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APPLICATIOI:�FOR CONSTRUCTI�IN PERMIT e"''�P�c � <br /> u,,.n���m�-�•�� TO BE COMPLETED IN INK—PLEASE PRINT � I <br /> ��,, �>� - 1 <br /> everett _- __ ------- - -- - <br /> BUILDING DEPARTMENT HEATING SYSTEM: l�J GAS �J ELECTRIC U <br /> � � 259-8810 � <br /> q�H � ' DEMOLITION _ i\ COMBINATION _ BUILDING MECHANICAL 'PLUMBING I ,1JN + <br /> ��� ^ OWNEH MAII.ADOHE55 ❑Iv ]I� PHONE � � -- I <br /> GCt,tiEt�[C� I9iq ,+/. �N'" ST ��'»ti �/S/C3 S47'`�-'.�13 <br /> iEN�NT MNL�UDR[SS CIIY )iP PHONE <br /> � I <br /> �N/� I <br /> C FI„111i[Gi0B0ESIGN6R MAllF00fiE$5 GtY ZIP PMONE <br /> "9 <br /> y nES/G^/ /1.^/r5_—_zC'l4___1.S�_Ji_"...__J_L_/:GGZT__.__.____ ___' <br /> � xp (1fNER4LCON1i'ACIOII I.Inll nUU11155 GIY /p' PIIUNE LILENSEI <br /> y � �EONli_'c t' GEUNE/ 1k /732 <br /> � �Cy MECHRNICALCONTRACTOF M�ILpUOlIE55 CILV 21P PHONE �ICENSE� <br /> � Ls1� F.��l-.�r�UJ�-�J"�7 ���r'L_U��t_7 <��Y:�_---��h[7n�� --- r ,:"- I <br /> � 1�. -_.G__... _ _ ,• . . �E YSC�` ti'O/0.2010lOo[ <br /> PIUMpINGCOM11�C1f11� IA�II �Pllllltiti I;IIY )II� PIIONE �ICENSEI <br />� ~ f�f!-'E�lL/"/fINCf: l�t�reiiL�:l. /� c` nc �jfl'i �SiU l'Ll1FP0.� /37G3 <br /> �r/Ne.,[Y'O <br /> �iy c�nssorwonK ����� L' <br /> �� H )G NEW I ! ADDITION � ALTEHATION _ REPAIR _ DEMOLITION _WOODSTOVE/FRPL INSERT I i BUILDING RELOCATION <br /> ~ r,ar�inr.t rt�.n:or�nNo ruor�e No <br /> C]�U1 , <br /> � onrancTrniceoFwonK ' Ei' i)icr�i55i! ' �259-�956 S7I7-9:2/� <br /> OESCRIBE WORKI.NUSOUARE FppipGE INVOIVED I <br /> ON NIL+� �-Uti/ST/:'L4-TIUr� ��jl� JQFT <br /> .._ . . . v��ovweou5rovuun.oiNc I HEFEOV CERTIFV THAT I HAVE READ AND EXAMINEO THIS <br /> i//JL Lr G/y�'//L Y %�l.S, APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGAL DESCPIPTION OF PqOP[qTY�SHOWN BELOW OR ATTACII I"pUR COPIES� PROVISIONS OF LAWS AND ORDINANCES QOVERNING THIS TVPE OF <br /> ior�_ mock oF �VTfI/'ic' 777" �/'�ORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR ' <br /> _ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> AUTHORITY TO VIOLATE OR CANCEL THE PqOVISIONS OF P.NY <br /> _ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OP. fHE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> CIl�Q4� �2 j� / � �ti � OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> ��------ APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTHACTOPS LAW 78.27 Rf,W AND 296.200 WAC. <br /> SIGflAiUR FCONiRACtORORnUT/10RREUAGENT DATE <br /> X ..�'z`�.,1.�rt�n-` �/�l/ <br /> ❑ROJECTAO�NE55 G�M�,p�p J�y (,�Gi �� <br /> !� <br /> APPI IC4N 5 CI�Y BIISINESS IICEN$E NO ANO BUSINE55 N�ME <br /> '-' PLUMBING MECHANICAL . <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF F.OUIPMENT FEE <br /> 1�I �i WATERCLOSGI �IOILEI) 15 � _ A�C NHNDLGUNITu-H.P. , <br /> --�- BATHTUB <br /> '�1 � _ -rj ; FORCED AIF SYSTEldS-B.T.U. M E.A. � <br /> 3 LAVATORV(WASH BASIN� ��_ UNIT HEATERS-B.T.U. M ; <br /> j� SHOWER _rj�__ �_ CLOTHES DRYF.H3 i <br /> 1�' � KITCHEN SINK&D�SP VENTILATION FAN � <br /> OISHWASHER � � ' <br /> �e _ � RANGE H000 � � <br /> LAUNDflY TRAV W��ER HEATER � <br /> � ' <br /> CLOTHES WASHER T— � � � <br /> ' _ _S �_ _ WGOD STOVE � <br /> � URINAL METAI.FIREPLACE&CHIMNEY i <br /> '�1 DRINKING FOUNTAIN �_ _1 FIREPLACE INSERT O �w <br /> FLOOR DRAIN � HEAi PUMP �- <br /> ' �-- ' _ _ --_._-'__ —. . __ - ' __ , <br /> BACKFLOW PHEVEM f:IIS � GAS PIPING <br /> � _—_ . _..__.. . _ . __ . . . � _.._ -. . ' _____--- ' <br /> ROOF DFAINS-FlAINL[AU[HS ! �'_ EXHAUSi FAN <br /> � SINK(SERVICE=BAR.ETC.�__ ___ _ � _ - ' <br /> — — -�_- <br /> ' ' � <br /> .-- _ —___________ ._-. ___ _..__.._.___ <br /> _- _____-___-__ <br /> — .___.—._- ______... _ . .. .__. __ __ . _. . .i _ __ {1QW.�11tnY.�,1 W�A <br /> � <br /> '�' ---- — — ' <br /> � <br /> � <br /> SUB TOTAL S C)c� ' SUB TOTAL $ <br /> __ — —___.. ' � <br /> ___"__ '_' . . <br /> � PEHMIi - �___ __'. ___ _.'_'__ _ . <br /> . $ ' PERMIT 5 ;� <br /> -- _._- .__.-____. . .. ..____ _ ._ . . . <br /> . _ _'_' ._ _. ___'_ _ <br /> ._- IOI�ALfEE $ S TOTALFEE $ � CPf <br /> FOR OFFICE USE ONLY: <br /> — _ __ _ <br /> FRQNTSEi�4CK fifdflF1111A�'K AIbPS1il14t'.v PIAf�f.n�CY.Hip,�qfR [[E qECEIPTNO. <br /> � Za _s/ � � zL� 7 G� ��x.� �c, <br /> USE ZONE i.or nnen �� w,cnr�i s{n�e FEES VALUATION FEE <br /> �,( ��� Jtt �UILOING � <br /> IYPEOiC�`�'�iSAILOWABIE IYPFOICI)t!$IACIUN iFii�:•,.. .. .�. i�:.���•��.'•:.,ti ---- 7 _� <br /> " ��� V�/� 2 3 rwn�oirac <br /> —�---—,l,�-- -,_ 1--- 5 � <br /> SIZEOFBIDG. NOOPS10RiE5 OASGIJENI �,��CNANICAL C � <br /> a �KGo a r�o --- z , <br /> OCCUPqNCVLOAD [Nf.51'I�r1KILqSti[OU ��Bcntli;Allnl�yrci �D�I710NALPLANCIILGH � <br /> �G `-$� OTHEfi � <br /> RFA50N F R SPRINKlEFS - i <br /> STATE�WLDINGSUNCHARGE (� �C� � <br /> INIANE(iY r�nm:n����n;��iF6:�- -- CITYUFEVF.RETT runnr,wniue: d� <br /> LUGIIL S�ILES � / <br /> 4� �� TAX CODE IS 3105 TOiAL � Z� � " <br />