"'" <br /> ,,, � „ ,,,,, TO BE COMPLETED IN INK—PLEASE PRINT � <br /> everett ( HEATWG SVSTEM: J GAS J ELECTR!C ;:l__.� - � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOUTION COMBINATION :. BUILDING MECHANICAL PLUMBING SIGN <br /> cv;vcn uni�anoarss ci,v nP cHor+e <br /> . �. � . . . . . ' �. . <br /> `�ViANi � IAAILADORE55 ❑�v ]�P PHONE <br /> APCMRECTOPOE9GM1ER MAIL��DR[55 LITY DP PHONE / <br /> � � Y �� l' /� � " t� .. , - � : ' i. �. � .. . .'�/ili '>� (' � S � � <br /> ��INFfIRILONTRACTON AIAILAOONE55 CILY ZIP+ PMONE ULENSEI <br /> i � (., <br /> ., " - .' 7:�- � � /� ci' ' _ _ <br /> VCCNANIC�LCONLRAGTOR •M�ILRDDRE55 � CITY �IIG( P��E LICENSE� <br /> `��y �`ilnAeiN;CONTR�GTOR 1nhIlADD(iE55 QTY SiF PMONE L�CENSE� <br /> �r <br /> � CtA550�WORK <br /> ,9,�H!�N ,>,� NEW ADDITION ALTERATION REPAIR _DEIdOLITION H'OODSTOVFJFRPL INSERT BUILDING(7ELOCATiON <br /> H C� /, /� �� Y.'". � � 'f!1'T COHTPGi PERSON AND PMO4E NO <br /> T � te<. <br /> F(' (7 � CO•I1HnLTPRIC[OFWORN �' � — <br /> O� O pls:�'idCwORNANDSOURRFFO0IPOEINVOLVEO <br /> 'i1H '� , 'r- I ,'i.�/ �.�j, i .�' . <br /> y~ -os�ouseoFem�owc � 1 ` I HEREBY CEATIFV THAT I HAVE READ AN� E%AIAMED Tri15 <br /> x'L_'� _' ;.�, i•�1�. APPLICATION AND KNOW THL SAM[TO BE TRUE AND CORRLCT.ALL <br /> [s]O PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE Or <br /> yd !"nL0E5CRIPiIOHOFPROFERiY�SMOWNBELOWORATT4CNFOURCAPIE51 <br /> :.� : WORN WILL BE COIdPL[TED WI7H WHETHER SPECIRED HERBN OR <br /> M�Cy .�,i_ �-�'', eiocK � �' ����� � NOi. 7HE GRANiMG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �� � 1 AUTHOfiIT'/ TO VIOLATE OR CANCEL 7HE PROVISIONS OF ANV <br /> �^ '��j��-; , OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTIOIJ OR THE <br /> 2 y 3C --,��� ��� PERFORMANCE OF CONSTRUCTION.THAT I AM AU7HORIZ[D CV THE <br /> ty � OWNER OF THIS PROPERTV TO PERFORId THE WOPK FOF WHICH <br /> �..� y ___ APPLICATION IS IdADE AND I GO�+�PLv WI7H �H[ STA7F <br /> C7(A CONTRACTORS LAW 1027 RCW AND 296200 WAC <br /> ��� SIGNRiUPEU�CONiRALTOROR�OINOHIZEOI.GkNi �:���lf <br /> lY l�i � _— , ,. <br /> ��vi - - - -- - -- X • - � �: � -- - —— <br /> �f OJCCi AD ICSS <br /> qnpi 1 Je115(,I iV BU3NE551 IGENSE NO RNO BUSItIE`511A41 <br /> � � � I � <br /> PLU1181NG MECMaNICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET� A'C—A�HNDLG UNITS—H.P. _ <br /> � BATHTUB _ FORCED Alq SYSTEMS—B.T.U. M E.A. ' _ <br /> I �� _— _ LAVATORV�INASHBASIN� UNITHEATERS—B.T.U. M � _ <br /> �HOWER CLOTNES DRVERS <br /> KITCHEN SINK&DISP VLNTILATION FAN _ <br /> DISHWASHER RANGE HOOD _ <br /> • LAUNDRVTFAV W4TER HEA7ER i___ <br /> i __ CLOTHES WASHER —r _ �'�'OOD STOVE .�� <br /> URINAL 1,1E7AL FIREPLAGE 8 CHIMNEV _ <br /> DRINKING FOUNTAIN FIRePLACE INSER7 � _ <br /> FLOOR DRAIN HEAT PU�.�P <br /> �1= _ BPCKFIOW PREVEN7ERS _ GA5?�PWG _ <br /> ROOF DfiAINS—RAWLEADERS EXHAUST FAN _ <br /> SINK(SERVICE—BAR.ETQ) —. <br /> i '�I � —. - / — — <br /> SUBTOTAL S SUB707AL S ' _ <br /> � _ PERMIT 5 —r _ PERMIT 5 _ <br /> ��� 70TALFEE 5 TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: ?�> � <br /> (H04i5[1p�6M REARSEtilRf,N SIpESEl9I.�✓. �LANCNEf.FNNA�Pn ![E �ECEIPiNO <br /> z� ' s ' �o so .�s- 9 �r „ �� os� v��� � <br /> usc�or+F iot natn '/ vncnNi Srte PEES VALUATION FEE <br /> �-S ti/7 Y y0 5P./Y. Ald eui�oiNc/oP �c.,,,S,.y � e. ; � �. <br /> �-��i���co�nsuiawaei� tvrcorcoxsiaauni n�o��..a�. x,o�o-x�:�•n_,.s —S'-frs 0 �t000 / � _, <br /> cnoor pWMBING <br /> .. :�`IJ __�T—�J -� - -- <br /> S�:�O�PIDG NO.OFS10R25 BP6[MENT MEGHANICAL �' <br /> rv_oD sq� I � - <br /> n�run�q�y�OAo FlRESraqqCnsaEon MEiGNiuMrtnnoN AD�RIONALPLANGHEGN <br /> / <br /> IJ ��� /S oniea <br /> Pr4:iN UfISPRW✓I.ERS <br /> S7AiC AUILOM�SUFGF4RGF y � S (� <br /> d.,n.�c. - � � -nm,sr.�di��n-tn��. CITYOFEVERETT r=uoi.icwo�Ks '' <br /> /J� LOCAL SALES <br /> 7 �� TAX CODE IS 3105 TOTA� <br /> /ca, L• �� <br />