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; APPLICATI4:� FOR CONSTRUCT .��N PERMIT ;'� <br /> � everett d <br /> 1 the Evorproen � <br /> � everett e �� <br /> , BUILDING DEPARTMENT 3 <br /> 259-8810 TO BE COMPLETED IN INK—PL�E�A E PRINT ,,� <br /> ' ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING VXMECHANICAL ❑PLUMBING ❑ SI(iN ;� <br /> (�ONRlER MAILAODNESS G7Y ZIP PNONG <br />'j ' l LI�(�]� �.1�h.1."fQ Q�. 2� �n �-c�,w�- �no�.�r fJ�. P���; a��03 � ; <br /> TEN MAII.� I7E55 CITY ZIP PlIONE � ' � <br /> 4 ! 3�3 • 3ioy ; <br /> ABCNITECTORDESIONER MAILAOORESS CIIY ZIP PNONE ' <br />� � OEHEMLCON7FlACTOi1 M�IIAD�fiE55 GITY ZIP PIIONE LICENSE/ <br /> ( <br />� � MECII�NIGILCONTR�CiOR M�ILADDRESS C11Y, Z�� �� �'�����E�� '����E�SUNLOWI�y(��1�� <br /> i; �wn I.,.o K I Iq 1 g . � 24 A� NE. Kui.I�C�amd G� � <br /> PLUMBINOCONTMCTOR MAILADOIIESS GIiV 21P PIIpNE UCENS / � <br /> ' �CU590F WOiilf <br /> � O NEW O ADDITION tXALTERATION CI REPAIR ��I DEMOLITION I_1 WOODSTOVEIFRPLINSERT ❑ BUILDINORELOCATION � <br /> 7ENANt IMPPOVFMENT OR IMEPqR PEMODEL ONIv CON7�CT PEfi50N ANU PHONE NO. <br /> CON7MCT PRICE OF W011N: I���. O U <br /> �� DESCRIBEWORKApNOSWAPEFOOT��EINVOLVEO • <br /> I b <br /> ;i �OSEDUSEOFBUI irro ^ I HEREBY CERTIFY THAT I HAVE flEAO AND EXAMINED THIS <br /> �I O�YV��/ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �i LEO�LDE5CRIPTIONOFPR� TV�SN� OELOWO�� CNFWRCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF . <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � iot e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE � <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER 37�TE OR LOCAL LAW REGUU1TINa CONSTRUCTION OR THE . <br /> , PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE ' <br /> OWNER OF THIS PFiOPERTY TO PERFOHM THE WORK FOR WHICH � <br /> � , APPLICATION IS MADE AND I COMPLV WITH THE STATE ' <br /> CONTRAGTORS LAW 1827 RCW AND 296200 WAC, <br /> �� SIaN�IUREOFCONiMCtORORAUT110N2EDA0ENT DATE <br /> �� I�,�� o zo 3-1 z <br /> �1 /i/� ny�� 'n X surntioK. 4nc . �� -�la�t�oan <br /> � ;�rno.rtcr�no�ss �Q/r1,�Q. �„�J (.GVV V�. 3 <br /> APPIICANTSCITYBU5INE55LICENSENO.ANOBU5INESSN/UAE i, <br /> :� � : ' <br /> �� PLUMBINp MECHANICAL �� � <br /> '� <br /> '.�� � NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> � � � WATER CLOSET(TOILET) � AIC—IVHNULG UNIiS—H.R � <br /> 'I <br /> �� BATHTUB ' FORCED AIR SYSTEMS—B.T,U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEA7EFiS—B.T.U. M � <br /> ' � SHOWER � CLOTHES DRYERS i <br /> ,i ' <br /> KITCHEN SINK 8 DISP i VENTILATION FAN ' <br /> � <br /> � � DISHWASHER � RANGE HOOD ��S <br /> � ����� LAUNDRY THAY ' � � <br /> , WATER HEATER : ; <br /> ' ' CLOTHES WASHER � WOOD STOVE ; ' <br /> I . : � URINAL ' METAL FIREP,LACE 6 CHIMNEY T � <br /> ' <br /> � DRINKINOFOUNTAIN � FIREPLACEIRSEtiT ;_.�� <br /> . FLOOR DRAIN � HEAT PUMP � ' <br /> � BACKFLOW PREVENTERS � GAS PIPING ' � <br /> pOOF DRAINS—RAINLEADERS � E%HAUST FAN � � � <br /> SINK(SEHVICE—BAfl,ETC.) ' � <br /> i <br /> I , <br /> i � <br /> ~— i <br /> ' � I <br /> ' i i <br /> i ' T <br /> � � T� <br /> ' SUBTOTAL $ ; SUBTOTAL E U'Dp • <br /> PERMIT S —i— PEflMIT S � i <br /> TOTALFEE S ' TOTALFEE S 'D " <br /> . FI70NTSETB�CN REARSET9ACK SI�ESETBACK PIANCNECNNUM0E0 FEE f1ECEIPTNO. , <br /> i USEZONE LOTMEA vnca+rsne FEES VALUATION FEE � <br /> � ❑ YES ❑ N� BUILDINO . i <br /> 1YPEOfLONST.�IIOWABLE IYPEOiCONST.AtIU�L �^� �ap''T«�^��13 ' <br /> cnwv � <br /> � PLUMBINO ' <br /> � <br /> S�ZEOFBLDO. NO.OFSTORIES OASEMENi �— , <br /> MECHAN�CAL � <br /> ❑ YES ❑ NO ' <br /> � <br /> OCCUVANCYLOAD FIIiE5PI1NNlERSPEOD HEIOIITLIMI1AlION OTHER � <br /> ❑ YES ❑ NO STAiE BUILDINO SURCHARGE � <br /> REASONFOFlSPflINNLEP3 • � <br /> SIATEENERGVSURCHAFiGE � � <br /> AP�IICAlIONACC.BY PlANSMPROVEDOY CITYOFEVERETT PUOUCWORNS � <br /> LOCAL SALES ' <br /> TAJ(COUE IS 3105 TOTAL ; <br /> . <br />