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APPLICATI�N FOR CONSTRUC'►-+ON PERMIT , <br /> everett <br /> Iha E�nrprnnn e <br /> GTV OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259•8810 i BUILDING i i MECHANICAL i I PLUMBING I I SIGN <br /> i l DEMOLITION i I COMBINATION <br /> �yuniinonness � � r.nv �r ruone f�I �� <br /> �owr+e��I�pp� / U�,�uc{-��-�� m `az�1-�� <br /> O <br /> N�Ni <br /> MRR�DDPC55 PIIONE <br /> CIIY ZIP PIIONE ' <br /> �RCNRECTOROESIGNEn AI�ILqIlORE55 � <br /> GEMERKCONTN�CTO� MMLADORE55 CItY 21P PI F LICENS <br /> � I <br /> ���--� -���� � CIt���� IIONE , LI NSE� <br /> I <br /> MEG��MICAICOM�R�C10R u�a�oones. <br /> FLWBING GOHiRAC10R <br /> MAit�O��fSS CI1V 71P P110NE UCENSE/ <br /> CL�SS OF Wd�K <br /> I I NEW I I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I � WOODSTOVE/FRPL INSERT i I BUILDING RELOCATIO <br /> con inc�renwN nNn r��ur+e No <br /> / TENNIT iMi'RO�'EMENi OR INIE iOR 11EA�OOEI ONLV ' <br /> V .� <br /> �� CONiR�CT PRiCE OF WO�K: I <br /> '' pEtCpISEyIOfIKANDSW� fWt�(lEi VOIVED <br /> � �_��IIL_��.— — � <br /> seouseae on+a I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � '� O APPLIC.ATION AND KNOW THE SAME TO 0E TRUE AND CORRECT.ALL <br /> - �pE;,�qIPTqN ROPERTY�SHOWN BELOW ORALT�GNFOUIICGPIF.51 PROVISIONS OF lAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioT e�a� oF NOT. THE GRANTING OF A PERMII' DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br /> PEFiFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PPOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTGRS LAW 1827 FCW AND 296200 WAC. <br /> S�GNAIU�EOFCONIMC10110RRl1THOR2EDAOENT OI1TE <br /> A <br /> ��� <br /> � PIqJECTADDRE55 A IC N GtYO MES CCN 1� ESSN�ME <br /> MEC A I <br /> Pl MSINO <br /> Np, TYPE OF FIXTURE OR REM FEE NO. YPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) ;_ NC-A/HNDLGUNITS-H.P. ,_;._ <br /> � FORCED AIR SYSTEMS-B.T.U. M E.A. ; <br /> BATHTUB ; <br /> LAVATORY(WASH BASIN) ---T_ UNIT FIEATERS-B.T.U. M <br /> � CLOTHES DRYERS � <br /> SHOWER , — ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER --' _ RANGE HOOU ' <br /> LAUNDRYTRAY ' WATERIiEATER � <br /> --�— WOODSTOVE ' <br /> CLOTHES WASHER — ; <br /> i � _ METAL FIREPLACE 8 CH�MNEY <br /> URINAL ' <br /> ; FIREFLACE INSER! <br /> I ORINKING FOUNTAIN — •— = �— <br /> HEAT PUMP � <br /> FLOOR�RAIN ' <br /> ' GAS PIPING ' <br /> BACKFLOW PREVENTERS ' , <br /> I — ��— _ EXHAUST FAN --- <br /> ROOF ORAINS-RAIN�EADERS � <br /> � <br /> SINK(SERVICE-BAR,ETC.) ___�— — � <br /> � �� <br /> I _ ,__ _ � <br /> � <br /> � ;-- � <br /> , �_ <br /> _—r—— � <br /> SUBTOTAL $ ' <br /> � SUBTOTAL $ ____.� _ pERM1T S <br /> — PERMIT S ' — TOTAL FEE 5 '— <br /> —" TOTALFEE $ RECEIPiNO. <br /> fRONi5E7BACK RE�RSEIB�CN SIOFSf:ID4GK <br /> rinNcuecnnunmrn rre <br /> USE20NE lOf�f1E� V�C�NfS11F. <br /> FEES VALUATION F� E� <br /> I I YES I I NO AUILDiNG �- - <br /> TNPA4CV YOdfM'(IIMJOMOt � -- 1 <br /> rrremcoNsruinw�eie irrrorcor+ster.iw�. �n„m PI,UMI3ING <br /> � <br /> siieareioo. No.orsiomes O�SFMfNi MpCiinNicAL _ _ � - <br /> I I YES I I NO __.____._—.-.._-._. � <br /> -- O111Ffi � <br /> OCWPANLYlOAO flfl[SPfiNNLEfi5fiF0'0 11[IGHILIMII�IION i <br /> I I YES I I NO Si�IE DUILUING SUt7CHARGE �__ <br /> — <br /> ne�son ron srnrt+KiEns STN E[NFRGY SURCHARGE ' <br /> i <br /> _ � <br /> APPLICAIION�CC.OV rinNsnrrnov�onv CITY OF EVEflETf puoucwonKs � <br /> LOCAL SALES ; <br /> TAX CODE IS 3105 TO7AL <br />