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' -" '•',-_.�.:. _Q: <br /> - /��'. <br /> APPLIC�;�ION FOR CONSTRl��T10N <br /> PERMIT <br /> Iha Ever�reen everett <br /> CITY OF � <br /> everett '� <br /> ., <br /> , <br /> BUILDING DEPARTMENT Y <br /> 259•BB10 TO BE COMPLETED IN INK— PLEASE PRINT <br /> pWNEP MAIL�DOPE55 GITY ZIP PMONE •' <br /> ��. <br /> pu.,lSon� �fiovP � : <br /> TEN�NT MnILA0�RE55 GITY 21P PNONE �, <br /> MLMIiEGfORDE5IGNER MAILAD�flE55 GITY 21P PMONE � <br /> p�Stc��t�uiw �wic� 7'� co��MFSiP ceKT�- S�jq-R� 461oc(" �p22- l33? t <br /> QENEMLCONTR�CfON MFILAODRE55 CITY ZIP PHONE LICENSE• '� <br /> t�p Co��TF^��R°'a ��oo oo�,�µ��a c6vrr�r� 5� g��o� 6L2- 1�'�7 'Trixm%�K147�F ;. <br /> MECH�NIC�LGONTR�CTOP MFIL�DOFE55 GTV ZIP PNONE LICENSE• <br /> — � r <br /> PLUMBINaCONTpAGTOR M�ILA�ORESS GITY 21P PHONE V:ENSE• � <br /> � i. <br /> CUS90FKVRK P <br /> ❑ NEW ❑ AUDI710N ❑ ALTERATION ❑ REPAIR DEMOLITION ❑ WOODSTOVE/FqPLINSERT ❑ BUILDINGPELOCATION � <br /> TEN�NiIMPROVEMENTOflINTEflIORREMODELONLY CONTAGTPERSON�NOPNONENO <br /> �x- ��� 62z— l33'7 ' <br /> CONTHACT PPICE OF WORK �: <br /> OESCRIBE WOPK AND S�U�flE FOOTAGE INVOLVED <br /> '� I�` 1 1� I; <br /> , �; <br /> OUBEOFBUILDINO IHEREBYCEFTIFVTHATIHAVEPEADANDEXAMINEDTHISAPPLICATIONAND ��; <br /> KNOWTHESAMETOBETflUEANDCORRECT.ALLPROVISIONSOFUW9AND �;� <br /> �[cu� ESGHIPTI N AOPEflTYISMOWNBELOWONATGCMFOUFCOPIES� ORDINANCESGOVERNINGTHISTYPEOFWORKWILLBEGOMPLETEDWITH r�� <br /> <u WHETHERSPECIFIEOHEREINORNOT.THECaRANTINGOFAPERMITDOESNOT �. <br /> 1 �.�' PRESUMETOGIVEAUTHORINTOVIOLATEORCANCELTHEPROVISION80F ;� <br /> 'JTI� BLOCK or �'�'�'1� ~+'—��' A'.1YOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER• <br /> FORMANCEOFCONSTHUCTION.THATIAMAUTHORI2EDBYTIIEOWNEROF ���, <br /> VOL✓�� �Z D� Q PA � THISPROPERNTOPERFORMTHEWORKFORWHICHAPPLICATIONISMADE F- <br /> . AND I COMPLY WITH THE STATE CONTRACTORS LAW 1d27 RCW AND �,, <br /> 296200 WAC. r <br /> /���tiwO��H �JN� SIGNATUPEOFGONTPPCTORORAUTHORIZEURGENT �RTE Y� <br /> 7Vw �; <br /> �07 1�+5r+faRE+�✓t IN X � <br /> l` <br /> %10JEGT ADORE55 �PPI.IGANTS CITY B1151NE55 LICENSE N0.AN�BUSINE55 NRME �� <br /> �� <br /> � GtfJ. <br /> PLUMBIN� MECHANICAL Ft; <br /> NO. TYPE OF FIXTUNE OR 1TEM FEE N0. TYPE OF EOUIPMENT FEE 1! <br /> 4 <br /> WATER CLOSET(TOILEn !VC—A/H NDLG UNITS—H.P. �; <br /> BATHTU9 FORCED AIR SYSTEMS—B.T.U. M EA <br /> UVATORYlWA5H8ASIN) UNITHEATERS-6T.U. M .":. <br /> SHOWEH CLOTHES DRYERS f' <br /> VENTILATION FAN � <br /> KITCHEN SINK 8 DISP. w <br /> DISHWASHER RANGE HOOD ?t.• <br /> LAUNDRY TRAY WATER HEATER I�•� <br /> CLOTHES WASHER WOOD STOVE i; <br /> URINAL METAL FIREPLACE 8 CHIMNEY j; <br /> ORINNING FQUNTAIN _ FIiiEPLACE INSERT <br /> FLOOR DAAIN HFAT PUIdP �, <br /> BACKFLOW PREVENTERS GAS PIPING ' <br /> EXHAUSTFAN �'� <br /> ROOF DRAINS—RAINLEADERS �: <br /> SINK(SERVICE—BAti,ETC.) <br /> l- <br /> �;� <br /> —_ `� <br /> fi <br /> (�. <br /> I;1, <br /> SUBTOTAL 5 pERMOTAL $ �' <br /> PERMIT 3 - <br /> TOTAL FEE S TOTAL FEE 5 ��� <br /> RECEIPiNO. F <br /> FRONTSEfB/�CN FE�flSEfBACN SI�ESETBAGN PUNLHECKNUMBEP FEE p.. <br /> Y� <br /> VFC�NTSITE VALUATION FEE f' <br /> 1I5E20NE LOTPflEA FEES i( <br /> ❑YES ❑NO <br /> BUILDING <br /> 7YPEOFCANST. OCCUP�NCY�HOIIP NO.OFOWELLINGUNITS �, <br /> �LLOWABLFJRGTUAL pLUMBING ��, <br /> SI2EOFBL00. NO.OFSTOF�ES BSMT. OCGLO�U MECHANICAL I <br /> OY r� <br /> O N "� <br /> HEIGMTIIMITATION OTHER <br /> FIPESPRINKLERSREOUIPED ❑YE9 ❑ NO STATE BUILDING SURCHARGE � <br /> STATE ENEFiGY Sl1RCHARGE � <br /> APPLIC�TIONA GBV PLANSAPPR.BY � pUBLICWQRKS <br /> C rora� <br />