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APPLICATIOR. FOR CONSTRUCTIc .�1 PERMIT °�����." <br /> .! , . , TO BE COMPLETED IN INK—PLfASE PRINT � <br /> oi��eF <br /> everett HEATING SYSTEM:�GAS J ELECTRIC J __ <br /> gUILDING DEPARTMENT <br /> 259-8870 <br /> DEMOLITION COMBINATION BUILDING �MECHANICAL PLUMBING _ SIGN <br /> �.,.,rq ....41ALLADUP[5� � <br /> ��>r u� �r S � t'�.�c.�d '�r`� l _����_,r �� � � �V�J� c++- ��� - ��I I_ <br /> 'ENANi,� I �� MAIL�DDRE55 C�'• ZiP ��ONE _ <br /> eRpHIiECTORDESWMER MAIL�ODRE55 WTY :iP FNONE <br /> GEHERM t ACTOB MAIL�DDRRS pITV $IP �MpNE ULENS[• <br /> UECHnHiCAL TqACiOA M�ILADDRE55 ❑iv Z�P vNOM1E �EN� <br /> y �H �, c;�-1-�n •311t` � i 11 I� �e �U P��-k� �'1&3�� a��� I <br /> [^ yiI PLUMBINGCONiH�GiOA ML�DDPE55 Giv ZIP PHONE lKENSE• <br /> � �,y ���.� r,r, N� m�c1-�,�,�cc� I noY�h��h1D3�-� <br /> G�H cussoFwonrc <br /> y y y NEW ADDITION �ALTERATION REPAIR DERIOUTION WOODSTOVE�FRPL INSERT BUILDING RE�OCATION <br /> t'C <br /> CONiALi PERSON PNp VrONE NO <br /> fC x n ] — <br /> CONTRPCT PRiCE OF WOPM � <br /> F] "D DESLRiBE WORrc�dDiBtl�Ei60�6��t1:�WK` <br /> � rxi � .� , �'C � �� � L Y � �. <br /> �H vBOPOSE�USEOFBU�LDiNG 1 HEREBY CEtiTIPV THAT I HAVE READ AND EXAMINED THIS <br /> y .�� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> � y iE��i oczmm�otic��A���tnrvisNowtiouc�+r��n**<r�.roumm�ev PROVISIONS OF LAWS AND Oi7DINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLE7ED WI7H WHETHER SPECIFIE� HEREIN OR <br /> io� e�a� �� NOT. THE GRANTWG OF A PERh11T DOES NOT PRESU1dE TO GIVE <br /> .`tl C] -- <br /> ..µ�- I t�-�IAUTHOfiITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> �� O ' -Ff- 4 - �O - �j!I -�� 1 OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �. H� PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> y y OWNER OF THIS PROPERTV 70 PERFORId THF WORK FOR WHICH <br /> r� H y APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> � y CONTRACTORS LAW 1827 RCW AND 296.200 WAC ( <br /> �..� S�GN�iUREO�CONiPaCiORCRAViNOFiZEOAGENf C4iE �'Q� (I°� <br /> n d� <br /> � � t+� -. ��� � . 1 � � , � / ..J� <br /> y HO y oFaFCteDoaE55 - - � <br /> ACPLIGANiS Cii V pU5�NE55 UCENSE NO RNO BUSINE55 NAM <br /> � PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. iYPE OF E�UIPMENT FEE <br /> WATER CLOSET IT04ET1 J _ _ _ AC-A HNDLG UNIiS-FI P �__ <br /> ___'___ ..._ __ ___— _ <br /> i BATHTUB FORCED AiR Sv51Eh1S-B TU M F:.A <br /> .- __-_ __-_-. ___._ __-_-__-___�._.- ---_ -___._- __-..__._- `_ <br /> I � LnVATGR��WASH UASIN� __ UNIT HEAT[FS-B.TU A1 _ <br /> SHOWER CLOTHES DfiVERS <br /> �� KITCHEN SINK 8 DISP VENTILATION FAN � _ <br /> OISHWASHER RANGE HOOD <br /> , � LAUNDRV7RAV WATER HEATER _ __ ' � <br /> I _ CLOTHES W�SHER _ _ �vOOD STOVE — _ <br /> �� UPINAL �dF.TAL FIREPLACE 8 CHIMNEV <br /> DRMI(ING POUNTAIN �� PIREPLACE INSERT <br /> FLOOR DRAIN ' HEAT PUMP <br /> ' BACKFLO�N FREVENTERS ' GAS PIPING <br /> ,� ROOFDRAINS-RAINLEADERS � eXHAUSTFAN <br /> SINK�SERVICE-BAR,ETC.) ' <br /> �� - <br /> �� SUB TOTAI $ � SUB TOTAL S �) I <br /> �� _ PERMIT 5 _ PERMIT _ 5 __� ; � <br /> 1' TOTALFEE 5 70TALFEE S <br /> FOR OFFICE USE ONLY: <br /> FnOHi5ET84CK AEPRSETBa[N S��ESET6aCK �:>'+C�fenNL1:PEP . �E[ FCU'°*"'G <br /> •j�� .)•� •. . <br /> use 2oNe LOi PPE� v�cu+r SrtE FEES VALUATION FEE <br /> BWLOING <br /> nPIOfCONtS�LIOW�B�F IYVFOfCON$I�CiU�I o[['.Jv�M� M1Otn�Nflu4';ov.'.5 ---'— ----- <br /> �"aj° PLUMB�NG <br /> YIEDFBLDG NOOFSIORI[5 BASEMENi MECNPNICAL ' <br /> UGGUPANGYLOA� Fi�E51'RNnLERSAF00 NE!GN1LiM�1ATiON AD�ITiONALPIANCM6Ck � <br /> OTHER <br /> NEASON FOA SPAINNlENS —� <br /> STATE BUIL�ING SURCMARGE <br /> iNinK(B� PLAHS APPROVEDBv CITY OF EVERETT PUBUC WORNS <br /> � LOCALSALES <br /> TA%COUE IS 3105 TOTA� <br />