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APPLICATI��N FOR CONSTRUCI�'rON PERI�/IIT <br /> Ihe Evnrpreen everett <br /> G1V OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> Y'DEMOLITION ❑ COMBINATION F]'BUILDING ❑MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ow.ynEn� �" � ���! ��n on ss an na rNor� <br /> WCl1,(i(/I � %�U l36Y. $ 3 [�`i,(.�`"r+'..0 lt�"t 2a .z S �f�jS <br /> TENANi MA1 AODRE53 , CITY IP PH <br /> � h2a/ <br /> ARCNILECTO/R� OESIONER MAI��f U�PE55 pTY IP PHONE <br /> �tc��-•�9 �i• �Co2 /l�cu�lf� Su. �lr� �¢� Lc.Q yYzol ' <br /> OENEH�I�CONiRRCIDiI MARADDPE59 CITY 21P PHONE 1.iCENSEI <br /> � <br /> MEGII/J11CAL iflAGTDiI AUILADDRESS CITY 20� PNONE ULENSE� <br /> PW��BINpCONTNAGT017 MARADDFE6S CIfY LP PHONE LICENSE� <br /> GUSSOF WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOQDSTUVE/FRPLINSEHT ❑ BUILDINGRELOCATION <br /> TEN�NT IMPAOVEMENT OR INTERqR REMODEL OYIV CONTACT PEFSON AND FHONE N0. <br /> ppNTR�CTPPICEOFWOi1N: /5� <br /> DESCRIBEWONKANDSWAPEFOOTAGEINV [D <br /> ��' I . <br /> R'1 <br /> rnovoseous asua ir+o I HEREOY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND HNCW TI1E SAME TO BE TRUE AND CORRECT.AlL <br /> LE6�lDESCRIPiqNOFPROPEBiY�SNOWNBELOWONATTACNFOUBCOPIES) PROVISIONSOFIAWSANDORDINANCESGOVERNINGTHIS�TVPEOF <br /> WORK WILL BE COMPLET[D WITH WHETHER SPECIFIED HEREIN OR <br /> �oT BLOGK vF NOT. THE GRANSING OF A PERMIi OOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANV <br /> OTHER STATE OH LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNEH OF THIS PROPERTY TO PERFORM TI1E WORK FOR WHICH <br /> — APPLICATION IS MAOE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS lAW 18.27 RCW AND 296.200 W4C. <br /> SIGNATVREOFLJNiPACTORORAUT/10PREDACENT DATE �/� <br /> VROJECT AOORESS ��jC���C/•1D/� <br /> � APPLICANTS CIN BUSIt1E55 LICENSE N0.AND DUSINE55 NAME <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET) � A/�NHNDL(;UNITS—H.P. � <br /> _�— <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. Pd <br /> SHOWER � CLOTHESDRYERS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER � RANGE HOO� <br /> —�— <br /> LAUNDRI'TRAY � WATERHEATEfi � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL 1.1ETAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPI_ACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP �— <br /> BACKFLOW PREVE�TERS � GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ' � <br /> � <br /> � � <br /> i � <br /> � I <br /> � � <br /> SUBTOTAL $ ; SUBTOTAI 5 ' <br /> PEFiMIT $ � PERMIT $ i <br /> TOTA�FEE $ ' TOTALFEE $ � <br /> FRONiSETB�CK PEARSETBAGK SIDESETBACK PUNCHELN 'UI.�@ER �,'I FEE /�q� RECEIPiNO. <br /> Z ���' � ...5� <br /> USEZONE IOTAPEA VALANi51TE FEES VAIUATION FEE <br /> �' ❑ YES O BUILDING i <br /> TVPEO,i�f si.�ILOWABLE 11PEOFCONSTACNAL ����' NO.qVAtuipGUNnS <br /> .LL"�i� �<sT G, ` =2 �— � <br /> PLUMBIN� ' <br /> --�— <br /> dREOFBLDO. NO.OFSTOflIES BRSEAIENT�/il MECNANICAL � <br /> 2(p L}U � � ❑ YES����0 NO <br /> OCCUPANCYIOAD FIFlESPANNLERSREOD HEIGMTLIAIItATION OiHER j <br /> �� ❑ YES ,CiYNO /S(/• STATEBUIL�INQSURCHARCE � <br /> REASON FOR SPRINKLERS <br /> S7AiEENERGVSURCHARGE i <br /> APPLIGAtIONACC.BV PUNSAPPROY BY CITYOFEVERETT PUB�ICWORKS ' <br /> LOCAL SALES ' � <br /> TAX CODE IS 3105 iOTAL <br />