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F FROMIEVERETT BUILDING DEPT TO: 2066433475 ]RN 17, 199P 2:13PM 0412 P.02 ) <br /> APPLICATION FOR CONSTRUCTION PIERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASL PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: YGAS U ELECTRIC u — <br /> z� <br /> 259.6810 <br /> 1 1 DEMOLITION I I COMBINATION I I BUILDING 11 MECHANICAL I I PLUMBING I I SIGN <br /> 'tl OMER WAIL ADDRERB CT' IIP PHONk <br /> t <br /> (g ��IrcS W'Uo E'el " clLt�P ()%(07 �r41 2323 <br /> Y EyH! N TFNANT MAK,ADDOESIS COY IIP RIDNE <br /> H 2 I-I ApCNRFC10N UklIONER MAL ADDHISS CDY IIP RIF <br /> 0 yyC a LL��(��� 1 2 3rb nlor f 11l G n 1AMy fx ON <br /> l I nyc� ���5 Uo 5 7�11v 3030 <br /> b <br /> In 'HG OLNCMLCONfRAGT IML AOOiICRG T—_ CITY IIP PNONE STATF I KI ME/ <br /> tj _ I�G11KS 1U41oP)nUcCl�c.�L4 L CL? 7 I,7'-1u-2323 c l►1mzlopiJ <br /> 1 <br /> :u C] MFCNANW CONTRACTOR MAK,ADMEN$ CITY IIP PNOM STATE LKCNSFI <br /> x n PLUMUNUCONTRACTOA MAL ADOIIESS C41 ZIP PNONC STAI!LICCMP/ <br /> 0 P O <br /> n • n <br /> .I <br /> 2 y G SSO MORA -• •. <br /> I NEW I I ADDITION I I ALTERATION I I REPAIR 11 DEMOLITION I I WOODSTOVE/FRPL INSERT 11 BUILDING RELOCATION <br /> N H ,pE /• TACTPERI A K)M NO. 1 �1 <br /> C t? N CONTRACT PIKE OF WORK �" L10 Cll -1.W t LE'�3-�— <br /> 'i r D SCRK1F Vp1IK 80UARl FOOTACC IWO VFI <br /> _. 1 <br /> nNN11 I'yl LJI�e.4,1`v I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED T14I8 <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALL <br /> LEMLU IIIPIKM(YPROOFRTYISNOMYIBEWWDOATMCNFOURLK1PIEsl PROVISIONS OF LAWS AND ORDINANCES GOVER41NO THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LIVE 1_». BLOCK OF __ ... NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> X Y AUTHORITY TO VIOLATE CANCEL THE PROVISIONS OF ANY <br /> 1 OTHER STATE OR LOCAL LAW <br /> REGULAT', .3 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATON IS MADE AND I COMPLY WITH 1HE STATE <br /> EW COM 8 LAW/B'T CW AND 288.200 WAC. <br /> / PhWkCI MENS L27� � ST SLL� IALAIMI M --IMT <br /> _� CII,IIAIMA,I P NP .17� <br /> �__I PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 1 WATER CLOSET QOILET) _ / I AIC-AFHNDLG UNITS-M.P. _ <br /> SATHIUB _ FORCED AIR SYSTEMS-B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) I UNIT HEATERS—B�T.U, M <br /> ��► SHOWER `' CLOTHES DRYERS ,. ! <br /> KITCHEN SINK A DISP _ VENTILATION FAN <br /> 1_ <br /> DISHWASHER 'I RANGE HOOD <br /> LAUNORYIRAY _ i _ WATER HEATER ' <br /> Oft �• CLOTHES WASHER �— WOOD STOVE — <br /> _ _ URINAL I METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN I FIREPLACE INSERT i <br /> ,low FLOOR-DRAIN �; HEAT PUMP <br /> _BACKFLOW PREVENTERS ; GAS PIPING <br /> _ ROOF DRAINS—RAINLEADERS _ __ EXHAUST FAN I <br /> WINK SERVICE—BAR,ETC. ' <br /> I <br /> ATj <br /> .• I <br /> _ BUB TOTAL S I SUBTOTAL 6 ' <br /> ' PERMIT i PERMIT <br /> TOTAL FEE i 1 TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> rr1cx4TRm!qK,, REAR ASiRACK INDC S9111ACK LYANDIECKNINSSR FEE RLCkIPI W. <br /> Usk TUN! Lot AHLA VACANT SITE FERS VALUATION <br /> ,e— _ BUILDING (� LJOL I — <br /> 11PIOICOKTi-MILAYAELL i/N of MST KIWI UlucT Irwmit"MITS • -- - I <br /> �_ ,911 PLUMBIND <br /> a1t[v DIiOS NO.IY RTORFS enSl•cwNr <br /> F ) MECHANICAL <br /> 26 cD7 S'r 6An Z ND _ •.•. <br /> TWUPANCYLOMI TKICSPRNKIFRSREOU HEOffLWOATION AODMONAI.PLAN CHECK --I <br /> A47 `� / SPRINKLER _ -J1- <br /> 1kA10N FOIL cPnrin Fp/ •l.�»•• <br /> STATE BUILDING SURCHARGE L I <br /> vmKB BY nANS APPR 1WII9Y CITY OF EVERETT PUNT IC WORKS <br /> ` LOCAL SALES <br /> � 4/1 1 TAX CODE IS 5105 tool n <br />