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�����t�; r��.�5:� <br /> � everett <br /> APPLICAT�lIN FOR �ONSTRIJG�ION �ERNIIT � ��� <br /> TQ BE GOMPLETED IN INK—PLEASE PRINT C �' I�r t5 � � I <br /> (nu Emrymen � � <br /> CITVOF HEATING SVSTEM: GAS I�� ELECTRIC ❑ � ���� I � � <br /> eVp r D�� RTMENT ' F EVERETT ts� <br /> 259 8810 CITY 0 <br /> i. <br /> f 1 DEMOUTION I ' COMBINATION BUILDING I i MECHANICAL I ij4{�,HIFjIN�it CounterSlGN <br /> NER IAAILA ORESS � GI Y �1`. / UP P I .�V'^ II! Y� I <br /> �xC�- � �C�� �.d�ti� - �c?�t- y -� � -�- _ ��. <br /> TENANT MAIL�DOFESS G7Y 21P PHJNE 1 , <br /> � il <br /> Af1CHITECTORDE5IGNER �d�ILAU0RE55 CIiY Z�P FHO�lE �� <br /> lj�, <br /> GENERAL NTF MMLAOOfiE55 CITY ZIP PNOZ{E IICENSE� � <br /> �� �d�eEY NATURAL GAS, INC. � ��� � � — �� I pi <br /> MECHANICAL CUN R6i ECT6�7 —'�"M�� � CITY ZIP PHONE LICENSE M <br /> 2605 MCDOugell ��' <br /> ���Ki—W�������� B CITV ZIP PHONE LI:ENSE� <br /> PW6181NGCONiR� O � � <br /> �_� <br /> CIASS OF WORK ) � <br /> I � NEW I I ADDITION . tTERATION i I REPAIR �� DCMOLITION I � WOODSTOVE/FRPL INSEHT I.i 9UILDING RELOCATION � <br /> cor+rncr rensori nr+o rnoHe r+o �' <br /> CONTRACTPFlICEOFWORK I� � I✓�� �/�� — p <br /> OESCRIOEL4 (iNARDS UA� f004GGINVOLVEU � �'�,� ��1 �' <br /> rt S���E� �U �Ll"1=�Cs' `- � � <br /> PFOPOSE�l15EOFBUiLOIN � I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> ���" � APPLICATION AND KNOW THE SAMf TO BE TRUE ANG CORRECT. ALL <br /> LEGALOESCRIPTIONO�PBOPERiV�SIIOWNBELOW O��iTACNFOUPCOPIE51 PROVISIONS OF LAWS AND ORDINnNCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior oiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY T^ VIOLATE OR ClNCEL THE PfiOVISIONS OF ANY <br /> UTHER STATE OR LOCAL LAW RE�3ULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTfiUCTI�)N.THAT I AM AUTHORIZED BY THE <br /> JWNER OF THIS FROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANC� I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW r�ND 296200 WAC. <br /> SIGN�7URE OF CONTP�CtOfl OR A�J�NOR ZF.O AGEM OAiE <br /> X ' k�� <br /> PROJECiAD�RESS I . ��.�� / , /� — <br /> ��� - L� �- �T APPL^�NtSCI7VBUSlt SLICE�lSENqANOBUSINESSNAME <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOIiIPMENT FE�_ <br /> WATEFi CLOSET(TOILET) � A/C-A/HNDLG UNITS-�H.P. _ � <br /> BAIHTUB ' fORCFDAIRSYSTEMS-B.T.U.1e E.A. <br /> L�VATOFlY(WASH BASINj --� UNIT hIEATERS-B.T.I�. M �_ <br /> SHOWER `_ _ <br /> CLOTHES DRYERS ' <br /> KITCNEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER �— RANGE HOOD ' <br /> LAUNDRY TRAY ; WATER HEATER ' _ <br /> CLOTHES WASHER WOOD STOVE � <br /> URINAL ' METAL FI�EPLAC`_&CHIMNEY _ ' <br /> DPINKING FOUNTAIN � FIREPLACE INSEaT � <br /> FLOOR DRAIN —'_ HEAT PUMP _ ' <br /> BnCKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DP.AINS-AAINLEADERS � EXHAUST FAN � <br /> SINK(SERViCE-BAR,ETC.) I — <br /> � <br /> � ' <br /> _ T <br /> �� � I <br /> I <br /> I <br /> T �— <br /> I <br /> SUBTOTAL $ ; SUBTOTAL S d ' -" <br /> PERMIT $ � PERMIT $ � <br /> TOTALFEE $ ' TO�fALFEE $ ' � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK RFARSETBACN SIOESEiBAGk PLANCHECNNUMFEF FEE RECEIPTNO. <br /> use zor+e �ot nnen VACANT SIIE FEE'i VALUATION FEE <br /> � <br /> BUILDING ' <br /> �— <br /> 1YPEOFCOHIS.ALIOWABIE IYf'FO(CONS7.ACIU�I OcturasCr uoOrGwtwNGUHnS � <br /> �nour PLUMBING i <br /> SIZEOFOL�Q. NO.OFSTOfiIES 0��3EMENT �� '� <br /> MECHANIC�I _ I <br /> OCCUPANCYLO�� Flf1E5PRNNLE�SREO'D NEIGIIILIMItAiION AD�ITIONA'_PLANCHECK i <br /> i <br /> OTtIER <br /> FEASONFORSPRINKLERS i <br /> STATE BUILDING SURCHARGE � <br /> --_ i — <br /> INTAkEBY P�!15APPROVE�OV CITYOFEVEREIT PUBLICNOflNS i � I <br /> LOCAL SALES I <br /> TAX COUE IS 3105 T�TA� S3 I .— <br /> . _. . . .. . <br /> _ — —� <br />