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[�7 [+1 � <br />�� xi <br />C H <br />ay�Gti <br />HZH <br />tC f� <br />H Xl <br />� H '�I <br />yN <br />[�70��3 <br />� M <br />H�g <br />�1]Y (�] <br />z9H� <br />t'�yx <br />HH <br />g`� <br />H <br />C�Cu� <br />��M <br />HO� <br />�. <br />1 <br />� ��� <br />� <br />��' <br />APPLICATIOrr FOR �ON�aTRUCT�dIN PE'RR�IT `'``'"'" <br />,�_ .,,,. ,, TO BE COMPLETED IN INK—PLEASE PRINT � <br />❑lY Of <br />everett HEATING SYSTEtd: 'e�GAS J ELECTRIC L� __ —__ _--� <br />BUILDING DEPARTMENT �--- <br />259-0810 <br />/DEMOLITION COMBINATION �BUILDING _ MECHANICAL PLUMBING SIGN <br />o�srveu mn��nooaEss crtv n> crrone <br />.rt.o.n�w�i�.. �.¢�E� _ g'L�'j Cou.eUE wa.`t 'N c��Tn� 4 0 �i �iSo <br />rcr•nra mm�-nooa=_,s cnr . w�onc <br />nac�uicaoaoes��c�+ea nmanom;[ss cnr ziP r��o�+E <br />_..• - - � ... .. _.. i a.-� o, �o� _ .in �sr �x.� Ftwv�wtve �nU,. 9So2� <br />G/LN�L�RA�CONIV1AC10R-'�—��lANLADORE55 Li1V ]��' PHCNE l�bcn>cr <br />Vr`I� \1Je'f� _— <br />�+sr�� <br />l�CCH�NiCALCCNIRRjC�IJ�1 MSiLAC�OP��C.yStiy�� CitV ZiP ��WtlE LiLLNSEt <br />v+4Jr/� —CL{-- �nT/1�� __ _. <br />PWMO�NGCONIINCJOH I.NiIA��RE55 GITY Z�P PMONE UCENSE• <br />CI A:u Of 1':OIiN <br />/NEW ADDI � ION <br />PqICE CF 150Ra <br />fORNAND50UAR[GOOiAG6 <br />!�' 1-1 V I h <br />use oF omioirv� <br />LEG>L J[ W RIPiION O� PROPt <br />Lpi OIOCN <br />AL <br />'L'31 t� hu M M ff La� <br />PLUMBING <br />NO. TVPEOFFIICTUfiE <br />WATEFi CLOSET �TOILET� <br />y BATHTUB <br />y LAVATORY (WASH BASIIJ� <br />� SHOINER <br />KITCHEN SINK 8 DISP <br />� DISHWASHER <br />LAUNDRYTRAV <br />( CLOTHES WASHER <br />UPINAL <br />ORINKING FOUNTAIN <br />fLOOR DRAIN <br />BACKFLOW PREVENTERS <br />�DEIdOLITION WOODSTOVE�FRPL INSERT <br />I CO4tAQ PERSCH AN� PNO4E h0 <br />BUILDING FELOCFTION <br />( � J � SI �U <br />� I HEREBV CERTIFV 7HAT I HAVE READ AND EXAMINED THIS <br />APPLICATION �1ND KNOW THE SA�IE TO BE TRUE AND CORRECT ALL <br />�owoa ntrnoi i�oun mr=iesi PAOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COIAPLETED \YITH WHETHER SPECIFIED HEREIN OR <br />oF NOT. THE GRANTING OF A PERMIT OOES NOT PFiESUME 70 GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE <br />.�1C PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOFlIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 FCW AND 296200 WAC. <br />SIGNRtUPEOFCONiRAC10RORAUIrOH2[D G' i y /0/iL �/ <br />�('� � C��1l�� K�� <br />APPLIGANiSL�lY9l1:P-'LiCCNSF110Af1�0U51N���� �� <br />ITEM <br />SUBTOTAL <br />TOTAL FEE <br />FOR OFFICE USE ONLY: <br />�RONiLFIDACn � PFARSEtBAGK <br />�,�' zs>' <br />usEzo�y[� �o*nnEn <br />�-Z oGo <br />i�r�orconis nuc�n�ua�c rvrEovcoxsr.aCtwi <br />size or e�oc <br />II'o8 %f t <br />��,f.., i3. <br />�.-u <br />NO OP SiORIES <br />PEE NO. TrYE oF1 <br />/(�'— A�C—A�HNDLGUNIT <br />��,__ _ � FORCED AIR SYSTE <br />UNIT HEATERS—B.T <br />/( �_ 1 CLOTHES DRYERS <br />�' VENTILATION FAN <br />— � RANGEHOOD <br />_� WATER HEATER <br />WOOD STOVE <br />MEiAL FIREPLACE ! <br />FIREPLACEINSERT <br />HEAT PUMP <br />. ✓ GAS PIPING <br />n/U evaoiNc <br />MNinVCY NO tN:YMlV4L1�iH�6 — <br />�ao;o � PLUM�ING <br />„Z <br />OASEMENT tAECHANICFL <br />v — <br />R�DITIONAL PI AN LHLCN <br />FIR[SPRNMLERSRE00 NEIGHTLIMIIAiION ' <br />/ — <br />N`� OTHER <br />STATE �UILDING SUFiChqqGE <br />r�nr�snaraovFonr CITYOFEVERETT ruoucwonKs <br />LOCALSALES <br />C%'%� q/„ TA% COOE IS 3105 TOTAL <br />T.U. M <br />� r-� �. . �_�_ <br />SUB?OTAL 3 �i%�7'� <br />PERMIT 5 <br />TOTALFEE 5 � <br />?n /rn <br />FEE RLC[IPLNO <br />2 9�r 7�`" S 33G <br />VALUATION FE <br />�60 -� ��ln��lU(, <br />i�ti�/; <br />