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T�i <br /> x:: <br /> ,{:�...�r. � �! <br /> " APPLICATIOr�I FOR CONSTRUCT.�1N PERI�zIIT everett , <br /> TO BE COMPLETED IN G. PLEASE PRINT � <br /> tne Evergreen <br /> ci�v oF <br /> r;��� �� everett HEATING SYSTEM:� U ELECTRIC �� � <br /> � ,„ BUILDING DEPARTMENT ,a,,.,,,,�� <br /> � 259-8810 LUMBING 1 SIGN '' <br /> ` i COMBINATION BUILDING ',)(MECHANICAL '.-)P � <br /> �� 7 DEMOUTION X Z,P P„rn,E _ <br /> OWNER M11LAD�RESS CIiY <br /> y L .�,�e. 'lflo''iro "5�3�v.f. c <br /> ' H (� C'I�w.n�5 it�lr.'L-3$'�R�S.w. �ifZlF+�t _ �. <br /> f� NAILAD�RESS GITV ZIP PHONE <br /> ��^ E4RNT _ — <br /> 9 <br /> MRILAODfiESS CIIY Z�P PMONC <br /> y� x� qq�MITECTORDE5IGNER '�� w � yp�__� ���e�.7L'�„ <br /> i.7 l. ^ cR� 7 <br /> t9 /�. JI[4�'�/�i �Z..��� �� <br /> [VR l�'w� �n�se»�_�_.� CITY 21P PHONE LIGENSE� <br /> ri C QENERAICONTRACTOH MNILRDDflESS <br /> 57•.. .. , -r'�bWL4'�'rc.211ut'3�e."i �l�+�� 4Uc�� �iSb—L93S t'�?•uv-��T231.�lA <br /> Q��J . ��� Z�p PHON' LICENSE M � <br /> � MECNANICALCONT ACTOR MpILA00RE55 <br /> � _ W�uu..,rt.a+c.'e-^�a=,,� —7"14"9991 <br /> M ���"��' CITY ZIP PMONE UCENSE� <br /> /.�' PLUMBINGCONTRACTOR M�ILF90RES5 -�4.s�6Y'S <br /> N vF(�'L�I.X�.a..v� '�3"r' � <br /> �� GUSSOFWORK . - <br /> �y�p Ix NEW L:�� ADDITION .- ALTERATION �_ REPAIR � DEMOUTION '. �. WOODSTOVJFRPL INSERT LJ BUILDING RELOCATION <br /> �� 7 fl 7S �� TACT PENSON ANO PHONE NO. <br /> d� ' cBt��-c�b- --x� <br /> � COMTRALTPRICEOF\YOflK �LO O� � <br /> (/� DESCRIBEWOflKANOSO�UAREF(�OTAGE YVOLVED <br /> `— � PROPOSEDUS�FBUI DIMG� � � <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � �� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESCRIPTIONOFPROPERTY�SHOWNN�LOWOFRTfACMFOIIRCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> � WORK WILL Bc COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT � o� g�p�l( �_ OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY � <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE . <br /> �-hY"� PERFORMANCE OF CONSTRUCTION.THAT I AM�UTHORIZED BY THE <br /> OWNEfl OF THIS PROPERN TO PERFORM THE WORK FOR WHICH � <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> - CONTRA ORS LAW 18.27 RCW AND 2962C0 WAG � <br /> SIGNRTUflE FCONTRRCTOflORAUTHOFIZEDAGENT �ATE I <br /> I <br /> G�i3 — I <br /> � PRQIECTPLDRESS Y8 �' I <br /> ppp� I BUSINESSLICENSENO.PNOBUSINESSNfME <br /> ��C'� X x MECHA AL I <br /> PLUMBING FEE I <br /> � i Np, TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> � WATER CLOSET(TOILET) � - A/G-AIHNDLG UNITS-H.P. <br /> � �- ��� p � � � FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> �� � BATHTUB <br /> � UIVATOI�Y(WASH BASIN) p � - UNIT HEATERS-B.T.U. M i <br /> i CLOTHES DRYERS . <br /> � SHOWER ��_ VENTILATION FAN � <br /> � \ KITCNEN SINK 8 DISP � I� <br /> � DISHWASHER _ ��- RANGE HOOD <br /> r� LAUNDRY TRAY WATER HEATER � <br /> CLOTHES WASHER / �� �MOOD STOVE � � <br /> � I URINAL METAL FIREPLACE 8 CHIMNEY �. <br /> FIREPLACEINSERT �� ' � <br /> � �� DRINKING FOUNTAIN HEAT PUMP � �� <br /> �I I FLOOR DRAIN _ � � <br /> 9ACKFLOW PREVENTERS GAS PIPING ,. <br /> � ROOF DRAINS-RAWLEADERS _ EXHAUST FAN _ � <br /> i. '�� SINK(SERVICE-BAR.ETC.) . J � ' . _ . / .F� V,l'> �1O � d'� ��, <br /> ��� � <br /> �T <br /> �_� — SUBTOTAL $ �= PERMOTAL � ��U �i%� '. <br /> PERMIT $ -� <br /> - TOTALFEE 5 Cab � TOTALFEE $ �JD'D7 <br /> FOR OFFICE USE ONLY: 3I�. �3 ' <br /> pLAN CME N NUMBER FEE PFCEIPT N0. <br /> �qON"f SEIBFCM REPF SETBAGK SIOE S ��ACN 8 f,� ; <br /> z p, u 5"' z , 3� � �:f y� � �� y 3.s;-�� s� <br /> FEES VALUATION FEE <br /> USF.�`F.I `OTpREA VAG4NTSIi[ � <br /> 88 � sui�oirvc �93,45 �a : -'O <br /> IlPEOIGONiS.ALLOWM1BIE lYPEOFCONSi.ALiV\t Mcq�Ur[� xom1'xmincw�ns rWMBING V� ' Gu � <br /> _ - R�3 n � <br /> SrzE oF e�_UG N0.oF Si0RiE5 BnSEMEN� MECHANICAL 7J � � � <br /> ,a�s Sf-� y ,v, <br /> S5 Sl' G — AD01710NAL PLAN CHECK / ' 9J � <br /> OGGIIPANGY lOAO FIPE SPRNNLERS fVEO'� HEIGHT�MIT�TION � I <br /> n/O Z OTHER � . <br /> REASO�SPRINKlERS � ���' <br /> STATEBUIL�INGSURCHARGE . i <br /> INTAKE BY PLANS APPROVEO BY CITY OF EVEREIT PUBIIC WOflKS �� '�l J � <br /> /J� LOCAL SALES �,- ' � � <br /> �r �=�i7 TAl(CODE IS 3105 rorn� -3 ��=' <br />