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. <br /> i� <br /> ���J APPLICATION FOR CONSTRUCTIJN PERMIT <br /> :,�c,.•�F�•� e��eret[ <br /> ��T��F e <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—�PL�E"A�SE PRINT . <br /> DEMOLITION COMBINATION BUILDING ��cmtCHANICAL PLUMBING SIGN <br /> dL���'I1 tl ��—nD° �4V�5�//"1�1'1511.�►' G� r�L v��^r�[/�,�'�(/` —�C�— <br /> C�, <br /> TCNA ' MAll�D0�i65 CILV ZIP Cn0!IE <br /> t �^- <br /> Y <br /> •PCMrtECTOFDES�G�IEA MARADDAE55 CIiV ZP PMONE <br /> G H tR�CtOP u . 5 ��TI �Zlp� >� .i E E• <br /> �� ��I <br /> MEGH�VaIUIGON A�.pR MM�q(JRE55 PiV iP PH N[ LIGE� '� �� <br /> �� ,fti'�3��- L -1 I <br /> PIUMBMGGONTR�Q(Ri MAIIADDAE55 GTV I�> PNON[ LIGENSE� .,f <br /> GUSSOf�WOR�: <br /> � NEW ,_ ADDITION FATION � REPPIR . DEMOI.ITIO�J . WOODSTOVE/FRPIINSERT . BUILDINGRELOCATIOY <br /> TENSHT MPaOVE VLNT OR MTER��EMODEL CN�I.y�� GONTAGT PERSON AND PIIONE NO <br /> f\ \{ <br /> CONTR�CT VRiGE Of WOFK: L) l.� <br /> DESCFIBE K�Np �R OOUG[INVOIVED <br /> �"�c�.�' .��� p �- �+-� _ <br /> vnoroseouseo�eu��o�n•c �,�n I HER[BV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � �� APPUCPTION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEG�lDESCRIPTqHOfPRO�EHTv�SHOWMBELOwORaTTALNfOURC0�iE5� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WuRK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT Bi°�" °F NOT. THE GRANTING OF '. PERNiIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTNER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> '� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WH�CH <br /> — - APPLICATION IS titADE AND � COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 FCW AND 296.200 WAC. <br /> SiGNATUAEOFCONTRn�TORORnLiMOB2ED�GEHT OQE <br /> PRQIECT�DDFE55 ,^;` � 1 � � ` _� /�� � �• `-' `�`� �i.� <br /> i�`� � ' -��v / I � � FPP iCnHTSdTYUU5INE UCENSENO RN�BUSMESSNAME <br /> L <br /> PLUMBING MECMANICAL <br /> NO. TYPE OF FIXTURE GR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET 1TOILET) NC—A,NNDLG UNITS—H.P. <br /> BATHTUb fORCED AIR SVSTEMS—B.T.0 E.A. <br /> UVATOFV(WASH BAS�N� UNIT HEATERS—B.T.U. M <br /> SIIOWER CLOTHES DRVERS ! <br /> KITC4EN SINK 8 DISP VENTILATION FAN <br /> T <br /> DISHWASHER RAI�GE HOOD <br /> LAUN�RV TRAV WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPIACE 8 CHIMNEY ; <br /> DHINKING�OUNTAIN FIREPLACE INSEH7 <br /> FLOOF DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> fi00F DRAINS—RAINLEADERS EtiHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) �_ <br /> — i <br /> SUB TOTAL 5 SU0 TOTAL $ I ''�' <br /> PERMIT 3 PE9MIT 5 � � <br /> TOTALFEE $ TOTALFEE S — <br /> FRONT SETO�CK RE�F SETBACK SIOE SET9nCN PLAN GHECK NUMBER FEE RECEIFT NO <br /> USEZONE �oTaRe� vncnNrsrte FEES VALUATION FEE <br /> �._ VES . NC BUILDING <br /> 1YPE Oi COH$i AIIOW�BIE 1vFE DI COtlSt�CiU61 oawwn va D�Cwt:�•.xc uv�i5 — <br /> G50.'D <br /> PLUMBING <br /> SIZE Of B�DG NO OF STOA�ES BASE�AENt MECHANICAL ` <br /> \1� i <br /> VES NO <br /> OCGUPRNLYlOAO FlPESP9NKLERSPEOD NE�GHi�uAltAi�.ON OTHER <br /> � YES NO STATE BUILDMG SURCHARGE <br /> REa50N F09 SPNiNKlERS <br /> $TATEENERGVSURCHARGE <br /> ewucnnorvncr, er ainvsnvaacreoev CITYOFEVERETT PU6uCwOFKS <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOT4i <br />