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^ ., <br /> APPLICATIO�� FOR CONSTRUCT►JN PE�MIT everett <br /> rna E.eqree� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ci r r oF <br /> everett r HEATING SYSTEM: ❑GAS CJ ELECTRIC U _ -� <br /> SUILDINQ DEPARTMENT � <br /> 259•8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBINO SIGN <br /> CWNER M�IL�DOPE55 t;ITv 21P --- PIqNE "-----' <br /> �►1��l� R�vr.� 2 A�s�cr. �ao�s �s�u.c. 5Eq77� 9£fISS 3G3 -o3//- <br /> iCN�NT MMLApLRE55 _—'---f.ItY ZIP PNOhc <br /> �RCHITECTqRDF.SMsNEH M�ILPDDNE55 CIfY p�p pq��� — � <br /> ��r�PA1��14L MFCq /NG ��DENI�EY P,E, 3E8'01 19l�S.e;, A�su�C/� 9Yao1 yS� �3�� <br /> GENFRALCOYTR�CInq YML�DDRESS CIiY 21P PIIUryE IICENSE/ <br /> Al�l►1 ASYX.. I�DiB ►S'� IJ,� � SE/47�'LE� _9f'S/SS 3�-03/� M�ETyM�/oZ�GI <br /> MEC�IeNIC�LCp1TRACiOR M,�IL�OGRE55 �ITY LP PHONE IICEN5F1 <br /> PLUMBINC CONTP�CTOR MAIL�DOqE55 CITY iIP PNONE IICEHSC� <br /> f.US40fMM11q( "-- — <br /> xNEW _ ADDITION � ' ALTERA?ION REPAIR � DEMOLITION � WOODSTOVE/FRPI iNSERT . , BUILDING RELOCATION <br /> CONTACi PERSON AND PNpqE NU <br /> fANTRACT VRYk 0�WOqN�p�()yt. ;77 '�� <br /> DESCRI9E WOR1c AND SOUARk FOOi�OE INVOlVEO �y) - <br /> f�'f <br /> _ "� uN <br /> P POSEDUSEOFBUIlDINO '— <br /> I HEHEBY CERTIFV THAT I NAVE READ AND EXAMINED THIS <br /> G14RP�T�S APPLICATION AND KNOW THE SAM[TO BE TRUE AND CORRECT.ALL <br /> IcOAL DESGRIFTIp101�PHOPE7TV(SH01VNflELOW Oq�7T�CNFqJR�ppIES� PROVISIONS OF LAWS AND ORDINANCES OOVERNING THIS TVPE OF <br />� �ot qi«;K � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />� --- NOT. THE aRANTING OF A PERMIT DOES NOT PRESIIME TO 61VE <br /> AUTHGFI7V TO VIOLATE OR CANCEI. �fHE PROVISIONS OF ANV � <br /> _ __._ OTHER STATE OR LOCAL LA1V REGULATING CONSTRUC110N OR TnE <br /> PEFFORMANCE OF CONSTRUCTIC)N.THAT I AM AUTHORIZEO BY THE <br /> OWNEq OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> --'----- -- — APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 298.200 WAC. <br /> _ -�__ SIQN�1U�pN�qpqA-�pAOENT OATE �/D/ <br /> � x �a�.. �/ <br /> PROJECT A�OREE.� t ' �' <br /> /��1�2� .,7�E� l'1/L.'Or+Tlr•' APVIICANTfiCITYBU51NE55LICENSENO�NDBUSINESSNMIE �I <br /> G 1 G �V� I / <br /> I`LUMSINCI MECMANICAL <br /> N0. TYPE OF FqRURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WA7 ER CLOSET(TOILET) A�C—A/HNDLG UNITS—H.P. , <br /> B!'"H7U8 ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOIYER � CI.OTHES DRYERS T— <br /> _ KITCHEN SINK 6 DISP VENTIIATION fAN <br /> _ DISfIWASHER RANGEH.'X1D � <br /> LAUNDRV TRAV ; WATER HEATEF <br /> _ CLOTNES WASHER � 'JpODSTOVE � ' <br /> —— ' <br /> URINAL ' METAL FIREPLACE 6 CHIMNEV <br /> DqINHING FOUNTA�.J I FIREPLACE INSERT <br /> FLOOR ORAIN � HEAT PUMP -T— <br /> �— <br /> _ F7ACKFLOW PREVENTERS ; GAS PIPIN(i � <br /> � fl00F DRAINS—pAINLi ADEFiS EXHAUST FAN <br /> . __ SINK(SERVICE_BAR,_,dTC.) <br /> � — <br /> ---_ —_ 1 <br /> ----- �---- --—I' , — <br /> _ _'—'__ i <br /> - - ---_----- SUB"'.'lAL S SUB 70TAL S <br /> _ __ PEqlAIT S PERMIT S � <br /> _j_._ ._ TOTAL FEE S TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FRONTSCTC�CN � REAR6ETBqCK SIDESETB�CI( � PLANCHECkNUM9EP FEE RECEIPTNO <br /> ,�i � -� � ays�� 3 S/.3� 3 33 <br /> USE ZONE lOI�RE� yAC�N 6RE FEES VALUATION FEE <br /> �2-3 C�5- r 3 �v BUILDINO '77 `i Syo ;S� <br /> rvPFOicoxts 1LL7M IBLE irPF of cON i AGN�I acur�Nn rM ppv[wrr,pxns <br /> �—•, �_ � cnaiv �L� PLUMBINO � <br /> Iy <br /> S�IEOFBIDO NOOF6TOPIES BASEMENT MECHANICAL —~_ <br /> �o °I �lo � — <br /> OCCUP�NCYlO�U FIRESPRNYLF.RSRE09 NEIOHTIIMIT�T10N AODITIONALPLANCHE�K <br /> �S• OTHER <br /> REASdI FOfl SPRMNlERS __ _ <br /> STATE BUILDINO SURCHARGE �;�lv <br /> INT�MEBV PL�NS�PPROVE�Bv CITYOFEYEREIT PUBLICWORKS ' c�' Q'� <br /> � LOCAL SALES ' +----- <br /> TAX CODE IS 3105 70TAL ��v, � <br />