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. � -. <br /> Y <br /> fl� everett � ; <br /> < APPLICATIO�i FOR CONSTRI"CT�N PERMIT � <br /> TO BE COMPLETED IN INK—PLEASE PRIN7 <br /> tM Eveq�'n <br /> CITV OF } <br /> '��M -' eVel�e�l HEATINGSYSTEM: GAS OELECTRIC ❑_ , <br /> '� BUILDING DEPARTMENT <br /> � 259-8810 6� � <br /> � + DEMOLITION COMBINATION BUILDING r IIECHANICAL PLUMBING SIGN <br /> ��� OWNER M�RAO�R[55 Ci1V ! ItP PNONE <br /> � �������Q.F^ ��15 Snohomi �✓� EuG'P,t� S8.2o1 a5q-��5 <br /> Tf.N�Ni <br /> M�ILAODNE55 QTV 21F PAONE <br /> ��� � I, MRECT OF DESIGNER MAIL A�DRE55 OTY ZIP iNON[ <br /> � � Q3 � a LLEN ►.i <br /> O GENEML iP�CTOP M�IL�DORE55 GIiV ZIP PHONE LICENSE• <br /> �j <br /> ��� q GiTy ZiP PNONE ULEHS[/ <br /> MECHANiGiLLOHTAA�10�1 MPIL�DDRESS <br /> • : LiCENSE� <br /> � � ', PIUMBMGCONTRACTOR MMIAU�RE55 CiiY ZIP PMONE <br /> N <br /> fi � CUSSOFV/OAN . . . <br /> G� , � NEW - ADDITION ALTERATION � REPAIR DEMOLITION , W�DSTOVBPRPL INSERT ��.� BUILDING RELOCATION <br /> � � ppNTACTPER50NRNOPkOMENO. , <br /> 2�-v J as9-s <br /> �� �«��.�T��E�,�K �— <br /> pESLRIBE WOAN�NO50V�FE FOOi�GE iMVOIVE� OD T� <br /> �Di�U' ��J � <br /> � PqOPO5EDU5EOFBWWMG I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> ^{[/-'] APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � iEWLp�S�RIPiIONOPPROP[RTY ISNOWNBEIOW ONATUGMPOUHCOPI[5� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORH WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot B��K or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROV�SIONS OF ANY <br /> � � OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTIOF OR THE <br /> - PERFORMANCE O�'CONSTRUCTION.THAT I AM AUTHORRED BV TME , <br /> ` OWNER OF THIS PROPERTY TO PERFORM 7HE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY NIITH THE STATE �� <br /> CON7RACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> . SIGYRNPEOFCONiR11GTORORRUTN��GEHT DA1E <br /> �P�/�j2 I <br /> x o�� � �.��5 , <br /> PROJECTR�DRE55 �� / qpPLIGANTSCiTYBU5irvE55LiCE1iS IO�N�BUS�NE I <br /> S 3 •� <br /> i MECHANICAL <br /> -C�� ;; PLUMBING FEE , j <br /> FEE NO. TYPE OF EOUIPMENT � <br /> Np, TyPE OF FI%TURE OR ITEM q��AMNDLG UNITS--H.P. I <br /> `. � � WATER CLOSET(TOILET) � I <br /> '� gpTHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> UNIT HEATERS—B.T.U. M � <br /> � ��� E LqVATCRV pNASH BASIN) CLOTHES DRYERS <br /> SHOWER I <br /> ' KITCHEN SINK 8 DISP VENTILATION FAN <br /> �ISHWASHER RANGE HOOD <br /> r1 .� j LAUNDRYTRAV WATER HEATER — <br /> �j � CLOTHES WASHER WOOD STOVE � I <br /> i URINAL METAL FIREPLACE 8 CHIMNEV _ . I <br /> � FIREPLACE MSERT __�— <br /> DRINKING FOUNTAIN HEAT PUMP �� <br /> I ,_� � FLOOR ORAIN / <br /> ` BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DSAINS—RAINLEADERS EXHAUST FAN <br /> , . <br /> ' SINK(SERVICE—BAR,ETC.) �� <br /> ' 1�1�1 � � ; � <br /> , <br /> � ` <br /> ` �— � <br /> '�� SUB TOTAL S _ -- SUB TOTAL S _ r' � I <br /> PERMIT $ PEHMIT g LJ; <br /> TOTALFEE 5 TOTALFEE 5 J _ '. <br /> FOR OFFICE USE ONLY: necem-r+o <br /> REMSETpACN SIpESETBRGN PLnHC��C�N��� iEF ' <br /> FRON15[TUACK / � � <br /> vACANi SitE FEES VALUATION FEE <br /> USLZONE LOTARER �, <br /> BUILDING <br /> ivPE04CONt5A«OWR6lE ttPFOfC�NSt.ACTURI u[cpwp+ xawnn�uwc�Ni�- rWM81NG <br /> ✓� <br /> 52E OF BIDG NO OF SiORIES OASEMENT MECHANICAL �! JJ_ <br /> O[JUPANCVIOF� fIFESPRNRLER5RE0'0 IIE1GNtUM1TATION <br /> ADOITIONAL PLAN CHECK <br /> OTHEH �___�_ ' <br /> PE450N fOR SVRINwLERS ' <br /> STATE DUILDING SURCHARGE i <br /> ( <br /> iNrnKcev rur+snvra�veoer CITYOFEVERETT Puoucwor�Ks I <br /> LOCAL SALES <br /> TRX CODE IS 3105 TOTAL <br />