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. .... . . .. ,. . •. �, <br /> APPL�IL.�►TION FOR CONST�+JCTION <br /> PERMIT <br /> fhs Ererpiean everett <br /> CITY OF � <br /> everett <br /> BUILDING DEPARTMENT � <br /> 259•BB10 TO BE COMPLETEp IN INK— PLEASE PRINT <br /> OWNEfl M�IL��ORESS / G�TY ZIP PMUNE <br /> `� ° t ' y� � �/ -/ -/^ 9�[��c� -776- 5�:6 : <br /> ^ � ! �'L✓ c- ! l�G" /� // Q✓t� /<TL`L t -s[o <br /> IEN�NT M�IL�DONESS GITY ZIP PHONE <br /> t <br /> , �HLMITECTOHDESIGNER MMLAUL`HESS T� CITY � 21P PHONE <br /> /h)� �' < <, �,��1�.�� ��� (`'f��/C� �fev 92,'�75 75�5-656`l C` <br /> Y �� C� � ., � Ir� � , k <br /> �I aENER�IC TRACTON M�IL�ODNi55 CRY 21P PMONE LICENSE�r� <br /> I �.�>rrk � c ° �'lC' -! '�2 .T;-1/lo'P IV ����.��•«�(� �!�'c?�� 776-�f _56���q��� '� <br /> MECM�NIC�LGONTHI1CiOR�— MAII�DURE55 CITY ZIP ��IONE LICENSE• <br /> PlUM91NOCONTRACTOfl MAIL�DOPESS GITY 21P FMONC UCENSE• <br /> CL�9S OF NORK <br /> �TI�NEW ❑ ADDITION ❑ ALTERALION ❑ REPAIR ❑ DEMOLI710N ❑ WOO�STOVE/FPPLINSERT ❑ BUIL�INORELOCATION ; <br /> TEN�NT IMPROVEMENT OR INTERIOR REMO�EL ONLY CONUCT PEFSON AND PNONE NQ � <br /> �fa c nr .CUG. ��l �S S S <br /> CONTIUCTGRICEOFWORIC O � <br /> DESGRIBEWORKANDSOUMEFOOTAGEINVOLVED �( I 21' <br /> N C -F i <br /> PHOP09ED USE OF BUIlUINO I Ff EREBY CL"9TIFY THAT I HAVE READ FND EXAMINED THIS APPLICATION AND <br /> KNOW THE SAME TO BE TRUE AND COfiRECT.ALL PROVI910NS OF LAW9 AND <br /> L[MLUESCflIPT10NOFPHOPEFtt�9HOWN8ELOWOR�R�CHFOURGOPIES) ORDINANCESGOVERNINGTHISNPEOFWORKWILLBECOMPLETEDWITH <br /> WHETHERSPECIFIEDHEREINORNOT. `1EGRANTINGOFAPERMITDOE8NOT <br /> � �� � PRESUME TO GIVE AUTHORIiY TO VIO�.�TE OR CANCEI THE PROVI910NS OF <br /> �oi� e�ocK oF ANYOTHERSTATEORLOCALLAWREGUl.Al1NGCONSTRUCTIONORTNEPER� <br /> S FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPERNTO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW IB27 RCW AND <br /> 286.200 WAG <br /> SIONATUREOFGONTHACTORORAUTMORI2EDAGENT D1TE ` <br /> X � O ��V, rYL"= '"r � � P� / �/^ � <br /> PROJECTAODPE55 � �PpIIC�NTSGITYBU31NES5UCEN5ENO�NDBU51NES5N�ME / , <br /> s� 3 / GL<<� �..�� �-1 c��,�P � ;. <br /> ; <br /> PLUMBIN6 MECHIINICAL �, <br /> NQ. TYPEOFFU(TUREORITEM FEF NO. TYPEOFEOUIPMENT FEE .' <br /> WATER CLOSET(TOILET) AlC—!V HNDLG UNITS—H.P. i� <br /> BATHTUB FORCEO AIR SYSTEMS—B.T.U. M EA � <br /> LAVATORY(WA9H BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHESORYERS ' <br /> KITCHEN SINK 6 DISP. VENTILATION FAN ' <br /> DISHWASHER RAN�E HOOD !�. <br /> LAUNDRYTRAY WATERHEATER I <br /> CLOTHES WASHER WOOD STOVE �� <br /> URINAL _' METAL FIREPLACE 6 CHIMNEY i- <br /> ORINKIN6 FOUNTAIN FIREPLACEINSEPT �� <br /> FLOOR DRAIN HEAT PUMP „ <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � <br /> r <br /> r <br /> SUBTOTAL S SUBTOTAL �5 <br /> PERMIT E PERMIT S <br /> TOTALFEE S TOTALFEE �—b ; <br /> FBONTSETB�CK REANSET&1CK SIpESETBACK YUNCNECK UMBER FEE RECEIPfNO. <br /> �,� �• ,� ' 4r�s°= as � <br /> u9eioNE LOT�HE� wt�NrSrtE FEES VALUATION FEE <br /> � O •� PF'YES ❑NO � <br /> BUILD�NG �s r zyc� <br /> IYPEOFCONST. OCC P�NCYGROIIP NOAFUWELI�VOUNRS <br /> /�IIOW�BLEM ue� /2_3 / PLUMBING � <br /> SIZEOF� NO.OFSTORIES esMr occ�oeo MECHANICAL � �� <br /> zza¢ � gN ' <br /> 572 NEIGNTLIMIT�TION OTHER �. <br /> 4 / � <br /> FIRE9PRIN3EnsPEOUIREU �s Q.No STATEBUILDINGSURCHARGE <br /> � <br /> STATE ENERGY SURCHARGE � <br /> �PPLICATIONACG9Y PLANSAPPRBY pUBLICWORKS 1 <br /> � ��• �� TOTAL � �3c;� <br /> _' �sP�: ��^H(T .t i u AN t� SJ 13��/'�'-*C.T za .$J!S N i 7'7�►l � ��O�lLVlfG. O/L `%�-v5 <br /> �_ i=, �.— C O/l�.i�c l.�r� Y�A w� i. �-- i <br />