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il <br />; ` � APPLICATI� FOR CONSTRUC�N P���IIT <br />� everett <br />: �E�� e <br />. �,r� <br />� everett <br />� BU�IDING DEPARTMENT TO BE COMPLETED IN INK L ASE PNINT <br /> i 259-8870 <br />� ❑ DEMOLITION ❑ COMBINATION � BUILDING �MECHANICAL ❑PLUMBING ❑ SIGN <br />! PHONFj�.. <br /> q M� �RE55 I� y� /`O ��ry � u f <br />� � U � i <br /> � M�RAODRE55 CITY ZIP _ PNONE <br /> �'�� / <br /> �RCMIiECTdIDESIONER MARAOORE55 LITY ZIP P�E <br />� TRAGTOR M IL/�D In/j���ClCITV '�^ ZIP E I <br /> � WVV 1...- .� <br /> yECH/JIICAI,CONT CTOR M�RADDFE55 <br /> arv r E� V� , -`J� ! <br />� p��pK-0�7qAGTpq M�ILA�DPESS CITV 2�P PIKKIE LICENS <br />., <br /> CUBS OF WxK <br /> � NEW G ADDITION ERATION I l REPAIR I I DEMOLITION I ! WOODSTOVE/FRPL INSERT [ I BUILDING HELOCATION <br /> 7ENMlTIMP110VEMENTORINTER�ORREMODEL�LY CONt�CTPEF50N�NDPHONENO. <br /> COMTMCT PPICE OF W011N: L �'_V <br /> pE�q� EFLp OEMVOWED'J �� <br /> ( T <br /> ouseoFeuaorc+a I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> � �(MI,pEg�pIPTqNOFPROPENNISMOWNBE�OWOAATT/�CMF(YIRCOPIE6� PROVISIONSOFLAWSANDORDINANCESGOVEPNINGTHISTYPEOF <br /> i WORK W�LL BE COMPLETED WITN WHETHER SPECIFIED HEREIN OR <br /> �T �p� ov NOT. THE GRANTING OF A PERMIT DOi S NOT PRESUME TO 61VE <br /> �� � AUTHORITV TO VIOLATE OR CANCEL �HE PROVISIONS OF ANY <br /> � ' OTHER STATE OR LOCAL LAW REGULATIN�CONSTRUCTION OR THE <br /> '� PERFOFiMANCE OF CONSTRUCTIClJ.THAT I AM AUTHORIZED BV THE <br /> , OWNEti OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> ; SIONQUP OFCONTPACtOROR�UTHORIZEOMENT DQE <br /> X V")`J1 y • I X/ �''�l �/_ �/ <br /> W l/ ��N � <br /> i MIOJECTAODRE88 APP ANTSCITYBUSME ICENSENO. DBUSINk55N�ME <br /> � �VM�� MECMANICAL <br /> ! <br /> Np. TYPE OF FlIlTUNE ON ITEM FEE N0. TYPE OF EOUIPMENT � <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> BATHTUB � � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER <br /> � CLOTHES DRYERS ' <br /> KITCHEN SINK 6 DISP � VENTILATION FAN � <br /> �' � RANGE HOOD ' <br /> � DISHWASHER � WATER HEATER � <br /> UIUNDRY TRI�Y � � <br /> CLOTHES WA:�F'ER i WOOD STOVE � <br /> � � METAL FIREPLACE d CHIMNEY ' <br /> I URINAL � <br /> ' FIREPLACE INSERT � <br /> DHINKINO FOUNTAIN � <br /> � <br /> FLOOH DRAIN � HEAT PUMP <br /> BACKFIOW PREVENTERS � GAS PIPING <br /> p00F DRAINS—RAINLEADERS � EXHAUST FAN � ' <br /> l ' <br /> SINK(SERVICE—BAR,ETC.) i � <br /> � <br /> � � <br /> � <br /> � � <br /> � � <br /> SUBTOTAL S <br /> � SUB TOTAL E ' <br /> PERMIT S � PERMIT E � <br /> TOTALFEE S ' TOTALFEE S ' _ <br /> FRONi6ETBACN RE�RSETBRCN SI�E5ETBACK PUNCHECNNl1MBEN fEE <br /> BECEIPT N0. <br /> 115E20NE LOTAREA VAC�NTS�TE FEES WILUATION FEE <br /> 1, YES LJ NO BUILUINO ' <br /> TYPE OF L01157.I�LIOWABLE IYPE W CONST ACi11AL ocCuwNh' NO a owFLL�xO uM��6 � <br /> °R0� PLUMBINO ' <br /> i <br /> SRE OF BLD�, NO,Of STORIES BASEMENT MECHANICAL � <br /> I_I YES U NO � <br /> OTHER ' <br /> OCCUPANCY101�D FIRESPRKK�EPSREOD HEIGMTLIMIT�TION � <br /> ❑ YES L7 NO STATE BUIL�ING SURCHARGE i <br /> RE�SON FOR 6PPINNLERS � <br /> STATEENERGYSURCHARGE � <br /> APPLIC�TION�CC,BY ' PUNSAPPROVEOBY CITYOFEVERETT PUBLICWORNS � <br /> LOCALSALES � <br /> TAX CODEIS 37U5 TOTRL ' <br />