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APPLICATIV►':a FOR CONSTRUC7'�i'ON PERMIT everett <br /> rnee�-��p,��n TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CIiV OF <br /> everett HEATING SYSTEM: ❑GAS 0 ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> i DEMOLITION i I COMBINATION �BUILDING r IMECHANICAL �(�PLUMBING I I SIGN <br /> owruen Mniuooness ` ertv zm PIIONE � <br /> �V�'/���r' Pr�l�K3 ��'Or �ooz u,t�TrxvR[s �-o3mo <br /> tEN�NT M�ILADORESS CIiY ZIP PHONE <br /> �V�A�rr Pil��tKs a�rr <br /> nncra�ecio�oesicuen uaanooness cirv zm rr�oNe <br /> �VO�(6!`T /'/J'/�Kf� ��dNI7 y h�'t �St�c�� �RoDun_ <br /> GfNEfULCONifUClOf1 M4ILADOR[55 CI1V ZIP PNONE LICENSEI <br /> D/��il� LO�vs7'Rv�no.d <br /> 1,1[LNANICqLCONIqnC10R MAILAODRE55 GITY 21P PMONE LILENSEI <br /> � T/�-T� /�I,�G/�, ^� 5 rr�r� �ac �4i�� <br /> PWMBMGCOMMCTOR M�IlA0URE55 CI'iV ZIP FHONE r/ UCENSEI �� <br /> sTnnf �Y��� . <br /> LLASS Of WORK <br /> X NEW I I ADDITION � I ALTERATION I I f7EPAIR � I DEMOIITION I l WUODSTOVE/FRPL INSERT f_7 BUILDING RELOCATION <br /> �D,O�O CONt�GT PERSON ANU PHONE N0. <br /> cor�mncrrniceorwonK ���j��/� 25"J-03ad' <br /> U[SCRIBE WORK�NO SOUAIIE FOOL�GE INYQV[D <br /> ga�tt STat'�lrc� ONJ� 3200 5a .��• <br /> PROPOSEDUSEOfBUILDING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> _�C((j�iJ �f1-G I�BCv/N/,r 9Yf�CG Sr//(/I(r/L APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHECT.ALL <br /> I.EG�L DESCf11PTI0N OF PPOPEqTY�SNOWN�ELOW Oq ATIr1CN fOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEHEIN OR <br /> ior o�ocK or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> G{J�z ,S, IIP � T� Z� N �� M. OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT!ON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPFRTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNATUf1EOFCON7qqCTOf101i�UiNOR12EDRGENT O�TE <br /> f`R0.1EGTpDDRE55 �>d�c�i7a�v�—P��/ � �/ �� �yya� ;.� /2j19�a <br /> QDb 5�'iTlf Is�H�vn_ RoAp `��R VIL(.p APP��CANL�CIttBU5ME55110 NSENO.�NDBUSMESSN M�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EUUIPMENT FEE <br /> WATER CLOSET(TOILET) WC—NHNDLG UNITS—H.P. <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES DRVERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRYTRAY ; WATEF HEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL � METAI FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT ; <br /> FLOOR�RAIN � HEAT PUMP <br /> BACKFLOW Pf1EVENTERS GAS PIPING � <br /> � <br /> t700F DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ET0.�, � <br /> -� � �� —av ' - � <br /> � �— <br /> � ; <br /> SUB TOT�L $ ,D ; -- SUB TOTAL $ ' <br /> _ PERMIT $ �p— PERMIT $ i <br /> TOTAL FEE $ o ;� TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: <br /> fRONi5E18ACK BEARSEIU4CN SIDES[ID4CN PUNCIIELKNl1M0EN FEE RECEIPiNO� <br /> use za+e tor nnen vncnNi sire FEES VALUATION FEE <br /> DUILGING � <br /> IVPC Of LONIS ALIOWABLt IYPE Of GON51 ACN�L accurnqcv NO n RMLLniGUNrtS <br /> �a�v PLUId01NG � <br /> 3� ; <br /> sizeoroioc. r�o.oFsromes onsrrnr:rvr MECH�NICAL � <br /> OCCUPpNCVLOAO fIRESPRNKlERSR[00 NEIGHiLIMI1RiON ADDITIONALPLANCHECN � <br /> i <br /> � <br /> OTHEfi i <br /> — � <br /> HE�SON FOR SPNNNLERS �— <br /> STATE BUILDING SURCHAliGE � <br /> MI�NEt1Y P�qNSAPPROVEOBV CITYOFEVERETT PUBLICWORKS � <br /> LOCAL SALES ' <br /> TAX CODE IS 3105 ioTn� 3 e ' — <br />