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. . ..�•• .. ...I. ':. . �.t..'... .. ... . : :. . :_ ' . .. '..3t '.�... �I��i111�.. .�. � ��.�q �. f. . • :v� .. . .. ........ _ . :tJ:. �.�11'�:. 4Y:_t[.r 'A.� � .._. <br /> f���.\ �•' �� . <br /> APPLIC�.i'ION FOR CONSTRI.CTION <br /> PERMIT <br /> CITY OF roe� � eve�ett � ', <br /> everett e ' <br /> BUILDING DEPARTMENT <br /> 259•BB70 TO BE COMPLETED IN INK— PLEASE PRINT <br /> E M�IL�ODRE55 GIIY ZIP P110NE I <br /> I�LtIC^d-I .���11'���1� � �Wf�`3 '"�f��(�<<'�� C l3C'lE'�'I` ���i-X'� 'J i'-���r7- ' `�i`j �� � <br /> IENANT M�IL� �NE55 C�TY 21P PHONE , <br /> Ai1CHITEGTONDESIGNER M�IL�D�NE55 CITY ZIP VHONE <br /> DENEP�LCONTP�GTOR M�ILAUORE55 LITY ZIP PHONE LICENSE• <br /> iatumu sAs Eamar,��t.¢ee, i�e. ti�f+TLt,P C�E��o�� <br /> MECH�NICALCONTfUCTOR 1625 E� I�II�IM �IVA�I� CITY ZIP PMONE LICEN`SE� <br /> �verett, WnMn�lon 98201 -'/ �Iv <br /> VLUMBINOCONTR�CTOR 758.����RE35 CIiY ZIP PMONE LICENSE• <br /> GUSSOFWORK <br /> ❑ NEW ❑ ADDITION ItYALTERATION ❑ FEPAIR ❑ OEMOLITION ❑ WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br /> TENANT IMPpOVEMENT OR INTERIOR REMOOEI.ONLY CONTAGT PE115QN�ND PNONE NO. <br /> CONTR�CTPXICEOFWORM .�'i•`l � / '�����11/, <br /> DEBCPIBE WORK�NO SOU�RE FOOT�OE INVOLVED <br /> �-��r�.l lac� C' )�Ct. l�(lr' c�+l.���- - -��`=�Y l.- � c <br /> PROPOlFD U�!Of lURDINO �� 1 HEREBY CERTIFY'HAT I HAVE READ AND E%AMINED THIS APPLICATION AND <br /> C i� `� _ -ti ,�� KNOWTHESAMETOBETRUEANDCORRECLALLPROVISION90FI.AWSAND <br /> V ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH <br /> LEWLDESCRIPTIONO OPENTY�SIIOWNBELOWO �TlAL11FOURCOPIESI yyHETHERSPECIFIEDHEREINORNOT.THEORRNTIN�OFAPERMITDOE9N0T <br /> PRESUME TO�IVE AUTHORI7V TO VIOLATE OR CANCEI THE PROVI910NS OF <br /> �oi e�ocK oF ANVOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> FORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORRED BV THE OWNER OF <br /> THIS PROPERNTO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> � AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296200 WAC. <br /> SiON�TUREOiCONT ORORAUiHORILED�GENI OATE <br /> X ��-"'� r�� 1 .�.c� ���C/ <br /> PPOJEGTAUDNESS � APPLIG�NTSCITYBUSINESSLICENSENO�NOBUSINESSNAME � � , <br /> PLUMlINO MECHANICAL <br /> NO. TYPE OF FII(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER ClOSET(TOILE'f) A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB I FORCED AIR SYSTEMS—flT.U. M EA OU ! 1J OO <br /> LAVATORY�WASHBASIN) UNITHEATERS-6T.U. M <br /> SHOWER CLOTHESDRVEFS <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> D�SHWASHER RANGE HOOD <br /> IAUNDRYTRAY � WATERHEATER <br /> CIOTHES WASHER WO00 STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKIN6 FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS _ GAS PIPING I <br /> ROOFORAINS—RAINLEAOERS __ EXHAUSTFAN <br /> � <br /> SINK�SERVICE—BAR.ETC.) ' I <br /> SUBTOTAL S SUBTOTAL a <br /> PEFMIT 5 PERMIT S <br /> TOTALFEE S TOTALFEE S �� <br /> FRONTSETBACN PE�RSEfd�CK SiDE5ET8AGK VUNCNECKNUMBER FEE PEGEIPTNO. � <br /> USE20NE LOTAREA WC�NTSITE FEES VAIUATION FEE .: � <br /> ❑YES ❑ NO � �� <br /> � BUIIDING � <br /> TYPEOFCONST. OCCUP�NCYGPOtIP NOAFOWELlINOUNITS ' <br /> ALLOW�BLFJACID�L PLUMBING <br /> 512EOFBLW. NOOFSTONIES BSMT OGGLOAO MECHANICAL <br /> OY <br /> ON <br /> MEIGMTLIMITATION OTHER <br /> FIRE9PRINNlERS REOUIRED O YES ❑ NO STATE BUILOING SURCHARGE <br /> � STATE�NERGY SURCMARGE � ���?� <br /> �PPLILATION�CGBY PL�NS/.PPP.BY � (�UBLICWORKS <br /> TOTAL <br />