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_ . < _ . . .__..: .� .�. . . . . . .._ : - ._.:_ . ._ _ __ ..,.. ,.K:�. <br /> APPLICATIC _J FOR CONSTRUCT.,JN P��MIT <br /> �E�e�� everett <br /> an oF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />' U OEMOLITION I I COMBINATION I I BUILDING I I MECHANICAL ,�UMBING I ] SIGN <br /> ONTlER MAII.�DDRE CITY ZIP PHONE <br /> `��"�i4�����/s_(�,lda,a����//IcBzr _ /7r8"1�,�,4�u�s►r� EJ�/1.e_Tit <br /> TENANT � MRIL ADDflE55 GITY ZI PHONE <br /> � <br /> �RLH ECTpR DESIG ER MAIL ADDPE55 CITY IIP PNONG <br /> � iie,e,7-'��ca yv� �U�dni ,��mvnsa'S �Dao 775-vs7�l <br /> GENERALCONTPRCTOF MRILADDRE55 qTV ZIP PHONE LICENSE� <br /> 1�P�UL�a/D C�.�o�S T. /7D,f�a[ 9sf3 �✓eretf, 1,c.19�g�b a�i -9/�l — <br /> MECHRNIGALCOIITRACTOq MAILADDRE55 ITY ZIP PNONE LICEIJSEN <br /> ���.415/..5��/ �D)P�I���iil�c,4 c i(�83/ j'1��2� Po Z����- P�,oNE uL/.J, ��k?2;� � <br /> /d'2 Q4. <br /> cuss oF woarc � <br /> I� NEW .-ITADDITION I-_I AITERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I�I BU�LDING RELOCATION <br /> TEN�NTIMPROVEMEN70RMTERWNPEMODELONLY � CONiACTPER50NANDPHONENO. <br /> CONTRACT PRICE OF WORK: �L <br /> DE�GNIBE WORK AND SOUARE FOOTAGE INVOIVED <br /> PROPOSEDU EOFBUI O�NG I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �J/ Jl� APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALL <br /> LEO�LDE5CRIPTIONOF PROPERTY�SNOWN BFIOW OP ATTACMFIXINCOPIES) PROVISI�NS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPEC�FIED HEREIN OR <br /> �or , e�ocK oF NOT. THE GRANT{NG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTIIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANI� <br /> OTHER STATE OR LOCAL LAW REGULAT�NG CONSTRUCTION OH THE <br /> PERFORMANCE OF CON�TRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPEFTV TO PERFORM THE WORK FOR WHICIi <br /> APPI.ICATION IS MADE 4ND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. �p <br /> SIGNATOREOFGONiRRCTORORAUiMOflIZEDtGENT DRTE SJ^ZG l� <br /> PRQIECTALOflE55 � 'L./ �,�/�/v�'V <br /> / �PPIIGANT5CI7Y0U5MES5LIC SENO �NDBUlNE55NAME <br /> PLUMBIN� MECHANICAL <br />� NO. TVPE OF FIXTUPE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) Q� A6 AIC—A/HIJDLG UNITS—H.P. �_ <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) S/ ;DU _ UNIT HEATERS—B.T.U. M _ ; <br /> T <br /> SHOWER ' CIOTHES DRYERS � <br /> KITCHEN SIIJK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER —r RANGE HOOD � <br /> LAUNDRYTRAY ; WATEtifiEATER ; <br /> CLOTHES WASHER —r— WOOD STOVE � <br /> —r— <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ; <br /> DRINKING fOUNTAIN � FIREPLACE INS[RT ; <br /> FLOOR DRAM � NEAT PUMP �— li <br /> BACKFLOW PREVENTERS ; GAS PIPING ; I <br /> ROOF ORAINS—RAINLflADERS � EXHAUST FAN � � <br /> SINIC(SERVICE—BAR,ETQ) ' ' � <br /> � <br /> — — � <br /> i i I I <br /> � � <br /> , � il <br /> � � <br /> —•— —�— I <br /> i � <br /> SUB TOTAL $ S; OD SUB TOTAL $ ' , <br /> PERMIT $ C� � Ou !d PERMIT $ � <br /> TOTA_FFE $ S 'DD TOTAI FEE $ � � <br /> FRONTSETBRCK NEAPSE7BRCN SIOESEiBAGR PIANGMEGKNUMBEfl FEE RECEIPTNO. <br /> USEZONE LOTARER VACRNTSITE FEES VALUATION FEE <br /> f.l YES f 7 NO pUIL01NG � � <br /> ttPEOfCONST�ILOWABIE TYPEOFfANST.�L111R1 ��'P/�'�r NoaDW[luxGUxi16 � — jl <br /> GPWP p�UMBING <br /> 1 <br /> I <br /> �'T <br /> SiiEOFBIDa. NO.OFSTORIES BASElACtli MECHANICAL � <br /> u ves i i No � <br /> OCCUPANCYLOAD fIBESPRNNLERSREOD MEIGHTLIAIITRTION OTHER i <br /> ❑ YES ❑ NO ; <br /> STATE BUILDINO SURCHARGE <br /> REASON FOR SPRINNLEflS —�— <br /> STATEENERGYSURCNARGE i <br /> APPLICATIONACC.OV PUNSAPPflOVEDBV CITYOFEVERETT PUBLICWORKS � <br /> I.00AL SALES <br /> TAX CO�E IS 3105 TOTAL � <br />