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� <br />r <br />APPLIC.,.�ION FOR CONSTRI,.;TION <br />PERMIT <br />1 <br />rne e�ero�een <br />CITY OF <br />everett `°.�fe1 <br />BUILDING DEPARTMENT � <br />259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNEP — MRILROORESS ptY ZIP PHONE �� <br />City of Everett 3002 lYetmore Everett WA 98201 259-8544' <br />TENqNT MAILpDDFE55 CItY 21P PHCNE <br />ARCHITEGTORDESIGNER MRILApOqE55 <br />The Dykeman Architects ]bn2 HPWirr i <br />J♦ <br />-3161 John N3761 <br />PHONE LIGENSE t <br />',7-lc-,I_ i�„ �,ur>���� <br />... •.•••••• u�ense. <br />PIUMBINGCON7PACTOR M�IL�D7RE55 CiTY ZIP PHOIE <br />4CENSE • <br />�.NEW'^❑ ADDITION ❑ ALTERATION ❑ qEPAIR ❑ DEMOLITION ❑ WOODSTOVEJFRPLINSEfiT ❑ B111L01NGRELOCATION <br />CGNTMCT PRICE Oi WORK <br />DESCRIBE WORI( �ND SOUaPE FOC <br />B:anch Library <br />�� <br />l0T � � BLOCK �/ OF <br />��11! �I /1i�]� -�—�� <br />r�uMeiNa <br />40. TYPE OF fl1RURE OP <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINKd DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SUB TOTAL <br />PERMIT <br />ALLOWR9LE/FCTWLf � <br />�'6ola sF t � / <br />79/.t�.s�r� fXATi'aRM. <br />FiqESPRINKL[q5RE0UIRED ❑YES y <br />B �G <br />� <br />�FC-IcN I I 1 I <br />Thomas Tredway or John Jones <br />The Dykeman Architects 259-3161 <br />I HEREBV CERTIFY?HAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />NNOW THE SAME TO BE TAVE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING TH!S lYPE OF WORK WILL BE COMPLETED WITH <br />W HETH ER SPECIFIED H EREI N OR NOT. THE GRANTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL L�W REGULATIIJG CONSTRUCTION OR THE PER- <br />FORMANCE OF CONSTRUCTI; �V. ?HAT I AM AUTHOfiIZED BV THE OWNER OF <br />THIS PROPERTY TO PERFORM TFIE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND <br />296.200 WAG // <br />SIGNATUREOFWNTRACTORORhUiNORIZEDAGENT DyATE•IZ'�7��� <br />X �T,�1�/�.�L�i�:jPe�a/ <br />��� -�,,�/ <br />RPPLICr1NT5CITYBUSM S5LiCENSENp.itryDBUSWE55NAME <br />MECHANICAL <br />FEE NO. TYPE OF E <br />A/C — A/HNDLG U NITS <br />FORCED AIR SVSTEMS <br />UNIT HEATERS— B.T.U. <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATEF HEA7ER <br />5 <br />S <br />SIOESETBACK <br />WLRNT tUUUITF <br />❑ YES �N(1 <br />NO.OF DWELCNG <br />� <br />MT OCGLOAD <br />N 2l0 <br />NEiGHT LIMITAP01 <br />N. .4. <br />FIREPLACE I <br />HEATPUMP <br />FAN <br />!z13�I <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />GTHEF <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />H.P. <br />BT.U. <br />M <br />EY <br />L9 <br />TOTFLFEE <br />FEE fI� <br />I �i �'� <br />VALUATION <br />-I ro..✓w.��� v� �c,w�(iy1 <br />� <br />� <br />