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APPLICATIC ) FOR CONSTRUCT' 1N PERMIT ��� <br />TO BE COMPLETED IN BIACK INK—PLEASE PRINT <br />�. <br />BUILDING DEPARTMENT HEATING SYSTEM _GAS J ELECTRIC J____ <br />� ---- <br />259-8810 <br />DEMOLITION {:QM9�NA��� '�+���d��f7� ii�Crljl�UQ^j:,.�11i9y�LUMBING SIGN <br />nWNFH MMl enORFSti C�iv 71n �y!RVNtNlE <br />�ivrsa .)oy,vsoti. S� � JO�F'��E .�, ��c,-; 9g,,'o� ,7GG �'S'D& _-- <br />tENANi M�II �DPRE55 Ci1V Ii� �H.NE <br />�RCNRECtORpE51GNFR MAU.ADORESS ��1� ��P P�E r..C�]N�I�.I�� <br />1 <br />CENFRUCp/':R�CT(M M�IIADDPE89 f,iiV IIP ...- — PHONE � . � E i.EN.Fl -"��' i} ""i <br />Il�l���ll�ini� r <br />MECHIINILIILCONiR�CTOR MAILADURESS CIiY IiP PHONE '��'�� ��„���('Ii i� � I� <br />��'�tJ��'�G���bG Pen.'s p� _Fv,����T��0�3�Sy-S432.�L �nl �G1�F�� <br />PL!IMBINGCONiMriOR r��iieoouess cnr zia aH�e siqr,9irtllp9kM:.: ii.l d.� <br />— . .i+-'i_I.–. --- �:.. <br />�yJ(��u'TRIICT PPICF OF WOAN <br />�"l:��i/'�W ���fl ��Il�� .. '.r_. <br />DESCFIBE WORN �NU StJU�RF F001�6E INVOIVED fONTACl PERSON �Nfl PIIONE NO �l�i �-�'j ,•� � �� � �(� 1 � <br />�,� -.rtt_ ls� s.4,a. ,�acty��c r n-S - _ <br />i�L1�1 �'1 � 7 i:ll: �. <br />�..i)R! E i� If9/Vr . - --- <br />i HEREBV CERTIFV THAT I HAVE READ AND EXAMINEf) 111iS <br />PROPOSEDlISE O� BUILOiNfi APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRFL f �LL <br />�1^�/ i p �� � PROVI$IQN OF LAWS Nq ORDINq�� 5 QUEP NIN�, T�IjI� TVPE � tt� <br />ica�ioexRirtadorvaore�rrisNowrvaeiowon�tr�cr+ ��si ,� T '�WbdK WILL�9E C0�1PL�TEb WIi{1 WF1�TH��fi'SP�Ct�l�d'H�RFIP! O� <br />�OPI <br />�.�•1.11 NQT..TH�iqanryTiNG,qFIAP�iMITiiP,W�SINQTiPF��SIJ�AF�,�T�)GIVE <br />iot aiOCK o% AUTHOfiITV TO VIOLATE OR CANCEL TNE PROVISIONS OF ANV <br />l�1 �.�� ' I OTHER STATEAq LDCAG LAW 9&GULATING CONSiFlUET10�41QR THE <br />�-�--- -� PEFFORMANCE OF CONSTRUG?ION. iHAT I AM AUTHORILED BV THE <br />OWNER Of THIS PROP�i�TV�KibL�iidd�t�f�lE��VI0III�.�IHR�VIWICH <br />,.APPLICATION IS M��i• AN- � 1I� COMPLY WITH T��.�STATE <br />v�ncei t�K io Nunreen �� COIOTRACTORS LAW 18Z7RGW �Mu 2%.21M WAC �� ����' � <br />N i i, <br />CONSTRUGTIONIO�N�ENDER.l0�RE55.TElEPHONENUMBER <br />� �'.-�--�-1,�.`s� � ��`i- <br />PROJECIADDREBS a/ � d.. / — r��. 1— X- .'rP:ll� I,I� 1__ nert— ----_ . <br />S� <br />PLUMBINO A CAL <br />NO. TYPE OF FI%TURE OR ITEM FEE = TYPE OF EOUIPMENT FEE <br />WATEii CLOSET (TOILET� A C--A�HNDLG UPIITS—HP __ <br />BATHTUB - CEDAIRSVSTEMS—B.T.�M EA. y__ <br />LAVATORV (WASH BASIN) UNIT HFATERS—B T.U. M _ <br />SHOWER ' CLOTHES DfiVFRS ___ _. <br />NITCHEN SINK 6 DISP <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASHER_ <br />URINAL <br />DHINKING FOUNTAIN <br />FLOOR DAAIN <br />BACKFLOW PREVENTERS <br />fOR OFFICE USE ONLY: <br />FR( Ni 5f LARf.K RE�O SEiBACk <br />USEItWE LOTARE� <br />IYPE Of dNISi � � 3T0111E! <br />OLCUPIINCY lWC <br />PE�SON <br />iH�eKF 9v <br />SUBTOTAL $ — <br />PERMIT $ <br />TOTAL FEE E <br />FlRE 9PRINItLERS pE0'� <br />FIPE �LI1RM NE00 <br />n�rE <br />•PPROVEDB� <br />VEM1TIl'ATION FAN <br />R��� FIOOD <br />WATER HEATER <br />FIREPLACEINSERT <br />HEAT PUMP <br />IYd.I <br />SIDFSEIB�CN PInNCHPca arnet r <br />53� <br />wc.r+r srte FEES <br />VES NO gi�ILDING <br />IXCuwWr NUOi0W1u�M.�a4'� ' <br />c�mr p�UM91NG <br />B�SEMENT MECHANICAL <br />VES NO <br />NEIGMT IIMITUION ADDITIONAI PUN CHECN <br />OiHER <br />STATE BUILOING SURCHARGE <br />CITY OF EVERETT PUBUL WORNS <br />LOCAlSALES <br />TAX COOE IS 3105 *oTp� <br />SUB TOTAL $ <br />PERMIT "— � $ �_— <br />TOTALFEE $ <br />NO <br />