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� \ . . _ . . . ..... .. _,..._... <br /> APPLICATIt.A FOR CONSTRU�? �ON PERMIT <br /> mB E�ro�ae� everett <br /> �,�oF e <br /> everett ; <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEA;iE PRINT ! <br /> ❑ DEMOLITION I 1 COMBINATION ,Y�BUILDING I IMECHANICAL LIPLUMBING ❑ SIGN i <br /> OV/NEfl MAILADDPESS CI7V 21P PHONE � <br /> 't�cx�ex.s 'c:�ea.xr �,N.�o•.� t7« 8►��owwr �,en.sT wA. � <br /> TE�NA�N/r MRIL RDDflE55 CITY ZIP PMONE I <br /> ARLHITE�OR DESIGNEn MAIL RDDRESS CITV 21P PMONE � <br /> Fe4�Gr ��3r.Rte�,p # Aasoc. �too etakrbN e�Ori+a�s wA 7� '- �n''� � <br /> GENEHALLONTP�CTOR MAILADDRESS fJT�' Z�P PHONE LICENSE� <br /> �j� � � ! <br /> !/U`��-�� I7e�t0 � <br /> MELM�NICALGONTR�GTOfl MpILADORE55 CITV 21P PHJNE ULENSEI ! <br /> PLUMBINGGOHTRACTOfl MRIL�ODRESS CITY ZIP PNONE 1.ICENSEI � <br /> f <br /> CLASS OF WOHK ' <br /> U N.VJ �DITION I 1 ALTERATION I J REPAIR I 1 DEMOLIT N I I WQODSTOVE/FRPL INSERT I J BUILDING RELOCATION � <br /> TEN�NTIAIPROVEMENTONINT�.RIORREMWELONLY CONTRC PERSONANOP101 NO. ( <br /> LlL � ew►_�D 2 ��14 �. <br /> CONTR�CT PPICE OF WOPN: T <br /> DESCRIBEWORNANDSOU�RB��G'INVOLVED � ' � � <br /> g� l� �►� s � �seN,.{�J'1u� J <br /> PROPOS 0�5[OFBUIID'•'^_ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> GI��'(' (�f�� � � APPLICATIOIJ AND KNOW THE SAME TO BE TRUE AND CORRECL ALL �� <br /> LEG�lDESCRIPTIONOFPROPERTY�5110WNBELOWORATT�CHFOURGOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF � <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � <br /> �oi o�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE I. <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY r <br /> � � Z 3S OTHEfl STATE OR LOCAL LAW fiEGULATING CONSTRUCT�ON OR THE <br /> PERfORMANCE OF CONSTFiUCTION.THAT I AM AUTHORIZED BY THE <br /> (.� O� � V O y 4 OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH � <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE E <br /> c^^ C TRACTORS LAW 18.27 RCW AND 296200 WAC. . <br /> ',V�' SIGNR EOFGONTRACTORO AUTHORIIED�GEN DATE �� <br /> � k <br /> X , [ <br /> , <br /> PRQIECTADDRESS — y <br /> � t'.� I Q1A T�� APPLICFNTS GTV BlI51NES5 LICEN E NC AND BUSINE55 NRME ;. <br /> �J\/[JV✓ <br /> PLUMBING MECHANICAL �, <br /> N0. TVPE OF FlXTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE � <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS�-H.P. �_ � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; i <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M I �; <br /> �T <br /> SHOWER ' CLOTH[SORYEFS _ � G <br /> KITCHEN SINK 8 DISP � VENTILATION FAN �_ �. <br /> DISHWASHER � RANGE Ii00D � �� <br /> LAUNDRYTRAV ; WATER HEATER ' �� <br /> CLOTHES WASHER —r WOOD STOVE � � <br /> URINAL ' METAL r'IREPLACE 8 CHIMNEY ' � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT i � <br /> FLOOR DRAIN �— HEAT PUMP —�—. <br /> BACKFLOW PREVENTERS ; GAS PIPING � � <br /> ROOF DRAINS—RAINLEADERS � E%HAUST FAN � i' <br /> SINK(SERVICE—BAR.ETC.) � ' ; <br /> � <br /> � � , <br /> � i <br /> � i� ' <br /> SUBTOTAL 8 ; SUBTOTAL $ ' � <br /> PERMIT $ � PERMIT $ � ! <br /> TOTAL FEE $ ' TOTAL FEE $ ' i <br /> FRON�BACK REAR;ETBAiK SIDE SETOA� P�N �F NOMBLR� FEE� � ,/ ,� PEC�N�/��� <br /> c. �� 1 <br /> orie � LOTAPE� L vnc�Nrsire FEES VALUATION FEE <br /> �� I] YES [ NO BUILDING p+o a�7 � �") <br /> ttPEOiLON51ALLOWABIE 1YPEOFCONSiRTUAL �uw.NCY HOOf IUNGuxnS � <br /> "'�"�� �A�� � PLUMBING i <br /> —r <br /> SRE OF BL F NO.Of STOflIES BASEMENi MECNANICAL ' <br /> � <br /> Z(J$ ' A�� Z I I YES �NO �— <br /> OCCUPANCYLOAD FlRESPRNKLEHSREO'D HEI411TlIMITAiION OTHER � . <br /> r , <br /> I I YES �fJO S1AlE OUILDINO SURC!{pRGE �i SG � <br /> RERSONFORSPRINNLERS � � <br /> STATEENERGVSURCHARGE i � <br /> . I <br /> �PPLICATIONALG.DY PUNSAPPHOVEDBY CITYOFEVEREiT PU9LICWOfiKS � ' <br /> LOCAL SALES � <br /> _� ycl TAX COUE IS 3105 TOTAL � � <br /> � <br />