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� .. .:..... ....`..�G,.s .�....iv. ..'r. <br /> .. . . :'.. .. i . : �' �:.�... _�...f2'd1l:u..:.l.Cn..�.:1.Y.� .nu <br />� i.i ... ...�... � . <br /> .t...�.:a.:{ .r.._. .V ..�.._-.. ..� .". . . . _.._ .. .._... . . <br /> Y q <br /> � <br /> • ( _� <br />;`�;;` �APPLICATIOK �OR CONSTRUCTIL�a PERMIT everett <br /> ,� e <br /> i,� TO BF.COMPLETED IN INK—PLEASE PRINT <br />-. ; Everpreen <br />,;� GiV OF <br />; everett HEATING SYSTEM: , GAS ❑ELECTRIC ❑ <br />' BUILDING DEPARTMENT <br /> 259•BB10 <br /> ❑ DEMOLITION I I COMBINATION i I BUILDING �,MECHANICAL L.I PLUMBING I l SIGN <br /> ` MAiIAD�PESS CIi 21P PHONE <br /> 3 Er�IC� �-�"�w ��(��1�hS 8av r► a� _ <br /> �NT MAILADORESS 11 ��T1Y' ( Z�P ��C 'I �� <br /> ; 1'�i�K.�RN.v � <br /> A1 LN EGT CA�gES�GNER MAII AUDRESS CIT' 2�P PHONE <br /> l�� /{ss�c:_�,-�rS Se��� �fl�933a. <br /> GENER/�LCONTR�CTUF MRR DDRESS t� `C��ITY Z0IP PNONE LICENSEP <br /> /� � � (•�• �+ �'I qD��� 438oia8 Omn� CC. 144�.f <br /> ��1i L�J�%S��i'�.c.�rUlt. J7�5' Ccl'F$ ` p, E'i � <br /> M"ELNMII,y�CONTRACTOR / MAIL�ypOR�SS / CITY ZIP PHONE LICENSE� <br /> �fiC. �hcet- 11'l�t� �ec��P 'qG�3 �Po9/ �co�-f�5maa�{s'� <br /> PLUAIBMGCON7FACTOR MnIIRDDPESS CIiV ZIP PHONE LICENSEI <br /> CLASS OF WORK <br /> I_7 NEW r� ADDITION f7 ALTERATION f�J REPAIR ( 1 DEMOLITION I.I WOOOSTQVE/FRPLINSERT ❑ OUILDI�JGRELOCATION <br /> � CONT�CT PEI150N M!D PHONE� <br /> CONTR�CT VPICE OF WORK 9y�a n�D <br /> OESCRIBE WORN �SOUARE FOOTAG INVOLVED 1 � <br /> L c ;w � �.u1;rS �/0�0 <br /> �r SEDUSEOFBUILOING � I HEREBY CERTIFY THAT I HAVE READ AIJD E%AMINED THIS <br /> �`� I APPLICATION AND KNOW THE SAME-TO AE TRUE AND CORRECT.ALL <br /> �— PROVISIONS OF LAWS AND ORDINANC�S GOVERIJING THIS TYPE OF <br /> IEGAIUESCNIPTIJNOFPfAPERN(SHOWNBELOWOBATtACHFOURCOPIES� WORK WILL BE COMPLETED Y�17H WHETHEH SPECIFIED HEREIN OR <br /> ior o7,(c ' v� eiocK y9y �F NOT. THF. GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS Of ANY <br /> OTHER STATE OR LOCAL LAW R[GULATING CONSTRUCTION OR THE <br /> PEHFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERT� TO PERFOFM T�tE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTOHS LAW 1827 N•.W AND 296 Y00 WAC. <br /> SIGNATUREOFCONTBACTOROR�I�HORIZED�GEN. DPTE <br /> ���a � � � � <br /> PRQIECTADORESS APPLIGANTSCITVBU SSLICENSENO.ANDBUSINESSN�ME <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OP FU(TURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/�A/HNDLG UNITS—H.P. � <br /> – � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> BATHTUB <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M /dSo�'a � <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTP.4Y ; WATERHEATER <br /> CLOTHES WASHER � WOOD STOVE ' <br /> � METAL FIREPLACE 8 CHIMNEY ' <br /> URINAL --- � <br /> DRINKING FDUNTAIN i FIREPLACE INSERT � <br /> T <br /> FLOOR DRAIN � I1EAT PUPAP _ � <br /> BACKFLOW PREVENTERS ; GAS PIPING � - <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> r— <br /> SINK(SERVICE—BAR,ETC.� i � <br /> _ � <br /> i ' <br /> � ' <br /> � ' <br /> SUBTOTAL $ ' SUBTOTAL $ 'OO I <br /> � <br /> PERPIIT $ � PERMIT $ s'� DO , <br /> TO(hLFEE $ ' TOTALFtE S '�O <br /> FOR OFFICE USE ONIY: <br /> Fl10NT SETBIICN <br /> f1EAB5ET?1ACK SIUESET2aCR PL1INLNECKNUMBER FEE RECGPTNO. <br /> usezor+e �oun�-n VACANTSITE FEES VAlUAT10N FEE <br /> � <br /> � BUILDING ' <br /> IYPEOFfANTS.AILOWABIE T17'EO'CONS[/iCTUAL ���' �d�'�'u��'116 � <br /> �^� PLUMBING ' <br /> i <br /> SREOFOIOC. NO.OFSTOfl1E5 BASEMENT MECHANICAL � <br /> ADDITIONAL PLAN CHECH � <br /> OCCUPANCVLOAD FIPESPflNNLERSREOD HEICI!1'JMITAiION � <br /> . � <br /> OTHER �_ <br /> . REASONFOflSPRINKlERS -� � <br /> STATE BUILDIN�SURCHARGE ' <br /> i <br /> INTANEBY PUNSAPP�OVEDBY CITYOFEVEREIT PUOLICWORKS � <br /> LOCAL SALES � <br /> i �—� TA1(COUE IS 3105 TOTAL ; <br /> - —� <br />