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i <br /> .� ,•, I <br /> APPLICATIL.� FOR CONS��RUC7 .dN r�RMfT �, <br /> IL � L everett <br /> rne eve�,ee� ��.. ( e�.'�'f�� C ��C.9a�Q_ <br /> �,�aF �-__ _ ___ e <br /> everett -�— <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOUTION � COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OVRI'.R M�II�ODRE55 CITV liP PHONE <br /> �ST/F-,��iC'/IPHi1sL /7LZ2 CJ. G�iSHdU ,L'i? SN,;Lri�Nis,u .[Jq `�Kz�,� �6L'-7�f''f s�3-�.k) <br /> TENAN7� MAIL�ODRE55 CiTY lIP PHONE i <br /> �10NE _ <br /> �PCNRECTORUESIONER M�IL�DDRE55 G�TY IIP PNONE <br /> T�,�,ey ,2,y,�eSi,��w za�z rocRv nvF ei� y�r�� zsz- 693'L <br /> QENEB0.CONiRACTON M�II��DRESS CIiV 21P PMONE IICENSE� <br /> ,�HC Ay O�✓Nc�E'S -- <br /> MEEM�M�BIitCONTRACTOR MMI�DDRESS QTv 21P PNONE UCENSE� <br /> .F.tEcTl4c'�c TO h't� .Dr��(!/NGi� <br /> PWMdINOCONTRAGTOR MAII�DDRESS QTY ZiP PMONE IICENSE� <br /> TD <?� �ciZ',�N/n:CO <br /> . cuss oF vroan <br /> I_i NEW I_' ADDITION X ALTERATION ,C REPAIR � � DEMOLITION _ � WOOUSTOVE/FRPL INSERT �BUILDINO RFLOCATION <br /> TENANT IMPROVEMENT OR INTERIOR REMOOEL O4LY CON7�C1 PEP50��PNONE fM �I <br /> �ONfR�CTPRILEOFWORIt: �� / i � <br /> ,�cl�+.-- Ly�h r i �/ /7Ta:�l+lx1.F <br /> DESCR16EWORN�NDSW�REFOCT�OEINVOIVED r1�' GJ(�b �S� <br /> NOVE -ON 2E5. SiRe+cTu/+d • �lPP. � 330 � 3>3 -9(��J_�/ S6fS- 7Sa'y _ <br /> PROPOSEDUSEOf8U1lU1N0 1 HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> ESiDc UT/HL APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALL <br /> ' LEMIDEBCRIPTIONOFPROPERtt�5H0YIVBEIOWOFATUCNFWRCOPIES� PROVISIONSOflAWSANDOHDINANCESGOVERNINGTHISNPEOF <br /> � WORK WII.L BE COMPLETED WITH WHETHER SPECIFIED NEREIN OF <br /> � �oT Bia" o� NOT. 1 HE r,qANTING OF A PERMiT DOE5 NOT PRESUME TO aIVE <br /> AUTHUfi1TV TO VICLATE OR CANCEL THE PROVISIONS OF ANY <br /> SE6 C�OB.V G7lTC! - �E � �Oci7 OTHEFi S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> " PERFORMANCI:OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> Plfri �//9P OF S✓/fl.e%/�U9T /�C.9J�s� OWNER OF THIS PFOPERTV TO PERFORM THE WORN FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> w a CONTRACTOHS LAW 1827 RCW AND 296200 WAC. <br /> � /f% �/yc. CfJsiivn PrD C V/, SIGNQUREOiCONiRACTOPORAUTNORIZEO�aENT DATE <br /> �. Pf.JIECT�WHESS f {��J � ��^ LQ ^'«"'"Q� <br /> y/(, E� ��ND �P GV/• /(yylJ APVUC�NTSCITVBUSMESSIICEN5EN0 �NDB1151NES5N�ME <br /> . PLUMeINO MECMANICAL <br /> � NO. TYPE OF FU(TUAE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> . WATER CLOSET(TOILET) NC-A/HNDLG UNITS-H.P. T <br /> BATHTUB FORCED AIR SVSTEMS-B.T.U. M E.A. <br /> ' LAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M i <br /> SHOWER CLOTHES DRVERS <br /> KITCHEN SINH 8 DISP VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAV ; WATER HEATEF <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY <br /> DRINKINO FOUNTAIN FIREPLACE INSERT i <br /> T <br /> FLWR DRAIN HEAT PUMP � <br /> � BACKFLOW PqEVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE-BAF,ETC.) ; . <br /> � � <br /> � <br /> � <br /> � � <br /> SU8 TOTAL S SUB TOTAL S <br /> PERMIT S � PERMIT S <br /> TOTALFEE 5 TOTALFEE E ' <br /> FRONTSEIoB�CN RE�RahT�K SI�ESEib,CN , �' PL�NCI CNNQMBEP FEE � �EC!"iPINO � <br /> 2 � � S a 3 3 <br /> use z ie l0T ARE� V�C�NT SITE FEES VALUATION FEE <br /> .. � VES � ' NU BUILOING W(/ /J �� ', l <br /> IYPf Of CONSTAIOW�BIE IVV[01 G!IH51 AL7111L K_.1 IXNoupv Mn q MrtwIM UNrtE --- -- <br /> Y I� �^'wP PLUMBING ��� .-� <br /> '3 —��-=�-5---' <br /> SREOFBlDO. NOOFSTONES P/.SEMENT MECHANICAL � <br /> 331 Sf I VES )( NO � I <br /> OCCUP�NGVLOAD �IRESPRNRlER511E0'0 NEIOHTLIMIT�TION CTHER i i <br /> B� <br /> -. �' VES bC NO Z STATE BUILOING SURCHAFGE f� ��-" _/ �' <br /> REASON FOR&PRINKLEPS I <br /> STATEENERGYSURCHARGE i j <br /> ♦PPIICATON�CC BV PlANS�PP�VE�BY CITY OF EVERETT PUBLIC WORNS /i . � � <br /> LOCALSALES i <br /> TIU(CODE IS 3105 TOTAL <l , <br /> � <br />