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--• APPLICATILN FOR CONSTRUC7YON PERMIT <br /> m,E„„�,,,,, everett <br /> CITV OF e <br /> i everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ❑ DEMOLITION O COMBINATION N BUILDING I l MECHANICAL I I pLUM81NG ❑ SIGN <br /> ONMER M�0.AODRESS p7y qp p�pryE <br /> � D�c FE �ir� SSzs B�9vwA f �vERE1T 98�?� 3+1 S-96�Z ' <br /> TENANi M�ILADDNESS LT' ZIP PHONE <br /> �RCMITECTORDESH3NER /.UILADURESS CITV 21P PNONE <br /> � RALCONTRAC�5 MRILADONESS CITY ZIP pHONE LICENSE� <br /> � ��✓ /f C/D//.vSoN `/3Z7 F+�KEs�' G�P. ��£PE�?' 9��03 ZSg-29/2 Ql�/}�ZC'�ZI� <br /> � MECMANIGLLCONTRAGTOR MAILADDPE55 CITY 21P FIqNE LICENSE� <br /> I VLUMBMOCANTR�CTOR MAILADDRESS CITY =IP PHONE LICENSEI <br /> � CLA690FW0liK <br /> ' � NEW O ADDITION �7 ALTERATION I_I qEPAIR I] DEMOLITION I ! N'OODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> � TENANTIMPROVEMENTORINiERqRREM�DELONLY CONTACTPERSONANOPHONENO. <br /> t �. <br /> j CWTR�CTPPICEOF,WORN: y <br /> DEBCRIBE WORK AND SOU�FE FOOTAOE INVOLVED <br /> �' �'i Y f�. <br /> PROPO6EDUSEOFBUIlDINO I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LE011LDEBCRIPTIONOFPROPEFTV�SHOWNBELOWORATTACNFOURCAPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN Ofl <br /> �ot e�oc�c oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPER7Y TO PERFORM THE WORK FOR JVHICH <br /> , APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ��`.;�` CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> � ' SIGNA7UPEOFCpNTRACTORORRUTHORIZEOAGENi DATE <br /> � <br /> PRO.IECT MORE69 <br /> ��,�crryCotiS��tZr�nl <br /> S '�� �t•Q APP CANT5CIiVBUSI ESELICENSENO.ANDBUSME55NAME <br /> PLUMOINO MECHANICRL <br /> NO. TYPE OF FUCTURE OR ITEM FEE N0. TYPE OF EOUIPMEN7 FEE <br /> WATER CLOSET(TOILET) � NC—lUHNDLG UNITS—H.P. <br /> BATH7UB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> _ LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHESDRVERS <br /> KITCfiEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER RANGE HOOD � <br /> � <br /> LAUNDRY TRAY � WAl�ER HEATER i <br /> CLOTHES WASHER i WODD STOVE ' <br /> URINAI ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT � <br />� FLOOR DRAIN � HEP.T PUMP , <br /> i BACKFLOW PREVENTERS ' GAS PIPING � <br /> ROOF DRA�NS—RAINLEADERS � EXHAUST FAN , <br /> � SINK(SERVICE—BAR,ETC.) � � <br /> � � <br /> i <br /> � � <br /> � � — <br />_ ' � <br />` � T— <br />+ � <br />� SUB TOTAL $ ; £JB TOTAL $ � <br /> i PERMIT $ � PERMIT $ <br />� TqTAL FEE $ ' TOTAL FEE $ � <br /> FRONTSETBACK PE�P6ETBACN SIUESETB�CH PLANCHECKNl1M6ER FEE qECE1PTNp. <br /> U6E20NE tOTARE� V�C�NTSITE PEES VALUATION FEE <br /> f] YES ❑ NO BUiLDMa <br /> TYPEDFLONST.�LLOWRBLE TYPEOiLON51.�CTUAL occuo�xcr xouoxtturry�ne � �T`y 6,3 �00 <br /> p�o <br /> � <br /> _'3 � PLUMBINQ i <br /> SIZEOFBL06. NO.OFbTORIES BASEMENT MECHANICAL � <br /> Sfl `Z�F LI vES NO � <br /> OCCUPANCYl0�0 FIRESPHNNLEHSflEO'D HEI(3NTLIMITATION OTHER � ✓� � J� <br /> / <br /> ❑ YES N�10 --�� SiATE BUILDING SURCHARGE � <br /> RE� OP 6PRINKLER$ � i <br /> STATE ENERGV SURCIiAFGE ' <br /> APPLIC�TIONRCG.BY PUNSAPPf�OVEDBY CiTYOFEVEHETT PUBLICWORKS i <br /> LOCAL SALES � <br /> �� TAX C0�°IS 3105 TOTAL � <br /> /o � `�J`i <br />�- - _ .__._ .. <br /> ..,,----._.. .__.._. _--- -,,,.... .,�.,,.��--.-_,_.._.._...--•-._._, <br /> - ---,-,- - - <br />