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APPLICATION FOR CONSTRUC ION PERMIT <br /> IM F,rorptrin TO BE COMPLETED IN INK—PLEASE PRINT <br /> City Or / <br /> everett I IILA711J(;SYSTEM: UGAS /ELECTRIC U_ <br /> BUILDING DEPARTMENT <br /> 259.8810 <br /> I DEMOLITION ' COMBINATION BUILDING /MECHANICAL <br /> MPLUMBING SIGN <br /> An Alu,m.ss cnY T,r Flow <br /> P <br /> 'y Ij(/J -II NAryI MAX ADDRESS CITY Tn• MgNE — <br /> r <br /> IUFCI pi DESRNL �jAR ANOn[SS � -LRV Tn' rlgNE - -- -_- <br /> y z �,� 11N_G' <br /> rV N r� Rr.Nr IIµCONIRM:I(R MAR ADDRESS CITY Tir In1G11E IK;EtISEF <br /> CA H 1 <br /> y p,i,:jJMI CAL CGt1111AC On MAR ADDRESS CITY TR PHONE LICENSE 0 <br /> M80 1.�/�tYT�U iii �1 $(rT �i_�.�_Y�lr�k' � i�x' �J_v!s'� /l�etr�r/vyo� <br /> 0 H I•LUMBINDCONIF1A TOR MAX ADDRESS CITU IIP RKMIE LICENSEF <br /> C$ eis4�-I—P 1�—/ AC� iti�[��3n!�xda r=��rt�[�i�2y`f zs��(11L�<7.y -f����rBit <br /> Z <br /> NEW I I ADDITION ' I ALTERATION 1 I REPAIR I I DEMOLITION I I WOODSTOVETFRPL INSERT I] BUILDING RELOCATION <br /> ��� .xe.A /JQ L°NtActrtnsan Tul/q rNONE ra d" n y <br /> T~A ,/,r1TnA�c�i rnK:E or walK I 5 �7_L//�C L.� .. <br /> BOJ I"I nrsCnRE WONK AND SOU E FOOTAGE INVOLVES -r- 7 7�-�) <br /> LLQ**11E-' r,n1�olrouo USE or ounow /1I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> y yo TCA T �:.�' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> corlEBl PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IeaAI T>ErenlPirRlorEnttlsl DI:Low on Anecnroun <br /> �� t/ WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> IO1,; ;��Y IRocK or �YJTJ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> •�"6. �'ri . , I� OTHER STATE OR LOCAL LAW TION.THAT <br /> I CONSTRUCTION OR THE <br /> ---(-�1 /j PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> _ APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> BRGNAILRE Or CONTRACTOR ORT AUI ITEDAGENT DAIEe,,: '_�d7 <br /> X C UYY �� UU <br /> rnwrGl ADD"ESS _ - E T <br /> APTR c IY BUST Sy K ISE NO AND US NESS NAME <br /> –, PLUMBING MECHANICAL <br /> �� NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) _5/ ' – ATC–AHNDLO UNIT S–H.P. I <br /> BATHTUB _–�O '– FORCED AIR SYSTEMS–B.TU. M E.A. ' <br /> -p LAVATORY(WASH BASIN) UNIT HEATERS–B.T.U. M <br /> SHOWER u '– CLOTHES DRYERS ! <br /> KITC14EN SINK 8 DISP VENTILATION FAN <br /> Af DISHWASHER _ – _�� ' RANGE HOOD ' <br /> LAUNDRY TRAY _ WATER HEATER <br /> CLOTHES WASHER _ � ' WOOD STOVE �— <br /> URINAL _ ' METAL FIREPLACE 6 CHIMNEY ! <br /> DRINKING FOUNTAIN I FIREPLACE INSERT <br /> FLOOR DRAIN <br /> 1 HEAT PUMP ! <br /> BACKFLOW PREVENTERS i GAS PIPING ' <br /> a� ROOF DRAINS–RAINLEADERS ! EXHAUST FAN ~ <br /> SINK(SERVICE–DAR.ETC.) _ 4 <br /> SUB TOTAL f _J fr – SUB TOTAL f �i0 i– <br /> PERMIT f PERMIT f <br /> left'_' TOTAL FEE TOTAL FEE f 2 r–' <br /> \ FOR OFFICE USE ONLY: <br /> r RONi eE1DACK REAn SEISACKSRIF SCIRmnih PLANC,Ir.CKNUMIUR FEE InCEIPi to <br /> os[TONE LOT AREA VACANISIN FEES VALUATION FEE <br /> BUILDINO <br /> Irrr M CORN;At I gAAU1T TOT IX CONST.ACIUM -~1 WRlwuwLwn --" -- <br /> PLUMBING <br /> snEOF DLDO NO Or STORIES RASFNFNI - — - - -- - - ' <br /> MECHANICAL <br /> rrcurAncY Loin FRE SPIRLERS"roll IIERIIILIMRAIKIt1 ADDITIONAL PLAN CIIEL'N <br /> 1 <br /> _ OnTER <br /> I R Asun run sm"Im Eng -- -- <br /> STATE BUILDING SURCIIAII.r , <br /> inTAAE nY rin45 APPROVIACITY OF EVERETT runuc WORKS <br /> LOCAL SALES <br /> TAX COAL IS 3105 TOTAL ello ; — " <br />