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.�:�,i <br /> •�. y <br /> APPLICATI� FOR CON�STRUC7�N PERMIT everett � <br /> �,E„�,�,�„ TO BE COMPLETED IN INK—PLEASE PRINT � I <br /> CITV OF }} <br /> eve���lL ' HEATINGSYSTEM: GAS ❑ELECTRIC Q <br /> BUILDING DEPARTMENT � I <br /> 259-8810 <br /> ❑ DEMOLITION I1 COMBINATION I 1 BUILDING �MECHANICAL (]PLUMBING f] SIGN <br /> i OWNER � M�ILAD�E55� — �� ^ll ' 21P y /�� �Q/ <br /> � C' C <br />' f TE �M1 AODRESS QTY IP PNONE <br /> t. <br /> 1 <br /> i� ARCHITECTOHDESK.NER MAILADDRE55 CITY 2�P PHONE <br /> 1 -- <br /> qAIG Tq T R� MAIL �FE � 7AiPq/���/ N� UCENSE� '. <br /> � O//// I <br /> i �t.LY <br /> MEGNNlILNLCOIITR�G';O ��IAU�RF55 CQV i� /L fP (S�LyONE _ LICE � <br /> ] PLUMBttIGCONTP�CTON M41LAD�RESS CITY � 21P PMONE LICEN6C� I <br /> { <br /> _ i C1A550F WORK ' I <br /> '; O NEW f 1 ADDITION �ERATION I I REPAIFi I I DEMOLITION I 1 WpppSTOVE/FRPL INSERT ❑ BUILDING RELOCATION � <br />•... ! /1� CONT�CT PERSON AND PMONE NO. . I <br /> ' y CpNTRAGT PRIGE OF WORK �''� �• <br />�I, . pEy�RIBE WOR 0 50 F T�GE INVOLVEO <br />�'v, � PPO BUILDIt:O I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> ,;� � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> i lE6�LDE5CRIPTIONOFPRIX+ERiY15110WNBELOWORATTACNFOURCOPIES� PROVISIONSOFLAWSANDOROINANCESGOVERNINGTHISTYPEOF , <br />'��-? WORK WILL BE COMPLETE�WITH WHETHER SPECIFIED HEREIN OR I <br /> ,� �or B�ocK or NOT. THE GRANTING OF A r'ERMIT DOES NOT PRESUME TO GIVE i <br /> _ '� AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY I <br /> - `. OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE � <br /> --� � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> ' �' OWNER OF THIS PROPERTY TO PERFORM THE WORK FOfl WHICH <br /> � APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> - � CONTRACTOPS LAW 1827 RCW AND 259200 WAC. <br /> SIGN�7UREOFCONiN�CTORORAUTNOR17=7A4E4'; D�TE <br /> ' � y <br /> - S A <br /> r. � PR0.IEGTADORESS � (� � _ <br /> iA PLIC�Hi5C1iYBU5iNE SL'CENSENO. N BUSMESSNAME <br /> 5"� PLUMBIN6 MECHANICAL <br />��� :f �� NO. TVPE OF FU(TURE OR ITEA1 FEE NO. TYPE OF EOUIPMENT FEE <br />�_�- WATER CLOSET(TOILEn ; A/C—NHNDLG UNITS—H.P. � <br /> BATHTUB , FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> 1,• �Rj� LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M i <br />�' ; SHOWER � CLOTHES DRYERS � <br /> +- g � KITCHEN SINK 8 DISP ; VENTILATION FAN ' <br /> 4 OISHWASHER � RANGE HOOD �— <br /> d LAUNDRYTFAY ; WATER HEATER ' <br /> C � CLOTHES WASHER � WOOD STOVE � <br />. URINAL ' METAI FIREPLACE 8 CHIMNEV � <br /> i- �� DRINKING FOUNTAIN � FlFEPLACE INSERT ; <br /> � FLOOR DRAItJ � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; � GAS PIPING ' <br />�� � ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br />� f. SINK(SERVICE—BAR,ETC.) ' ' <br /> 6 � <br />,r,. � I <br /> 1 � �— <br /> i <br />�� i � <br /> J � � i <br /> I. � i <br />; i <br /> SUB TOTAL $ ; SUB TOTAL S _�yO�_ <br />�' � PERMIT S � PERMIT $ /�,� � <br /> i . <br /> i� � T01'AL FEE E ' TOTAL FEE E ' <br /> ;+ FOR OFFICE USE ONLY: <br /> 1 FRONTSETB�CK IiE�PSETBACK SIDESETB�GN PLANCNECKNUMUER FEE FECEIPTNO. ' <br />' I USEZONE LOTAPE� WCANTSITE FEES VALUATION FEE <br />� . BUILDING � . <br /> � � TVPEOfGON75.MLOWABLf iYPEOftON57.ACNAI a:tlm�Nn laarvhYWHGUM05 j �, <br /> �� cnwo FLUM�ING � '� <br /> --r— <br /> s ' S2EOFBLDU, NO.OFSTORIES BASEMENi MECNANICAL �� ' <br /> , � , <br /> OCCUPANGYLOAD FIf1E5PNNKLER5RE0'0 MEIGNiLIMITATION ADDITIONALPLANCHECK i i <br /> i <br />• OTHEP � <br /> i <br />�I', - REASON FOR SPRINNLERS —� <br />�� STATE AUIL[71NG SURCHARGF i <br />' INTANEBY PL�NSAPPPOVEOOv CITYOFEVERETT PUBLICWORNS � � <br /> LOCAL SALES � <br /> TAX CODE IS 3105 TOTAL G� � <br /> nr'.n1...I "'Y . .. r � �.'., '��t: . ..n'. .. . ^..•.1� .ai :... . . .. .. . . . . .... , . - . . . _ <br /> . .. . ...... . ' .. ... .. . . u F..., . .�'c . � I. <br /> � <br />