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APPLICATIq.. FOR CONSTRUCTIt�N PERMIT everett <br /> �E��� 70 BE CONtPLETED IN INK—PLEASE PRINT � <br /> cm oF <br /> �verett HEATI�iG SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING ❑ SIGN <br /> ON?!ER MAILADDRE55 CITV ZIP PMONE <br /> J F�„ ��o Q-c� I ZL�- I<q 61. oL� S !z. �r=� $'t+-�.,,c, w•ti- 4 S'Zf€' .— <br /> ry,� �wtLS30 - <br /> �Nµ� M�ILADDRESS CIiY 21P PNONE <br /> ARCNITECTOHDESIGNER MAILADDPE55 . ��n' ZIP PHONE <br /> OENENALCONTNACTOR M�ILADDRESS CITY ZIP PHONE UGENSEII <br /> MECHANICALCONTNACTOR MAILADbRE55 CITY ZIP PMONE LICENSE• <br /> pIUMBINOCANT(I�CTOR W�LADDRESS CITY IIP PMONE LICENSEI <br /> GLASS OF WOPK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION O WrJODSTOVE/FRPL INSERT ❑ BUILDINO RELOCATION <br /> CONfACi PERSON AND PHONE NO. <br /> CONTH/�CT PRICE OF WOHK <br /> pES�pIpE WppN�NO SOUARE FOOT�OE INVOlVEO �y <br /> pnoroseouse euRotta � � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � APPIICATION AND KNOW TNE SAME TO BE TRUE AND CORFlECT.ALL <br /> �E4µpESCqIPTNXIOFPROPEPTY�SNOWNBEIOWORATTACNFWRCOPIES) PROVISIONSOFIAWSANDORDINANCES60VERNINCTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WMETHER SPECIFIED HEREIN OR <br /> �or eiocK '.� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> I OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> - PERFORMANCE OF CONSTRUCTION.THA71 AM AUTHORI2ED BY THE <br /> I OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> _ � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ' CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br /> : SIONATUREOFCONTR�CTOROflAUTHORIZEDAOENT DATE <br /> �`_� � � ' �, A <br /> �i n <br /> t irY\ <br /> ' pROJECTAODRE.^+$ _ AVPLIC�NTSCITVBUSINESSLICENSENO. BUSINESSNMIE <br /> 1?2/1..� <br /> �L ZT•�K. <br /> � PLUMSINO MECHANICAL <br /> � N0. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILE� � A/�A/HNDLG UNITS—H.P. � <br /> BATHNB ; FORCEDAIRSYSTEMS—B.T.U. fi' E.A. ' <br /> ;.AVATORY(WASH BASIN)� � UhIT HEATERS--B.T.U. M � <br /> - SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR ORAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF DRAIN�RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � � <br /> � — i <br /> � � <br /> � � <br /> � ' <br /> SUB 1 OTAL S ; SUB TOTAL S ' <br /> PERMIT S � PERMIT S � <br /> TOTAL FEE E ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY� <br /> FRONTSETB�CN REARSETBACN SIDESETB�CK PUNCMECKNUMBER FEE REGEIPTNO. <br /> USE20NE .OTARE� V�CANi51TE I'EES VALUATION FEE <br /> BUILDING S' <br /> fYPEOfCONiSJLIOWABLE 1YPEO�CONST.ACTOAL OLCUPAM.'V raaVMui�uxns i <br /> "W PLUMBING i <br /> i <br /> S�ZEOFBLDG. NO.OFST�RIES B�SEMENT AIECHANIChL � <br /> OCCUPANLVLO�D FIRESPRNKLERSREO'D NEIGMTIIMITATION ADUITIONALPIANCNECK i <br /> i <br /> OTHER � <br /> REASON FOR SPRINKlERS <br /> STATE BUIIV�':G SURCHARGE �� � <br /> i <br /> INTANE 9Y PUNS APPROVED BY CITY OF EVEREIT PUBLIC WOFiKS <br /> LOCAL SALES — <br /> TAX CODE IS 3105 ror�� �c� � <br />