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_t� ::..: �. `� : �. .. '` .'_'"' . .. .. ' ____ ""' _. , .._:y<_e,�. . ... . ., �.��._..�:. .'� .... � .:'.:'1L'"i11'L"a: �ie.�."'WiflR75A <br /> ,/". <br /> AP"PLICATI�r�I FOR CONSTRUCT'r�N PERMIT ' <br /> everett <br /> fhs Ere�preen ' <br /> everett e ' <br /> BUILDING DEPARTMENT � <br /> i <br /> 259-8810 70 BE COMPLETED IN INK—PL/EASE PRINT � <br /> ❑ OEMOLITION ❑ COMBINATION � BUILDING �,MECHANtCAL ❑PLUMBING O SIGH <br /> DW�NE+p M�RMDRE55 O CITV ZIPL�� PHONE /t!1��!� �I <br /> / y Si.vS'F � ��iS�i/�/��V�E� -�L'3/ U?vnOL .3�f I" [l�� -T X e�CJ� i <br /> TENAM � MA0.ADDHESS CT' ZIP PHONE I <br /> F <br /> ARCHRELTORDESKaNER MA0.ADDRE55 CrtV LP PNONE <br /> t <br /> �GEfN`ERAL LONTRA/CT�OR MAJILJ ADDRESS CITY 21P PMONE IIGENSE� I <br /> wf34� LO^71 l�.�'7`�r- 12`t� �I/i `�S�J(o %a"'b'�,(,'] � <br /> MECN�NIGU.CONTR�LTON MMLAODRE6S CRY 21P PHONE L�CENSE� � <br /> �r��F=zL�'HLr ��lL/ �If// ��? �L'T `�FZG�/ 2S� �/� �'!/Z'-72� /.2/ �"7 <br /> PIINABMOCONTRALTOP M��L'�D011E59 CITY ZIP PHONE LICENSE� r <br /> � <br /> C1A550F WORK � t <br /> ❑ NEW I{3 ADDITION ❑ AITERATION ❑ flEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION � <br /> TEN�NTIMPPOVEMEMORINiERj�0j$REMODELONLY CANTAQPEFSONMIDPHONENO. �}!� <br /> CONTRIICT PPICE OF WORN: -/ � e+ ' ��Lv �I� ( <br /> OESCR9E VlORH N!D 6W�RE FOOTAOC�INVOLVED � � <br /> �. F <br /> PROPOSEOUSEOFBUILDINO I HEREBV CEHTIFY THAT I HAVE HEAD AND EXAMINED THIS <br /> � � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG�LDESCHIPTIONOFVPOPEHTV�SNOMMBELOWOR�iTACNFWRCAf'IES) PROVIS�ONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WI7H VdHETHER SPECIFIED HEREIN OR <br /> �oT &� °F NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR �ANCtL THE PROVISIONS OF ANV � <br /> OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE r� <br /> PERFORMANCE OF CONSTiiUCTION.THAT I AM AUTHOR!YED BY THE <br /> OWNER OF THIS PROPEqTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND t COMPIV WITH THE STATE i <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> fiNiNATURE OF GONTR�GTOH OR�UTMOR2EU�OENT D�TE <br /> PPOJEGTMDRESS 3 � "�� '— ' °--�"-" s <br /> �e�JI B�L`� /f APPL ANTSGRVBUbIN[SSLICENSENO.ANUBUSINE6SN�ME <br /> PLUMlINO MECHONICAL <br /> . <br /> NO. TYPE OF FO(TURE OR iTEM FEE NO. TYPE OF EOUIPMENT FE y <br /> WATEH CLGSET(TOILET) � AJ�:—NHNDLG UNITS—H.P. � 7t�AJ �� �' <br /> BATHTUB ; �GACED AIR SY5IEMS—B.T.U. M E.A. ' <br /> UVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M T_ � <br /> SHOWER ' CLOTHES DfiYERS � �� <br /> KITCHEN SINK 8 DISP � VENTILATION fAN � r� <br /> DISHWASHEF � RANGE HOOD � � <br /> 4: <br /> LAUNDRVTRAY ; WATER HEA7ER ' t; <br /> CLOTHES WASHER � WOOD STOVE i ' <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � j: <br /> DFINKING FOUNTAIN i FIREPLACE INSERT i <br /> FLOOR ORAIN � HEAT PUMP � � <br /> i� <br /> BACKFLOW PRFVENTERS i GAS PIPING �_ k <br /> ROOF DFAINS—RAINLEADEFS � EXHAUST F'AN �� <br /> SINK(SERVICE—BAR,ETC.) ' � � <br /> i � <br /> � � �g� <br /> � I U <br /> � � <br /> � � <br /> SUB TOTAL E ; SUB TOTAL S ' �' <br /> PERMIT $ � PERMIT E � <br /> � I' <br /> TOTAL FEE $ ' TOTAL FEE E � <br /> FRONTSETB�CN HEAR6ETB�CH SIOE6ETBACK PLANGHECKNUMBER FEE RECEIPTNO. Y <br /> a <br /> USE20VE LOTANEA VACANT6ITE FEES VALUATION FEE �' <br /> i <br /> ❑ YES ❑ NO BUILDINO . � r <br /> TYPf 01 CONST AILOWABIF TVPE Of CONST.�CTIUL ��Y �a OW[llMO NIrt6 � ", <br /> ��0� PLUMBIN6 _ ' �1 <br /> 61ZEf)FBLW. NO.OFSTCRIES BRSEMENT MECHANICAL � L <br /> ❑ YES ❑ NO � ^` � <br /> OCGUPANCYLO�D FIFESPflNKLER5RE0D HEN3HTLIMITATION OTHER i �. <br /> I ' <br /> ❑ YES ❑ NO STATE BUILDINO SURCHARGE � <br /> i • <br /> NE/�SON FOR SPNINKLEHS —� <br /> STATEENERGYSURCHARGE i y <br /> �FPLICATIONACC.BY PLANSAPPROVEOBV CITYOFEVERETT PUBLICWORKS � i <br /> LOCALSALES ' — ' <br /> �(.� TAl(CODE IS 3105 Tot�� � '`ri = ! <br /> I <br />