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APPLICATIC _� FOR CONSTRUCT_ JN PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GA£ ,CLECTRIC U 1 <br /> 259-BB10 <br /> DEMOLITION ' COMBINATION Y BUILDING �MECHANICAL f'pLUMBING SIGN <br /> �O NER M�il DDRE55 �� CiIY ZIP PHONE <br /> ���IISiY�'_ F,JU�T� YG' �����_�%c�203 ����- �?Z�� <br /> iEN�Nt uqILeDDHE55 Crtv 71P PNONE <br /> ��NRECTORpE51GNEp M�IL�D�RESS citv ZIP PNON[ <br /> ---��"� �./�,ee iT _ �;.t�7-Q�9y�/ <br /> GENE AICONTMCTOR M�IL�DO�ESS Piv ZIP FHOIlf ST�T[LIC NSE/ <br /> b��a11,:�P� CGNST, ('n�,, � = . �r _�3_ 3 --3 ,>9 ��n;m �te�� o� <br /> MECM�N!C�LCONip�CTO MA�L�O�f1E55 cCi7�V',, 71i PHONE SiATEUCENSE� <br /> -�L•11J1L—���'X1TI1�7(.� —�G�� �;��-�y�� <br /> PlU INGCONiPACTOR M L RbURE55 ,7 Fi1Y LiP PIIONE SiFtE l CENSL� <br /> _��(__(� .Lt h� 7'�� (�,��1�'�L' J�C��/ __7`l -n/ ' _ <br /> CU55 OF WORK ——_ <br /> K NEW ADDITION ALTERATION REPAIR DEMOLITION WIXIDSTOVE;FAPL INSERT BUILDIN:i RLLOCATION <br /> CONTALT PERSON ANfI OYE IIO <br /> CONiR�CiPpICiOiWONK r^' ��.5r�,1=__ ���(J -,5�����_ <br /> +.u�a-��� `�Q-� <br /> DFSCRIpE N'ORK�ND SOU�FE FWT�GE INVOLVED <br /> cS i�T�t,uzS�—l��$'�,.� <br /> �PROP SEOUSEDFBUI�a r I HEREBV CEHTIFV THAT I HAVE 4EAD AND FXAMINED THIS <br /> .I�S APPLICATION AND KNOW THE SAME 10 BE TRUE ANU CORRECT. A�L <br /> �ecetoescaiviaNnvvnovearvisNowNeei.owoa�rraa�vovncories� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> � WORK WILL BE COMPLETED WITH l'JFETHER SPECIFIED HEREIN OR <br /> wt�_ BIOCN _ OF _��i��r�� NOT. THE GRANiING OF A VERMIT DOFS NOT PRESUME TO GIVE <br /> � 9y ����J AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> F � O/ � 1 , nf�2 OTHER STATE OR LOCAL LAW REGULAfING CONSTRUCTION G�1 THE <br /> PERFORMANCE OF CONSTRU�TION.THAT I AM AUTHORIZED OY THE <br /> OWNER OF THIS PROPERTY TO PEPFORM THE WORK FOR WHI(;N <br /> — APPLICATION IS MADE AND I COfdPLV WITH TNE STAI E <br /> CONTfiAC70RS LPW 1827 RCW AND 296200 WAC <br /> �awect�ooAess / x,��.�����—�.'�"`n`'�=-- .— — <br /> � _ ' � � " (i�vqiltiNlSSi.'CINS[Ii0 <br /> PLUMBINO MECHANICAL — <br /> NO. TVPE OF fIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> ,3 WATER CLOSET(TOILET) A'C—A'HNOLG UNITS—H P <br /> BATHTUB FORCED AIR SVSTEMS—D.T U. M E.A. <br /> LAVATORV(WASH BASIN) UNIt HEATERS—B.T.U. M <br /> SHOWER CLOTHES ORVERS T-- <br /> KITCHEN SINK 8 DISP i � VENTILATION FAN � <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRV TRAV WATER HEATEA � <br /> � CLOTNES WASHER WOODSTOVE <br /> _ URINAL METAL FIREPLACE 8 CHIMNEV i <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS _3 GAS PIPING <br /> POOF DRAINS—FAINLEADERS EXHAUST fAN T <br /> SINK(SERVICE—BAR. ETC.) <br /> -- —�-- <br /> SUB TOTAL $ SUB TOTAL $ <br /> _ PEqM1T $ PERMIT 5 <br /> TOT�I FEE $ TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRJNTSFLBACR REARSE�dACN SiDESEiBACN PUNGHFf.NIyIMP� �f.f PECEIViNO <br /> ri <br /> �J � Z�� Z� , vF �� � 1 ���/7 <br /> useza+e iot�ae� v�e�nTsrtc FEES `VALUATION FEE <br /> �- I � 32g ���5 � <br /> oui�oiNc S 5 �J f��,.�lJ <br /> IVVEOfGJNiSAIIGWABtC rvV[pl�pNS�ACIV�I nrmrvy�.� hor�rrmtinxcun��s ------- <br /> � � ',�� � PLUMBING <br /> Si1E OF 6L00 NO OF ST qIES BASE ENi �/��— <br /> ISYZ S/ L����M+ � O MECHANICA� — /_/�i— <br /> _IK <br /> OCCUPPNLYLORD FIRESPqNNLER5RE0'0 HEIGIRII)MiIRT10N ADDITIONALPUNCHECK � <br /> _"�� �' i <br /> SPRINNLER <br /> AE�SON FORSPRINNlERS <br /> -_��__ <br /> 6TAiE BUILDING Sl1RCHARGE � �G <br /> INr�KE Bv PLRNS�PP�Ovp08v CITY OF EVERETT PUHLIC WORKS /� i �. <br /> J i� LOCAL SALES ' <br /> �'-���,t�,l TAl(CODE IS 3105 rorn� � <br /> - �.� 1 ; <br />