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i���i•ri��l <br /> APPLICAT101_ FOR COIdSTRUCTI�,.N PERMIT � <br /> �,t,, . , <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> ,,. .,�..,. <br /> CIIY OI _--- -- <br /> everett �HEATING SVSTEM' J GAS ❑ELECTRIC J__---_-----� <br /> BUILDING DEPARTMENT <br /> 259�d870 <br /> DEMOLITION COMBIPJATION BUILDING MECHANICAL PLUMBING SIGN <br /> u.ni�annncss arr :m v��one <br /> �,,:�,,�, � � C Z 'L <br /> � � p�sf�-f'_�__�` o.� �YE�T� w 98Ao� S/7 , 9 <br /> l�llr'L� � 6l8 � �.�,� ���, ��,o��E <br /> ,�u,i�, iJ�i����RE55 <br /> NiCilitECT0�0E51GNCR i��A�Lq00RE55 <br /> GIIY Z�V PIIONE <br /> C[NFI�LCONIFACTOR AIPILAD�RESS CITV 21P P110NE IICENSE� <br /> 1 ',(q <br /> L'�(/�1-G'� PMON[ IICENSE• <br /> � �� 64CIIANIULCONiPAGTOR MAILRD�RESS CITV ZIP <br /> A� � �LUMOINGCONiRRCiOA A1nILA0DNE55 <br /> CITV ZIP PHONE UCENSE t <br /> q H <br /> > HN <br /> r, CLA$$OF WOfiK <br /> y �N NEW ADDITION � TER�TION REPAIR DEMOLITION WOODSTOVE�FRPL INSEfli BUILDING RELO A I <br /> � COMPCT P[RSON RN�PMON[NO. <br /> K y � � �t <br /> Q� H Q� C(4tRACTPRICEOf WORK � <br /> ��„� u`.yni�.�wo��¢ar�osoun� -roorncert+vavm <br /> e'f,e.�"�l%,e�e�.+ .- �,t C- ���x.� � e.-�... <br /> x caovo eouseoF,imiou+c i �y �' " � I HEREBY CERTIFY THAT I HAVE PEAD AND E%AMINED THIS <br /> H <br /> � � d � „Q- �!`YL�I,� APPIICATION AND KNOW THE SAh1E TO�E TRUE AND CORFECT.ALL <br /> O H "L PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � � C i[r.a�o .,cRian��HOFP�oaEarrisNowHoeiowonn*'ncr�vou coaiesi yyORK WILL BE COMPLETED WI7F1 WHE7HER SPECIFIED HEfiE1N OR <br /> �„ n io� �7 g�aK oF _,�G�F-Z�S1 -��- NOT. 7HE GRANTING Of A PE(76�1T DOES NOT PRESUME TO GIVE <br /> �..� 0 a AUTHORITV TO VIOLATE OR CANCEL THE PflOVISIONS OF ANV <br /> x y� OTHER STATE OR LOCAL LAW R[GULATING CONSTRUCTION OR THE <br /> � ,.� PERFORM1IANCE OF CONSTRUCTION.TH�T I AM AUTHORIZED BY THE <br /> H y OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> t7 V� � _ APPLICAiION IS h1ADE AND I COMPLV W�TH THE STAT� <br /> nd y CONTFACTORS LAW 1827 RCW AND 296200 WAC. <br /> �� r SIGHRitIR[O�CONiPAC10ROHAU➢IJ��iZEO�G[Ni UAIf <br /> HON X � <br /> ��r+o�ccr noon�ss ���� <br /> 3�/ ry �'L` /GC APPLICA11i5CIiY�I!5':t�5 N'�AI:D�I MESSNANE <br /> � � L w <br /> PLUMBING MECHANICAL <br /> NO. <br /> TYPE OF FIxTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) A�C—A�HNDLG UNITS—H.P. _ i — <br /> I '—� _ BATHTUB _ FORCED AIR S`.'STEMS—B.T.U. M EA. 1 <br /> � LAVATORY(NIASH BASIN� UNIT HEATERS—B.T.U. M ___�_ <br /> � CLO7HES DRVERS <br /> SHOWER <br /> KITCHEN SINK 8 DISP _ VENTILATION FAN <br /> � DISHWASNER RANGE HOOD <br /> i � L�UNDRYTRAY WATF.R HEATER <br /> � WOOD STOVE <br /> CLOTHES WASHER <br /> METAL FIFEPLACE 8 CHIMNEY <br /> URINAL — ; <br /> DRINHING FOUNTAIN FIREPLACE INSERT �. <br /> FLOOF ORAIN HEAT PUMP <br /> �� — GASPIPING <br /> BACKFLOW PREVENTEflS <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> ' SINK(SERVICE—BAF,ETC.) <br /> �1�1 — <br /> �-1�� — SUB TOTAL 5 _ — <br /> L SUB TOTAL 5 <br /> �� PERMIT 5 PEFMIT 5 <br /> TOTALfEE 5 TOTALFEE 5 —� <br /> FOR OFFICE USE ONLY: neceiP*r+o <br /> rHON*56IDacn <br /> nenasErnncK siocseitmcK rinrva�ecnr�m.m�a ree <br /> i�rqqEp WCPNTSITE FEES VALUATION FEE <br /> us[1orv[ _ <br /> BUILDING ,..5�� '�� � �� <br /> fYPFOiCON15ALL�WAOIE LYPE�fLON51PLNRL OLGp��VC+ NoO�RdTu'vG�'��'�s P�UTABMG <br /> SREO�F/Op�O�G� NOOF��ES B�MENi IAECHANICAL p <br /> "Cr�' / ADOITIONAL PLAN CHEGN / '?S <br /> OCCl1PANCV I AO Flq[SPR�ENS RW D HEIG11i UM�iRi=_ON <br /> � .� O7HER _ <br /> �— <br /> fl[ASON ORSPRiNKI[q5 Lr �SL� <br /> S7ATE�UIIUING SURCHARGE <br /> �,-��r�„�,fl� ainr�snranoveoov CITY OF EVERETT ruuucwonKS <br /> LOCALSALES � /} <br /> ��C,J TAX CODE IS 3105 TOTAL /"'! ;3'S <br />