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APPLICATIONyFOR CONSTRUCTIl.�I PERMIT everett � <br /> m.Ewro� TO BE COMPLETED IN INK—PLEASE PRINT � t <br /> � <br /> cirr oF fr <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ y�^vC { <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOUTION [ 1 COMBINATION ��UIIDfNG [-;MECHANICAL ❑PLUMBING 17 SIGN <br /> �Ep MRM1�ODRESS GTY Z�P PNONE <br /> �riN /'� �o/ClE� (a/a3 /7zhlD G'wc�r�.c�a/�li�J� GUH 9�,4�7 7'�'3 393'� <br /> TENIINT 1/�M1AODRE55 <br /> %F',�'Y /�l�� �G9 4�a,.� �'.�9�U.9`l EY�-��r i.��it y8zo 3 ��3—os� 7 <br /> �RCMITECTOHDESIGNER MAILADDR[55 GTY 11P %�E <br /> QENE�I � ��T� MMl A�DHESS CITY ZIP PHOHE L�CENSE� <br /> MECN�p�.�Tq/�Tpq � MA�DDFESS CItY 21P P110NE LIGENSE� _�— <br /> _��i�f} <br /> ��� zry P/qNE LICENSE� <br /> PLIHAl�MO .WTHAGTOR M41L�OOPE53 <br /> N <br /> CU86 WOi1K <br /> ��FIEW ❑ ADDITION I 1 ALTERATION I 1 REPAIR � I DEMOLITION I 1 WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> � LONTAGTPEF90N DPMONENO. �. <br /> � .e7 1 <br /> CpNTR�CT PPICE OF YIORK � �l« 7 3 3 � <br /> OE6CRI8E WOR1(�ND 6OU�AE F(%1TA E INVOLVEO <br /> 7 � � � <br /> pqpP09EDU/6�EOFBWlDINO I HEREBV CEFTIFY THAT 1 HAVE HEAD AND EXAMINED THIS <br /> /i�APA��— ��5���n>»A G APPLICATON AND KNOW THE SAME TO BE TRUE AND COHRECT.ALL , <br /> �Ew�oE p�pT10NpF P 91'EHTY�SMOM410ELOW ORATT�GI URGOPIES� PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THIS TVPE Of <br /> �—D�,P,; 9 WqRK Wlll BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR t <br /> LOT b�ocK ov NOT. THE GRANTWG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OH CANCEL 7HE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THA?I AM AUTHOPIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOPK FOR WHICH <br /> APPLICATION IS IdADE AND 1 COtdPLY WITH THE STATE <br /> — CONTRACTGRS LAW 18.27 RCW AND 296.200 WAC. <br /> S�GNAiURE OF CONTA�CTO�i OR AUi110t1IZED AGENT OATE <br /> � ���� � - -�r X �,��J� .�/r� <br /> PIIO,kGT��DRE55 ��v��/���{ �� �,/�,��� �pp���NSG�T�BVSINE55LICENSENO.�NDBU5MES5N�ME i <br /> (!/ !J'r�/U <br /> n���NQ MECMANICAL � <br /> Np, TEfPE OF FIXTURE OR ITEM ��EE NO. TYPE OF EOUIPMENT FEE i <br /> WATER CLOSET(TOILET) � A/G—lVHNDLG UNITS—H.P. !_ <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORV(WASH BASIN) � UWIT HEATERS—B.T.U. M �_ <br /> SHOWER ' CLOTHESDRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ��: <br /> DISHWASHER � RANGE HOOD _ ' � <br /> IAUNDRY TRAV � WATER IIEATEF G <br /> CLOTHES WASHER � _ WO�D STOVE ;_ � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> DRINNING FOUNTAIN � FIREPLACE INSEHT �� <br /> FLOOR URAIN � HEAT PUMP ' � <br /> � � <br /> BACKFLOW PREVENTERS ; GAS PIPING _ ' <br /> ROOF DRAINS—RAINLEADERS ; EXHAUST FAN !— <br /> � <br /> SINK(SERVICE—BAR,ETC.) i i <br /> � ' . <br /> � <br /> � � <br /> � <br /> � - � <br /> � i <br /> , ' i. <br /> SUB TOTAI S ' SUB TOTAL 3 ' ( <br /> � <br /> PERMIT $ � PERMIT $ �_ � <br /> TOTAL FEE $ ' TOTAI FEE $ ' �� <br /> FOR OFFICE USE ONLY: ' <br /> FRONT bETBACK REAR 6ETBACK SIDE 6EtBRCK PV.V CNEC NUMBER PEE � RECEIPT NO <br /> Zo� � � q� ac¢�� . �SzQ°�' <br /> U6EZONE LOTAREA VACANi51TE FEES VALUATION FEE � <br /> i � <br /> � BUILDING � p0 '��_ t' <br /> 7YPE OF CON75.�IIOWABLE iVPE Of COHSL IiL7UAL ottuwxcr NO p UwttUxc uxns ' �� <br /> �"0110 .� PLUMBING �" <br /> 6V.EOFBLD6. NO.OFSTORIES BRSLMENT MECHANICAL �� . <br /> y0 SF Alo '_(r�f�5�5�;Cnr <br /> OCCUPANGVLOA� FIRESPqNNLERSREOD HEIG!IT1.'MItATION ADDITIONFLPLANCHECK �I ��d il <br /> n►o ( ' � 4 <br /> DTHEfi � <br /> -�T � <br /> REA60NFORSPA�NRLERS �Cm f <br /> SThTE�UILDINaSURCHARGE •� � <br /> INTAREBY PUNSAPPROVEUBY CITYOFEVEREI"f CU�LIGWORKS � ! <br /> �.� LOCAL SALES � <br /> Z�t� TAX CODE IS 31�il5 TOTAL 3,�j ;Z6 i <br /> . � <br /> — -.._ . ..---- <br /> .........,.,�..,, _ �. ..,.,-,,e_..., - - ' --,a.. <br />