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i � .. <br /> ;. <br /> APPLICi����ON FOR CONSTRI�►�TION <br /> PERMIT <br /> Ihe Everpreer everell <br /> CITY OF � <br /> ; everett <br /> BUILDING DEPARTMENT <br /> 259•eB10 TO BE COMPLETED IN INK— PLEASE PRINT <br /> � �OWNEP // AIAILRODRESS CIiY ZIP PNONE <br /> /' / ---L�O//, GIiY <br /> a ZIP PMONC <br /> � 'TENANT M/ILAD�RE55 Q,���•�".�� <br /> y:yl �4.s..o� �O//7—�f/Qrar�ssr Lt�. � �'—L— <br /> � ARGMITECTO�tbE5�6NEF MAIIAD�RESS � r ��TY ZiP PMONE <br /> � pENEHRLCONTN�CTOR MAILAD[1PE55 LITY ZIP PHONE LICENSE• ��. <br /> � MECH�NIC�LCONTRACTON MFIL��OPESS GIiY 21P PMONE LICENSE� <br /> X PLUMBIN GONtRRC Oq MAILROORESS CIiY 21P PMONE LICENSE• <br /> � n� !Y ffi �J�'ra �oBN <br /> �or� �c �a �r�a... /( ✓- �4 � <br /> I CL�90FWORM <br /> � ,� � �- /t---�L�6 �1dL <br /> . � NEW ❑ ADDITION ❑ ALTERAiION ❑ REPAIR � DEMOLITION CoOqCWOODOSi�NDI'Iwr+[NoSGRT ❑ BUILDINGRELOCATION <br /> TEN�NT IMPROVEMENT OR INIERIOR PEMOOEL ONLV <br /> I <br /> CONTRAC7 PRIG[OF WORIC I <br /> y OESCFI EWORKAN�SOURREFOOTAGEINVOLVE� <br /> �J I <br /> yfRpP09E�p useor i Na IHEREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND I <br /> ��� /�O�f r�� � KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND I <br /> dC YLt ORDINANCES GOVERNING THI57VPE OF WORK WILL BE COMPLETED WITH <br /> � LE�AlDESCflIPTIONOFPROPERtt�SHOWNBELOW��AtTRGMFOURCOPIES� WHETHERSPECIFIE[]HEREINORNOTTHEGRANTINGOFAPEPMITDOESNOT <br /> � PRESU ME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �oT e�ocK oF ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER• <br /> � FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> : qNID PRC�OMP YTWTHRT�E STATE CONTRACTORSH AWL1B27 RCW AND <br /> � 296200 WAC. <br /> SIGNAiUREOFCONTPACTONOf1AUiHOP12EDPGENT DRTE <br /> X /�i 0 ���',� ��/�.2��i <br /> �\g(IOJECTAD�RE55 � pPPE�JCNTS YOU iNE55lIGCNSE�NDBII�M� <br /> 0" ' � <br /> , PLUMBIN6 MECHANICAL <br /> ! Np, TYPE OF FI%TUHE Ofl ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � WATERCLOSET�TOILEn A/C—A/HNDLGUNITS—H.P. <br /> ' BATHTUEI FOR�ED AIR SYSTEMS—B.T.U. M EA <br /> LAVATORY(WASHBASIN) � UNITHEATERS—B.T.U. M <br /> SHOWER CLOTHESDRYERS <br /> ' KITCHEN SINKS DISP. VENTILATION FAN <br /> � DISHWASHER ' RAN�E HOOD <br /> LAUNDRYTRAY WATERHEATER <br /> CLOTHES\VO.SHER __ WOODSTOVE <br /> � URINAL "� METALFIREPLACEBCHIMNEY _ <br /> ' DRINKING FOUNTAIN FIFiEPLACE INSERT <br /> FLOORDRAIN � HEATPUMP � <br /> , BACKFLOW PFEVENTERS � GAS PIPING �j Bµ t I� <br /> � ROOFDRAINS—RAINLEADERS — EXHAUSTFAN : <br /> SINK(SERVICE—BAR,ETC.) �. <br /> f <br /> � <br /> SUBTOTAL S SUBTOTAL S <br /> ' PERMIT S PERMIT $ <br /> TOTAL FEE 5 � TOTAL FEE S <br /> FNONTSETBACK PERRSETBRCN .^+IOESE7BAGK PLANCHECKNUM9ER FEE PECEIPTNO. <br /> USEZONE IOTAREA VACr1N1SITE FEES VALUATION FEE <br /> ❑VES ❑NO <br /> BUILDING <br /> TYPEOFGONST. OCGUPANCY�ROUP NOAFOWELLINOUNITS <br /> ALIOWABLE/AGTOAI PLUMBING I <br /> SIZEOFBL00. NO.OFSTORIES BSML OCGLO�O MECHANICAL � <br /> ❑Y <br /> ❑N — i <br /> MEIOHILIMIIRTION OTHER I <br /> FIRESPFINKLERS REOOIREO ❑YES ❑ NO __ STATE BUILDING SURCHARGE � <br /> STATE ENERGY SL'RCHARGt ' <br /> APPLICATIONALC.eY PLANSPPPR.BY PUBLICWORKS <br /> TOTAL I +� <br />