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APPLICATIUN FOR CONSTRUl:1 .ON PERMIT <br /> everett <br /> �he E,.�„�..K,� e <br /> cm oF <br /> everett <br /> BUILDING DEPARTMENT TO BE GOMPLET'=D IN INK—PLEASE PRINT <br /> 259-8810 <br /> DEMOLITION COMBINATION ;� BUSLDING MECHANICAL PLUMBING SIGN <br /> O1\4:ER MAIIADDRE55 Gltt ➢P PMOYE <br /> �Ti:�7ti � Wr�4utivF.,rn yl J( G4�./cv�;v �.�i= E✓Fne i% <br /> y � � TENANT MARADOF[55 GTY 21P PHONE <br /> i5 <br /> t9 <br /> p � ARCNRECTORDESIGNER MAILADORE55 Lltt 21P PNONE <br /> C M <br /> N <br /> M ',L GENERALCONTRAGTOR MAILADORE55 GITY 21P PNONE LICENSE• �� �� I LK�� <br /> Ky � i'"( ,fr N✓ 13� J1 luuo �f Saa,c-,:y �u„-T r3G-'> /Ll��r✓ic.c�.�- 6.r'.?-.ZriL <br /> Q y' Q MEGNANICPLCONTRAGTOR MFILApORE55 CITY 21P PNONE LICENSEI <br /> �p H �q <br /> N H[� ' <br /> � y 'j PUl1.IBINGCONTRALTO' MPILADDRESS C�iV ZIP PHONE LICENSE� <br /> O d <br /> ,'�j � CUSSOFWOFK - <br /> � . � �I-1 NEW x ADDITION i-� ALTERATION �. REPAIR �._. DEMOLITION ��. ! WOODSTOVFJFRPL INSERT i J BUILDING REIOCATION <br /> H �x ,���,� �� CONTACTPERSONAN�PMON[N0. <br /> y' M 7EN�NTIMPRWENLNTORINiER10RREMOOELONLY <br /> y,' '3 Y� /.'n.L, �j 2 o wr� ( ✓'3- .,�✓—/2-_ <br /> r H � GONiRACTPRIGEOFWORN: G <br /> � y M DESCRIBE ORK ANO URRE FOOTAGE INVOLVED <br /> � �q r PROPOSEOUSEOFrUILDING I HEREBV CER7IFY THAT I HAVE READ AND E%AMINED THIS <br /> y � S1� � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> p y — y+� � I �rY r S PROVISIONS OF LAWS AND ORDINANCES;OVERNING THIS TYPE OF <br /> �6�n�oe IPTIONOFPROFE ISMOVMBEIOWOHAtTAGHFd1RGOP1[5) yyORK WIIL BE COMPLETED WITH WHETHER SPECIFIED ��CAEIN OR <br /> iorJY �'- Y 0 e�ocK oon p o oF r� ��� (���Ll��� NOT. THE GRANTING OF A PERMIT DOES NOT PRESU�dE TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERfORMANGE OF CONSTRUCTION.THAT I AM AUT�IORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APf'LICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br /> SIGNAiUR[OFGONTRACTOROPAUiHORREDAGENT ORTE <br /> XC/27� .S'0 ✓ �ll1f' ��C���ArJ� 9e <br /> PRQIEGT R�DRE55 <br /> y63G [i��ir�"��tl'� ��C FPP��CRNTSGTYBUSMESSLICENSENOANDBUSMESSNRME <br /> �'� � ', PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. �.YPE OF EQUIPMENT FEE <br /> I �� WATER CLGSET(TOILET) � _ NC—A-HNDLG UNITS—H.P. ; <br /> ' BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. i_ <br /> 1 LAVATORY(WASH BASIN) UNIT HEATERS—B TU M <br /> '�� SHOWER CLOTHES DRYERS <br /> � ��' KITCHEN SINK E DISP VENTILATION FAN <br /> � � DISHWASNER RANGE HOOD ' <br /> , LAUNDRY TRAY WATER HEATER <br /> i �� C�UTHES WASHER ; WOOD STOVE � <br /> !�' �RINAL METAL FIREPLACE 8 CHIMNEY <br /> . DRINKING FOUNTAW � FIREPLACE INSERT <br /> � FLOOR DRAIN � HEAT PUMP <br /> � BACKFLOW PREVENTERS GAS PIPING _� <br /> � �I � ROOF DRAINS—RAINIEADERS EXHAUST FAN <br /> SINK(SEflVICE—BAR,ETC.) <br /> �— <br /> � <br /> �,,ll ' � <br /> SUB T0T.4L $ SUB TOTAL $ <br /> PERMIT S PERM�T S � <br /> i' ' TOTALFEE $ TOTALFEE $ ' <br /> FRONTSETBRLN REARSETOACK SIpE5Ei0�CN PLANGHE NUMO� FEEI �_s R[CEIPTNO. <br /> 2�v � Zo� J� � Fv <br /> oL <br /> use E IOTAREK`/ 00 VALANTSITE � FEES VALUATION FEE <br /> _ � ❑ YES NO BUILDING '1 � `�' C' 'C�1 <br /> 7YPEOitON57.AllOWABIE MEOfLONS1.ACiURI ��� NoavnTuixcuxitt i <br /> cnav p�UMBING � <br /> S�CEOFOLOG. NO.OFSTOPIES DASEMENT MECHANICAL � <br /> I q �7 Si �OD I Li YES IXNO i <br /> OCCU ANCYIORD FIRESPRNKlEN5RE0D HEIGHTLIMITRION OTHER <br /> �Q- � �.! YES :�1J0 1 ,� <br /> STA�E BUILDING SURCHARGE ' <br /> � RERSONFORSPRINNLERS <br /> S7ATEENERGYSURCHARGE <br /> APPUCr1T�ONr1CC.BV PLANSAPPROVEDOV CITYOFEVERE7T PU�LICWORKS <br /> /� LOCALSALES ^ <br /> �,� TAX COOE IS 3105 TOTAL ,�� <br />