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. ^ .- � <br /> APPLICATItiN FOR �QNSTRUCI .ON PERIII�IT <br /> ms evsro,s,� everett <br /> ���� e <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DE:.IOLITION COMBINATION _� BUILDING MECHANICAI PLUMBiN(i SION <br /> OMMER MAK�UDf1E85 f.ITV zIP PHONE <br /> �y,�r�s.1e�� S {u� 'IL� -►e.G�' !S[" ie. � N/1 �rl�b S4l t195 <br /> � TENANT T M�IL�ppRESS - <br /> CICV TiV� PHONE <br /> •R(NiTEGT OR(iE5!6NER MAtt I�D�RE55 •�Tqy� tip p1qNE <br /> �W Gl•�� i�AO �4� T�SC l�r Wh'C �_r+wM� �.�. �OSiL �3� � <br /> OEI+ERQ CONT"�[fOP MML�DARESS C�TV 21e pMONE IICENSE I <br /> �:� /rix� laD2. - ID� �MOMa�+►SN 1�1l. 9 _19L�0 ��111$ t1.3o�4f+T1�J�L1L� <br /> dECH� 1CAlCf.NiR�CiOR MM.�ODRE59 CITV�—� zIP PhJNE iICEN5E1 <br /> Pll1A1BIRG CONiR�GTOR MML�DORE59 Cliv IIP PNpNE IICEN9E� <br /> cuae or vronK -- <br /> i I NEW � ADDIT'ON qCALTERATION REPAIR DEMOUTION WOOOSTOVEIFRPLINSEFT i i BUILDINORELOCAT�ON <br /> TEN�NT�MPROVEMEN�Ul f+TER�R REMODEL ONIY GONi�CT PERSON ANO PNONE NO <br /> CdRRACT PRICE OF WONN�. �IS�� v� ��) �3_� <br /> DEBCRIBE VYORN AND BOW RE FOOTAOE RNOLVEO <br /> �1�a.+++.+c a;.r.o ��`nn, _ <br /> PROPOSEO UBE OF BUILOMNi ' � `� '— <br /> I HEREBY CEHTIFV THRT I HAVE READ AND EXAMINEO THIS <br /> O�_1.tS {i. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> LEWLDESCRIPTqN 'PqpYER`Y151bWNBEIOWOR�ITACNFOUqCOPIES� PFOVISIONSOFLA�NSANDORDINANCESOOVERNIN(3THISTVPEOF <br /> WORK WILL BE COMaIETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot e�xK or NOT. THE r3RANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORIYV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL lAW REQULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF TF'IS PROPERTV TO PERFORM THE WORK FOR WHICIi <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTOR;t lAW 1827 RCW AND 296.200 WAC. <br /> SION�T WEOFCONf9�CTOROR�UIHCR�yEDA6ENT U�iF <br /> X <br /> PipJECTADORESB <br /> 1`� . ��tM `-u �'p R� rG � � �PPI�G� iSriTyBU51NE5SlIC NSENO �NOBU9MESSN�M[ <br /> /�M�K G. /r`M <br /> PLUMBINU MECHANIC:AL <br /> NO. TVPE OF flIRURE OR ITEM FEE NO. 'fYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) ArC—�A�HN:LG UNITS—H.P. <br /> BATHTUB FOR(:EO AIH SYSTEMS—B.T.U. M E.A. <br /> LAVATORV(WA9H BASIN) � UNIT 4EATERS--B.T.U, M <br /> SHOWER � CLOTHESDIiYERS <br /> KITCHEN SINK 6 DISP VENTIIATION fAN � <br /> DISHWASHF.q � RAN6[HOOD � <br /> LAUNDRV TRAV ; WATER HEATER <br /> CLOTHES WASHER � WOOD STOVF <br /> —•-- <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> OHINNING FOUNTAIN i FIRFpLACE INSERT ; <br /> FLOOR ORAIN � HEAT PUMP � <br /> BACKFLOW PREVENTEHS ; pAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXNAUSi FAN � <br /> SINK(SERVICE—BAR.ETC,) <br /> � ' <br /> I - �T <br /> - I __- 1 <br /> SUB TOTAL S SUB TOTAL S <br /> PEPMIT S � PF.FMIT S <br /> TOTAL FEE S TOTAI.FEE S <br /> FIIONTBETB�CR RE�RSETti�f,H SIOESEiB�CX PLANCNECKNUMBEP FEE RECEIPTNp <br /> o sYsf � oS ,3o J8s7 <br /> use za� LOi AREA WC�NT SItE FEEB VALUATION PEE <br /> C�I� VES �NO BUILDINO �G� ; o0 <br /> IYPEitLYYi1�LlOWABIE �^'r^�IACIWDI ocn�wxcr xnnowt�.i�x;uMi�s . _.__ <br /> � � II� �IH/` �v �� PLUMPING <br /> BIIEOFBLIX3 NOOFSTeRIES B�SEMENT MECHIINICAI <br /> QZU � VES NO -- -- -- <br /> OCCUP�NCYIWD FIRE`S/PqryI(LfAiNEOO HEqNTLIMITdION OTHER � <br /> � IkS NO S7RTE BUIlDINO SURCHAR6E <br /> RfASdi fOR BPAMNIEPS /` — -- �T�D <br /> STATEENEROVSURCNARGE <br /> �iPLICQ10NACC BY PIAN511P pOVE 'BV CITY OF EVERETT PUBUC WCRNS � <br /> � � LOCALSALEB � <br /> � �j TAX CODE IS J105 roru � � � � <br />