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( <br /> +�'":? everett ; <br /> ������� e <br /> pppLICATION FORECONSTRUC7��N PERMI <br /> ,rre eve�P,ecn _ ', <br /> r,ITV OF <br /> everett HEATINGSYSTEM• G S UELECTRIC _ <br /> - <br /> DUILDING DEPARTMENT ❑ yiGN <br /> 259-8810 I ! BUILDING �i ECHANICAL LIPLUMBING _ <br /> I DEMOLITION I_I COMBINATION Z�P rrwwe <br /> t�tv i_ !l��53•9`�__ <br /> �� MAR ADD�ESS �� D`^,, �./j��f ' <br /> +.�� R U`I,���Y r�,or+e <br /> ,���� �� /L� ciir ziP <br /> IC���NT AM /�M�R�DONESS _ <br /> ��/'��(i' 21P PNONE <br /> GIiY <br /> — — MAR ADDP <br /> �fIC1111EG�OA�S�ER ��ENSE I � <br /> t QTY <br /> ZIP PIWNE <br /> TRAG( 55 <br /> .F.NEf1/�ICON QA� IICENS / //.(]/�// <br /> �/] cllY (��I/1,[�//"� �1/�j/E /RQ.�j '_7 ����i[i• <br /> rdF.CN�NJ��LtON(R�CTOR M��L��DR //-'/S �IJ--�� ��� "' ,I <br /> �.y/� J vNowe � <br /> %1' cnr nv <br /> vIWP�NGCd�TR�CTOR MAII/�DDAE55 <br /> cussoFv.oaK , p�TERATION I�I REPAIR i-1 DEMOLITION f I \NOODSTOVE/FRPLINSERT ❑ BUILDINGHEIOCIUION <br /> I NEW I 1 pODIT10N �t�cT $ONANDPI �r+o. I <br /> GONTRACT PP10E OF MIORI( ��,� � , <br /> DESC�IBEWd�RANDSQL1qE OOUGEINVOIVED <br /> � 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> pppp�p�',�EO USE OF BUILD APPLICATION AND KNOW THE SAME TO BE TRUE AND CARRECL ALL <br /> i � PROVISIONS OF LAWS AND ORDINANCES 60VERNING THIS TYPE OF <br /> I 1EO����.EpTyjSppWNBEIOM�OA�TT�CHFIXINCOP�ES� y,IORK WILL BE COMFLETED WITH WHETHEH SPEGFIED HEREIN OR <br /> � NOT. THE GHIINTING OF A PERMIT DOES NOT PRESUME TO 61VE <br /> �pT—� BLOGK AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> PERFORMANCE OF CONS RUCTION.THTATG AM ASUTFIORR 0 BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH . <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �TRECoF�CowTa�cionon�un�oniaD O�T�DrEC. . <br /> l1910JFGT�WRESS �PPLIC�NTS GITY BU51 55lILENSE NO.��S�u N/�ME <br /> �� � � ' MECHANICAL <br /> TYPE OF EOUIPMENT �E <br /> I PLUMBMH# FEE �• � <br /> � �p, TYPE OF fll(TUNE�R�TEM a�qMNDLG UNITS—H.P. � <br /> � WATER CLOSET(TOILET) , � FORCED AIR SYSTEM •T• • E•A• ; <br /> i BIITHTUB � UNIT HEATERS�—B.T.U. � <br /> I LAVATOHY(WASH BASIN)� , CLOTHES DRYERS i <br /> . SHOWER � VENTILAT�ON FAN � <br /> � KITCHEN SINK 8 DISP , RANGE HOOD � <br /> � DISHWASHER � - WATER HEATER <br /> � <br /> UUNDRV TRRV � WOOD STOVE � <br /> � CLOTHES WASHER , METAL FIHEPLACE 6 CHIMNEY � <br /> URINAI � FIHEPIACE INSERT � <br /> � ORINKIN(i FOUNiAIN , 11EAT PUMP � <br /> FI.pOR DRAIN � GAS PIPING I ' , <br /> � r� <br /> BACKFLOW PREVENtERS E%HAUSTFAN � <br /> qOOF DRAINS—RAINLEADERS � � <br /> � <br /> SINK(SERVICE—BAR.ETC.) � � <br /> � <br /> _ � <br /> � <br /> � � � <br /> SUB TOTAL S <br /> SUB TOTAL E PERMIT S _ ��— <br /> PERMIT E ' TOTAL FEE 3 � <br /> _ TOTAIFEE S <br /> FOROFFICEUSEONLY: s�oese�oncK f'UNGNEGNNUMBER <br /> FEE RECEIPTNO. <br /> fIlONT5ET9�GR HE�RSE7BACK FEE <br /> VALUATION <br /> ioi a�En vncnHr sne FEES .� �— <br /> usE zar�E BUILDING � <br /> ��_ � <br /> OLtU�14fr x0 fFIM2lUHGUNi�6 � <br /> IVPf Of f.ON15�«�'�A�E ir1'[n�LON9.�CID�L ��r p�UMBING � � <br /> i <br /> enser�eNi MECHANICAL � <br /> S11E OF BLO(3. N0.oF sroR � <br /> 1 <br /> pDDITIONRL PLAN CH[CK � <br /> FmE srnrnaens neo�o H[IGHT LIMI1�ilON i <br /> xcurnNcr tono T <br /> OiNER � <br /> _ � <br /> nFnsrn+ron srnMa'�as StATE BUILDiNG£URCH�RGE � <br /> wuKe nr rier+s nrrnoveo m CITY OF EVERETT PUBLIC W�RKS � <br /> LOCIIL SIILES ror►� � <br /> TAX CODE IS 3105 <br />