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,:. <br /> � 41PPLICATI� FOR CONSTRUC7�N PERMIT everett <br /> ` "" TO BE COMPLETED IN INK—PLEASE PRINT � <br /> �.r,-IM Ewrpreen <br /> �"�� CITVOF } <br /> eVerel� • " ' ''HEATINGSYSTEM: GAS ❑ELECTRIC O <br /> . i, BUILDING DEPARTMENT <br /> j 259•8810 � <br /> � ❑ DEMOLITION CI COMBINATION i I BUILDING iR'MECHANICAL I 1 PLUMBING ❑ SIGN <br /> � <br /> �� ONTlER M�ILAODRESS CITY ZIP FHONE <br /> 1 <br /> " AJoon�DE SAYAUI L�:t(o 1 T�� S.l�.#IOIa �VERETi' qR`.ZO�-I 7�13-55(� � <br /> .13� TENMIT MAILADDHESS qTY ZIP PNONE <br /> •+ <br /> �� MCXITECTORGESIGNER MAILADDflESS CITY ZIP PHONE <br /> y OENEflALCONTRACTOR MAILAOORESS CITY ZIP PNONE LICENSE� <br /> �� <br /> .� (�fl�(�11t1E�n-fHN'1Z('�AL pD.(j�_�j l,vurD ,'rrr� � 9��4� 77�{-�?E-1� <br /> .,� MECNANICNLCONTMCTOR MAILADDRESS —�_ CITY ZIP PHONE LICENSEi <br /> �i Q14MDICMGCNA/JILA� a o t�r!�32� ��._�,ro���c�A q80�1� yyy-88u 1 a..Y1�P�r i7r�o� <br /> � .' PLUMBIN�CONTR�CTOfl MAILAODRESS CITY ZIP PHONE LICENSE� <br /> C OFN'ORK <br /> .. NEW I� I ADDITION I I ALTERATION I I P�EPAIR I I DEMOLITION I i WOODSTOVE/FRPL INSERT f I BUILDING RELOCATION <br /> � CONTqCT PERSON AND PHONE NO. <br /> �. CONTMCt%iICEOFWORK J� Q�p�- =1,L�d eRAtJTC�(2f� 77�}_ R��� � <br /> � DEBCqIBE N/ORK ANU SIXIARE FOOT�OE INVOLVED <br /> ; 4�-I. !e 7°I 5. F . <br /> � vaovoseouseoFeuaowa I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � '' APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �' IEML DE6CPIPTqN OF PROPEHTY(SHOWN BELOW OR�TTACH FOUR COPIESI PROVISIONS UF LAWS AND OFiDINANCES GOVER�I�'3 THIS TVPE OF <br /> I;j WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br /> �ot etocK oF NOT. THE GRANTING OF.4 PERMIT DOES NOT PRESUME TO GIVE <br /> },� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> �' � PERFORMANCE OF ONS RUCT ON.�THATG AM AUTHORIZED BY HE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> '� APPUCATION IS MADE AND I COMPLV WITH THE STATE <br /> ;; CONTFACTORS LAW 1827 RCW AND 298.200 WAC. <br /> ��� SIGNATUHEOFCONTflACTORORAUiHOHIZED�OENT D� <br /> A � <br /> ,� - - R6E X <br /> ) vno.ieer�ooness <br /> ,� � � APPUC�NTS CI INESS LICENSE NO.AN U ESS NMI <br /> PIUM INO MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) � NC—NHNDLG UNITS—H.P. , <br /> �'i BATHTUB ; FOflCED AIR SYSTEMS—B.T.U. M E.A. � <br /> �q UWATORY(WASHBASIN)� � UNITHEATERS—B.T.U. M ' <br /> �1 SHOWER � CLOTHES DRYERS � <br /> ;� NITCHEN SINK 6 OISP ; VENTILATION FAN ; <br /> '� DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> , , i <br /> ,� �URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> �� DRINKINO FOUNTAIN � rIREPLACE INSERT ' <br /> � FLOOR DRAIN � HEAT PUMP � <br /> �� BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ',� ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> ' SINK(SERVICE—BAR,ETC.) ; � <br /> � � — <br /> i � <br /> i <br /> � � <br /> � , <br /> � , <br /> SUB TOTAL $ ; SUB TOTAL S ' '� <br /> PERMIT $ � PERMIT $ ';� <br /> TOTAL FEE $ ' TCTAL FEE $ � � <br /> FOR OFFICE USE ONLY: <br /> FRONTSET&1CK REARSETBACK SIDESETBACK PLANCMEGRNUMOER FEE RECEIPTNO. <br /> USEZONE LOTARER yACRNi51TE FEES VALUATION FEE <br /> �'T <br /> BUILOING � <br /> i <br /> 1YYEOFCONTS.RLIOWABLE TYPEOfCONSIRCIUAL ocNr�r;cr NoOrpw[wnc�MnS <br /> �pWr PLUMBING � <br /> I <br /> 52EOFBlD(3. NO.OFSTORIES 6ASEMENi MECHANICAL � <br /> � � ' <br /> i <br /> OCCUPANCYLOAD FIRESPRNKLERSPE00 HEIGNiUMITATION ADDITIONALPLANCHECK � <br /> OiHER � <br /> flEA50NfOTSPHINKLERS � <br /> STATE BUILDING SURCHARGE � <br /> INTAKE BY PlANS APPflOVED BY CITY OF EVEflETT PUBLIC WOflHS i <br /> � LOCALSALES ' <br /> TAX CODE IS 3105 TOTAL �� ;� <br /> .; <br /> � <br /> ,F,�., � - _ ._ <br />