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,��� <br /> . p rr ; � <br /> ; '-`' � i�5';!1 C% �; ;.;w�� <br /> APPLICATION FOR CONSTRUCT p R�N�i �<�i <br /> A P � 19g.� �`. `�y <br /> m.e� .................... everett 6 <br /> c�rvoF CITy..OF............... <br /> eVerett Publid Vyo ks oR�� ~ � � <br /> BUILDINd DEPARTME�NT ept, � .�.�� <br /> 259-8810 TO BE COMPLETED IN INK—PLE�A E PRINT .,;p.� <br /> ❑ DEMOLITION �� ❑ COMBINATION CI BUILDING W'MECHANICAL ❑PLUMBINO ❑ SIGN'���� <br /> p M�0.ADDRQSS CITY 21P PNONE 3� _.,SL <br /> �cv�rwc�'rL zloo o �lq-t+'� P � u�o G�ao3 �nc� ,;`� <br /> iEWWT IAI1RApppEeS/���� Q� GTV ZIP i110NE � <br /> NW�� �— ' ' � ' i'. <br /> 11RLNTECTOROESIONER WIL1100lIESS CITY 21P Plp'IE . ' '. i: <br /> OENE WLL CONTMCTOR AMIL 11DURE88 CITY ZIP VNONE LICENSE/ '.�� <br /> , �Sll11lD I V` II�fo305 SI,RT�(L �}UF �Y K1P IA�A) qY,ll'�1 S?� y4bL�� 1 ;:��e <br /> ,. � <br /> r�warro caririucron �.uw�ooness atr -�: � <br /> ZIP %qNE LICENSE 1 . <br /> ClASS OF WO1Mt .� <br /> I..I NEW I 1 ADDITION �ALTERATION I 1 REPAIR I.I DEMOLITION I I WOODSTOVEIFRPL INSERT ❑ BUILDIN(i RELOCATION <br /> 7ENANt MPIqVEMENT OR MITERqR�MODEL ON/I.Y� .� CANTAC7 PEPSON MIO PlIONE NO. <br /> CAh�nllCiVRICEafW01Vc: ��pcO ` <br /> DESCN�BE W011K 60W1RE FOO7�OE U/VOLVED <br /> �� rmi�n � <br /> vnoroaeousEa��,'� ^ n�� I HEREBY CERTIFV THAT 1 HAVE READ AND E%AMINED TNIS <br /> VI 6N 1�W 1 1 L APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � lEML0E5CMPilONOFP fl V�Sf10WNBELOW011ATi11C WflCAPIES) PROVISIONSOFLAWSANDORDINANCESOOVERNINOTHISTYPEOF <br /> WORK WILL BE COMPLETED WITN WHETHER SPECIFIEO HEREMI OR <br /> ior eioGc oF NOT. THE (iRANTINO OF A PEPMIT DOES NOT PRESUME TO QIVE -• <br /> .� p( /� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION3 OF ANY ; <br /> il ��"� ' O • O OTHER STATE OR LOCAL LAW RE6ULATINO CONSTHUCTION OR THE •..• � <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE �� <br /> OWNER OF THIS PROPERTV TO PERFORM THE WOHK FOR WHICH �� <br /> APPLICATION IS MADE AND I COMPLV WITH THE BTATE �.;�, � <br /> CONTRACTOR9lAW 18.27 RCW AND 298200 WAC. ��; � <br /> SN3NATU EOFCONIMCTORqiAUTHOHIZEDIIOENT WTE <br /> X umJlml� Vl'�G �g a oq��2 � . <br /> i PRPJECT AODIIE89 Q� : <br /> IIPPLM.�WT9CI�YBUSINESSL EN {iO.ANDBU5R1E68NM1E �Y� ( <br /> - PLUMBINO �' � <br /> MECHANICAL <br /> ' NO. TYPE OF FIXTUflE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE .I <br /> WATER CLOSET(TOILET) � AIC—AIHNDL6 UNIT�H.P. , ,� <br /> BATHTUB ' FORCEDAIRSYSTEMS—B.T.U. M E.A. � I <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ' � <br /> SHOWER � � <br /> CLOTHESDRYERS � �' � <br /> �V KITCHEN SINK 8 DISP - � VENTILATION PAN � ' + <br /> DISHWASHER � �' � <br /> RANCiE HOOD � <br /> LAUNDRVTRAY ; WATER HEATER � `• � <br /> 4 <br /> CLOTHES WASHER � WOOD STOVE , •J <br /> URINAL ' METAL FIREPLACE 6 CHIMNEY � ` <br /> DRINKINO FOUNTAIN � FIREPLACE INSERT ; •} <br /> FLOOR DRAIN � HEAT PUMP � <br /> � BACKFLOW PREVENTERS ; OAS PIPINO ' � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � �! <br /> SINK(SERVICE—BAR,ETC.) ' � �j <br /> — � <br /> � � <br /> � i � Sr <br /> � i j F� <br /> . ' �' . �;:i � <br /> ' ' �, <br /> SUB TOTAL S i SUB T01AL = ' �� <br /> 'ii <br /> PERMIT . S � PERMIT S � ;; <br /> TOTAL FEE S ' TOTAL FEE � � !�' <br /> 'lqNi6ETl11CK REMSEI&1C1( SIDESETBACK FLANCHECKNUMBER FEE HEGEIPfNO. <br /> s�mne IOTMEA V�CANT6ITE FEES VALUATION FEE <br /> C.I VES C'1 NO BUILDINO . i � '� <br /> rr[acoxscaiow� ivnacoxsr.�croa OCdIMFC/ Ip.OfDW[LLMOUMI6 � <br /> � PLUMBINO <br /> i <br /> �ZEOFBLOO. NO.OFBTOn�E8 BASEMENT MECHANICAI i �• <br /> ❑ res ❑ No —}-- ' '�' <br /> CGIPANCYLWD FMiESVRNI(lERSiIEffD HEqHTLM1IT�TION OTHEH j _ <br /> , L7 VE3 ❑ NO SiATE BUILDINO SUHCHAROE i <br /> 3ABON fOR 6iRll�ltlEp9 � � <br /> ST11TE ENENOV SURCHAR(iE � <br /> wuuraa�cc.er rurrs�rvnovEoar CITYOFEYEREIT pUBLICWONNS � <br /> LOCAL SALES � <br /> � TAII CODE IS 3105 TOTAL ' <br />