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i <br /> � APPLICATII��I FOR CONSTRUCI�.�ON PERMIT <br /> everett <br /> �ha Evergreen � <br /> CITV OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 253-8810 <br /> ❑ DEMOLITION I I COMBINATION �BUILDING ! i MECHANICAL I PLUMBING I 1 SIGN <br /> M1IAIL ADDRESS /'� G / A I' <br /> CI1V ZIP PHONE � <br /> I . ER Z�c.�V F�K-l_"\—_�,� �/ � ��_. . <br /> I TEN�Ni MAILAD�fiE55 CItY <br /> Z�p PIIONE <br /> ARCHITECTOPDE5IGNEH MAILADDRESS <br /> CITV ZIP PHONE <br /> GENERALGONTRACTOR MAILADDPESS <br /> CITV 21P PHONE LICENSc• <br /> I ���� Z�p PHONE LICENSEI <br /> MECHANICRICONTRACTOR MAIIADDPE55 <br /> �� (PL]U�MBIN��CcONTRACTOR MAILADDRE55 CIIY 21P PHONE LICENSE�(�� (e1��,l�(� / <br /> 1- l�`c.--� �c -� , �,l �,. c � 3 �rl��'���I� 1� i7Q Stl..r" <br /> � �� � �a �QO('�l �_a���= <br /> �lAg$OF WORN <br /> IVi'�IEW I ADDITION I i ALTERATION i t FiEPAIR � � DFMOLITION I I WOODSTOVEIFRPL INSERT I I BUILDING RELOCATION <br /> TEN�NT IMPROVEMENT OR INTERIOF FEMCOEI ONLY <br /> CONT�CT PERSON AN�PIIONE NO. <br /> � CONTRACTPRICEOFWOfiN: ___ -- ----'—'------ <br /> UESCRIBE WOflK AND SOUARE FOOT�GE INVOLVED <br /> PROPOSEOUSEOFBUILDING I HEREBV CERTIFY THAT I HAVE REHD AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LE��LDESCRIPIqNOFPFlOPE01Y�S110WNNEI.OWORAl1ACI1f�0Ut1fOPIf.S1 PROVISIONSOPLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT e�ocK oF — NOT. TIiE GRANTING OF A PERMIT DOES NOT PRESUME TO aIVE <br /> AUTHORITY TO V10LATE OR CANCEL THE PROVISIONS OF ANY <br /> O1NER STATE OR LOCAL LAW REGULATING CONSTPUCIION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> I SIGNA7l1REOFCONifiAC70NORA77HOR2EDAGENT OATE <br /> ! X , 1^ <br /> V[J <br /> �� � PROJECTAODflESS � ,/J ppPL NTSCIYBUSINF$SLI NO. BUSINESSNpME <br /> / � t � � <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATECi CLOSET(TOILET) °j �(.;� � A/C—NHNDLG UNITS—H.P. ' <br /> BATHTUB — <br /> FORCED AIR SYSTEMS--B.tU. M E.A. ' <br /> � I --� UNIT HEATERS—B.T.U. M � <br /> LAVATORY(WASH BASW) ___,� �-�CL _ ------- �T— <br /> � CLOTHESORYERS • <br /> SHOWER ---'-- ---- -- -- � <br /> ------- ' VENlILAI�ONFAN � <br /> KITCHEN SINK B DISP ___;— -- — <br /> DISHWASHER � _ _ RANGE HOOD ' <br /> WATER HEATER � <br /> '� LAUNDRY TRAY � — ' <br /> , WOOD STOVE ' <br /> p.'� CLOTHES WASHEfl _ ,— � <br /> URINAL ' METAL FIFIEPLACE 8 CHIMNEY <br /> � <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> � � <br /> �'"' FLOOR DRAIN i HEAT PUMP_ <br /> '��� BACKFLOW PREVENTERS , __GP.S PIPING ' <br /> � � EXHAUSTFNJ ' <br /> ROOF DRAINS—RAINLEADERS _,_._ _ �- � <br /> � <br /> SINK(SERVICE—BAR,ETC.) � --- � <br /> � <br /> � <br /> — — — � <br /> , � <br /> � <br /> � <br /> SUBTOTAL $ 1�:' ;C't> SUBTOTAL $ ' <br /> PERMIT $ � <br /> PERMIT $ I C1 'C'f) 70TAL FEE $ <br /> TOTAI FEE S <br /> _aU [Y) <br /> fPONTSETAALK flEPRSETBACN SIOF.SE7B�CR <br /> P�AN CHECK NUMBER FEE RECEIPT NO. <br /> usezor+e LOTAqEA vncnNrsiTe PEES VALUATION FEE <br /> I I YES I i NO gUILDINC � <br /> 7YPEOfCONSi.AILOWABLF. IYfEOFLONSt.RLtuAI �curnHv xoMowRuncuxns — � <br /> cnmir � <br /> PLUMBING <br /> i <br /> SIZEOFOLOG. NOAFS7OOIES PASENFHI MECIIANICAL � <br /> I I YES ! I NO --�--------. ._._--' ; <br /> O711ER ' <br /> OCWPANCY LO�D FIBE SPfiNNLE115 R[O-D IIF.IGIII LIMIIAIION � <br /> I 1 YES I I NO 5!N F.HUII.DING SURCIINiGF � <br /> OEASON I0f1 SPRINNLERS � <br /> S7A1E FNERCY FUViCHAHGE ' <br /> i <br /> APPLIC�TION ACC.BY PL�NS APPf10VF.�BY CITY OF EVERETT PUBLIC W0�7NS � <br /> LOCAL SALES �` � <br /> TAX CODE IS 3105 TOTIIL <br />