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APPL�CA�i��0�1 FOR CONST�iUvT10N <br /> � PEFiMiT <br /> Ihe Everpreen <br /> CITY OF rvcrell <br /> everett ' e <br /> BUILDING DEPARTMENT <br /> 259-8810 TO 8E COMPLETED IN INK— PLEASE PRINT <br /> ' OWNER / ANILADONE59 4/ ' CIiV ZIP PNONE <br /> � I�ct{ /�1�SLhllCtwav�noNi 1 �35� Cv,l� �:r 7o�s'n°c SPa. ��. S6/�y 36G-s���/ <br /> � TEN�NT 1AAILROOPE55 LIiY ZIP PHONE <br /> MCHIiECTOR�E516NEN MAILAODRESS GITY 21P pHONE <br /> 6ENEfl�LCONiRACiOfl MMLAOOPE55 CIfY 21P PIIONE LICENSE• <br /> MEGHANIG�ICONSfl�CTOR MAILA�OBES9 CIIY ZIP PMONE LIC[NSE� <br /> PLUMBINOCONTN6Ci0R MAIL�UDBE55 CILY ZiP PHONE LICENSE� <br /> ; �n sr �� S. o -5 l. /�/G/m/3�/�/Ir►L <br /> CL'SS OF WOpN <br /> ❑ NEW A�DITION ❑ ALTERATION ❑ FEPAIR ❑ DEh10LITION ❑ WOODSTOVE/FRPLINSERT ❑ 6UILDINGRELOCATION <br /> IENANT IMPqOVEMENT ON INIERION REMOUEL ONIY CONi.1CT PEq50N AN�PIIONE NO <br /> CONTP�GTPRICEOF WOFK <br /> DESCRIBE WOflK�ND SOUMiE FOOIAGE INVOLVEO <br /> 7YaYA/v/ //YIOQGY/C/�7(JJ/ <br /> P9GPOSED U9E OF BUILOINU I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS APPLICATION AND <br /> j � NNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> LEOALDESCflIPT10NOFPFOPERTY�SHOWNOELOWONATTRLIIFOUNCOPIES) ORGINANCESGOV�RNINGTHISTYPEOFWORKWILLBECOMPLE7EDWITH <br /> W HEiHER SPECIFIED HEREIN OF NOT.THE GRANTING OFA PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> j LOT e�ocK oF ANYOTHERS'ATEOflLOCALLAWREGULATINGCONSTRUCTIONORTHEPER- <br /> FORMANCE OF CONSTRUCtION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPEFTY TO PERFORM THE WORK FOR WHICH APALICATION IS MADE <br /> � AND I COMPLY WITH THE STATE CONiRACTORS LAW 1827 RCW AND <br /> 296.2U0 WAC. <br /> i SI4N�tUFEOF Nf TORORRU 11 Ep� DRiE <br /> i PPQIECTAOOflE53 � L ��/--- <br /> , pPPLI CIIVBU I GENSE .F DBIl51NE55NRM <br /> ; �f`L 3 Euc-i�YC r��-►J W A-� <br /> I � PLUMBIN6 � MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATERCLOSET�TOILE7) AIC—AIHNDLGUNITS—H.P. <br /> i <br /> BATHTUB FORCED AIR SYSTEMS—B.T.�. M EA <br /> � � LAVATORY(WASH BASIN) UNIT HEATERS—B.i.U. M <br /> � SHOWER CIOTHESDRYERS <br /> � KITCHEN SINKd DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> ' LAUNDRYTFAY - � WATERHEATER <br /> � CLOTHESWASHER WOODSTOVE <br /> � URINAL METAL FIREPLACEB CHIMNEY <br /> 1 DRINKING FOUNTAIN FIREPLACE INSFRT <br /> I FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS GAS PIPING <br /> � � ROOFDRAINS—RAINLEADERS EICHAUSTFAN <br /> ' SINK(SERVICE—BAR.ETC.) � <br /> .� _ <br /> i <br /> � - <br /> � - - - <br /> � . <br /> SUBTOTAL S SUBTOTAL 5 <br /> ( � PERMIT 5 � PERMIT S <br /> � — <br /> TOTAL FEE 5 70TAL FEE 5 <br /> FRONTSETBACK REAqSEfBFLK 51DESEIBACK PLANCNECKNUMBEfl FEE BE�EII+iNO. <br /> USEZonE LOTnnE+� �ACRNi511E FEES VALUATION FEE <br /> ❑YES O NO <br /> auaowc <br /> � TYPEOFCANST. OLGUI'ANCYOPOUP NO.OF�WE�LINOUNITS <br /> � ALLOWABLEJACil1Al <br /> � � PLUMBING <br /> j 312EOF�LOQ NO.OFSIOtilES BSMT. OCGLOA� <br /> 1 . o v MECHANICAL <br /> O N — — <br /> � NEIOHTLIMITATION OTHER <br /> i <br /> FIRESPRINNLERS REOUIRED o ves o No STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCHARGE <br /> APPLILATIONALGBY PIANSNPPi10Y <br /> � PUBLIC WORKS <br /> I TO7AL <br />