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- �_ <br /> APPLICATIO.. FOR CONSTRUCT►.IN PERMIT everett <br /> rne E,re.�,�„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CIiV OF <br /> everett HEATING SYSTEM: � GAS ❑ELECTRIC O —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> Ci DEMOLITION ❑ COMBINATION i�� BUILDING �CMECHANICAL �PLUMBING ❑ SIGN <br /> OWNER •—� MAILADDRE55 CITV ZI PMONE <br /> �����a df�l'9r.�G�t,t������ f�,r��=.cr-� �/��� <br /> YEN��If MAI�qDOF 55 CITY ZIP PHO?!E <br /> ARCHIi�CTORDE51GNEfl MAILADDRESS CITY 21P PHONE <br /> GENERALCONTRACTOR MAILADDRE55 CITY ZIP PHONE LICENSE• <br /> MECHANICALCONTR�CTOR MRILADDRESS C,I�' ZIP PHONE LICENSE• <br /> � `r'����, �� � fi - t y ��%�,C'��' Q�.�r�/ '��a=G/G�r�MiJf/�Tri'�+ '�bbf',� <br /> PLUMBIN C�� M�IL�DURESS CITV ZIP PHONE LICENSE� � <br /> )��n'Nr�rc-T�, /h%��'�!'C�7'la'�'r1�, �'�G�t.e"f;U �t"Z�/ -�9=G-���iri �/h��/�JJjy'yl��! � <br /> cussTodwoaK I <br /> �7 NEW f_� ADDITION -1 ALTERATION C'. REPAtR `_' DEMOLITION f_�. WOODSTOVE/FRPLINSERT G BUILDINGRELOCATION II <br /> � �� ,E,� ^LJ CONTACT PERSON AND PHONE NO. <br /> L' <br /> CONTRACT PqICE OF WORK <br /> DESCRIBE WORK AND SW�PE FOOi�GE INVd.VED <br /> PR SEDUSEOFBUILDING , I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ,/f( ' J - _�.0 APPLICATION AND KNOW THE SAME TO BE TRUE AND CCRRECL ALL <br /> LEGALDE eriori OPERTY�SHOWNBEL WORATTACHFWRCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT �ocK oF NOT. THE GRANTING OF A PERMtT DOES NOT PRESUME TO GIVE <br /> n �y� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> _ ((/� � `�� � F�(/ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> TRACTORS LAW CW AND 296200 WAC. <br /> SIGNAT OFCONT OpORAUT ZED NT D�TE <br /> X � <br /> rAae T ss ' `" <br /> ) �(� . \ � y�/ � ICANTSCITY BUSINE S LIC E NO.AND BUSM �S NRME <br /> �.0 ,(/ L/ <br /> LUMBIN(3 � MECHANICAL �� <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—A/HNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) � UNIT HEATERS--B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL ' METAL FIREPLACE 8 CHIMNEV � <br /> DRINKING FOUNTAIN � FIREPLACE INSEPT ; <br /> FLOOR DRAIN HEAT PUMP i <br /> BACKFLOW PREVENTERS ; CaAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � <br /> , �— <br /> � �— <br /> i <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMiT q PEHMIT $ i <br /> TOTAL FEE $ ' TOTi�I FEE $ � <br /> FOR OFFlCE USE ONLY: I <br /> PRONTSETB�CK REARSETBACK SIDESETBACN PLANCHECKNUMBEF FEE RECEIPTNO. <br /> �F��CC� <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> BUILDING i <br /> ttPEOitONiS.AIlOWABIE iYPEOFCONSi.ACTUAI ottuo�.utv x00�VntwqGUNrtS � <br /> GRWP PLUMBING � <br /> i <br /> � SIZEOFBLDG. NO.OFSTOPIES OASEMENT MECHANICAL �JS � <br /> OGGUPANCY LOAD FIRE SPRNKLERS REO'D HEIGHT LIMITATION ADDITIONAL PLhN CHECK � <br /> i <br /> OTHER � <br /> REASON FOR SPRINNLERS <br /> STATE BUILDING SURCHARGE i <br /> INTAKE BY PLANS APPROVED BY CITY OF EYERETT PUBLIC WORNS ' ', <br /> LOCALSALES <br /> TAX CODE IS 3105 TOTAL <br />