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� APPLICAT14�1 FOR CONSTRUCT.JN PERMIT �``'"�" „ -� <br /> �� TO BE COMPLETED IN INK—PLEASE PRINT � � <br /> ffl��E✓C.'0'fr•'1 <br /> CI:V OF <br /> everett HEATING SYSTEM J GAS J ELECTRIC J � <br /> BUILDING DEPARTMENT � <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> �" L� q MPRA�DRE55 <br /> cITY l�P Pr�01E <br /> _,,ul�—� 3y��- shor� ��t �r <br /> iu+a!�Y' <br /> N.MlA0DRE55 CITV Z�P PMONE <br /> piuJuiff,lOADESiGN[R MRIIADOPE55 GITY 21P P110NE <br /> GC4ERGLCOHLRAGIOR MAiIADORE55 <br /> GIiY ZIP PIIONE IICENSE• <br /> ��� <br /> M[G�AMLAlC04iRnCiOR uA�LnDDRL55 GTY bP PHON[ IICENSE• <br /> n�x /� N !✓u�.l�c�f I�� iNa -l�!(��'� EvT SYu� L5�-t3si No,�ir� �os �eZ <br /> �y3VJ ClUM91NGCOYiRACiOli M�ILADORLS`.i GtV ZIP PNOVC Uf,ENSE• <br /> ir-t �3 <br /> � � �/CU-1SSOFWOAN � <br /> y,/NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTO�E�FRPLINSERT BUILDINGRELOCA <br /> H'� � conrncrceaso�+nrvoP��or�Era <br /> �9 HM �yJ�VV <br /> y H CONiRACT PNIf.E OF WO�N �/�/ <br /> H <br /> zp O�CSC�'I�oEP:O�KAND50URR[ iAGfiNVIX`VCD � <br /> � HC ��1�—rK��.1 C� <br /> Q M raoros[ous[oFouaomc I HEREBV CEFTIFV THAT I HAVE READ AND E%AIdINED TMIS <br /> H [�q ty ���Hw APPLICA710N AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � PROVISIONS OF LAWS AND OFOINANCES GOVERNING THIS TVPE OF <br /> �" n ICGRLJCSCNiFT�ONO(Pf10P +tt�s�owrvee�owoaarucurouncories� yrORK WILL BE COMPLETED WITH WHEiHER SPEGFIED HERE�N OR <br /> Z y� iar e�ocK oF NOT. 7HE GRANTING OF A PERMIT DOES NOT PFiESUME TO GIVE <br /> � - AUIHORITV 70 VIOLATE OR CANCEL TNE PROVISIONS OF ANV <br /> N y OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> (y(/1 PEFFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TNE <br /> � �yOWNER OF 7HI5 PROPERTV TO PERFORM 7HE WORK FOR WHICH <br /> �� APPLICATION IS MADE AND 1 GOMPLV WITH THE STATE <br /> C+ CONTRACTORS LAW 1827 RCW AN�296200��AC. <br /> ySIGNRiUNE O(LONiRACTOR OR AU1NORiZED AGENT O�TE <br /> y �y VqOJECiADDAE55 qPp�,ILNNi" 'Sr�rygpSN SLICENS[40AN�OUS�HESSNFME <br /> - S�evt �/✓.(. �vl <br /> PLUMBING MECHANICAL <br /> f Np, TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) A:C-NHNDLG UNITS-H.P. <br /> f�. � � � FOFCED AIR S`.'STEMS-B.TL. M E.A. ' <br /> ' BATHTUB _T <br /> �' � LAVATORVIWASNBASW) UNITNEATERS-B.T.U. M <br /> SHOWER CLOTHESDRVERS <br /> .� .,� KITCHEN SMK 8 DISP VENTILAI ION FAN ___� <br /> � � DISHWASHER RANGE HOOD <br /> LAUNDHVTRAV WATER HEATER <br /> CLOTHES WASHCR WOODSTOVE <br /> ; �"' URINAL ME7AL FIREPLACE 8 CHIMNEY <br /> � DRINKING FOUNTAIN FI(7EPLACE INSERT <br /> PLOOR ORAIN HEAT PUMP I <br /> BACHFLOW PREVENTERS GAS PIPWG i <br /> 1 � — �- EXHAUST PAN I <br /> �I I ROOF DRAINS-RAINLEADERS <br /> S�NK(SERVICE-BAR,ETC.) _ I <br /> ( ! � li <br /> � <br /> SUBTOTAL 5 SUBTOTAL S S ' � <br /> PERMIT $ PERMIT S - <br /> 1 ! TOTALFEE 5 TOTALFEE S .� ' I <br /> FOR OFFICE USE ONLY: <br /> �� PLANCHECNNUMBER �EE HECBPLNO <br /> � FRONi 5[10PGN RC�R SEI9ALN SIDE SEtOALN <br /> usc za�r ior�Aee VAC�N151iE FEES VALUA710N FEE <br /> i <br /> �UI�DING _ ' <br /> t�itUiCON15FllOWAB�[ iVP[OfLON5l�tlp�t oa��nn voawrtu�Hcex's - <br /> PLUMOWG <br /> SiI[OF Ft�DG NOAF STONIES O�SEMENT MECHANICAL � <br /> �KGi1PANCYIOAp FlPEtlPRNKI[NSP[OD HEIGHTIIMIiAiION <br /> AD�IPONAL PLAN CHEGK <br /> 0711ER <br /> � <br /> qL4WN FOR SPRINNLENS <br /> STAIE 13UILDING SURCHARGE <br /> ;�,��.i�r ---- rinr�s�rPaovEoer CITY OF EVERETT .�uoucwonKs <br /> LOCAL SALES <br /> TAX CODE IS 3105 T'�Tp� _� I <br />