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� � <br /> APPLICATIOI�. FOR CONSTRUCTIL N PERMIT everett <br /> rne F.ve�yreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> everett �"�'�� <br /> HEATING SYSTEM: ❑GAS K�F�.ECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> �59-8810 <br /> �] DEMOLITION COMBINATION �BUILDING MECHANICAL 7�PLUMBING SIGN <br /> OWNER MAILADDRESS CITY ZIP PNONE <br /> Rod Nicholas 16000 Mill Creek Blvd, q11U, Mill Creek, WA 98012 337-6611 <br /> TENANT MRII AGDRESS CITV 21P PNONE <br /> ARCHITECTORDESIGNER MAILAODRESS CITY 21P PMONE <br /> CYaine Design 126U0 N.E. 85th St. Kirkland WA 9801'l ti'17-U3:i6 • <br /> GENERALCONiRACTOR MRILADDRE55 CITV ZIP PHONE LIGENSEI <br /> Rod Nicholas 1G000 Mill ��eek Blvd., f7i11 Creek WA ytiU1'l 3:i7-6611 RODNIFT137D0 <br /> MEGMANICAL CONTPACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE� <br /> Electrical Energ;� 18908 Highway y9 qE, Lynnwvod WA yfiU36 778-0555 II.DCPEC160JE <br /> PIUMBING CONTPAf.TOF AIAIL ADDRE55 CIiY ZIP oHONE LICENSE• <br /> Danco Plumbing P.O. Box 277, �erett WA 98'l03 258-6938 OANGOWAS187BN <br /> CUSS OF WORK <br /> IX� NEW ! � ADDITION i-, ALTERATION :. , REPAIR I .I DEMOLITION __- WOODSTOVE/FRPL INSERT ;.i FUIL�ING RELOCATION <br /> //�J CONTACT PERSON AND PHONE N0. <br /> CONTHACTPRIGEOFWOFK /✓��� Qu�t Johnson 337-9733 <br /> �ESGRIBE WORK AND SOl1ARE FOOTAGE I/NVOLVE� '/� <br /> � �/,� �I—' �L�,LL4CI�'L. �O 7 <br /> PROPOSED �EOFBl11LDING I NEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Single Family Duplex APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DE��PA�PERTY(SHOWNBELOW ORATTAGH FOl1RCOPIES� PROVISIONS OF LAWS APID ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHEq SPECIFIED HEREIN OR <br /> �pr e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> y AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF ANY <br /> SC?E AttdChEd � q,.(� � G(. � 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 /> ��C'<, � � ���� APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SIGNATUREOFCONTPRCTORORAUTHORIZEDAGENT DATE <br /> PPQIEGT AODRESS //�� n � � � , � :w��— <br /> ✓���/ ,^_� ���v'��_ /��p APPLICRN CITYBUSINESSLI NSENO.ANDBUSINESSNAME <br /> �7 /-/V t.J <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> 6 WATER CLOSET(TOILET) p � • A/C-NHNDLG UNITS-H.P. � <br /> 4 BATHTUB ' - FORCED AIR SYSTEMS-B.T.U. M E.A. ' <br /> 6 LAVATORY(WASH BASIN)- p � - UNIT HEATERS-B.T.U. M � <br /> 9 SHOWER ' - CLOTHES DRYERS ' <br /> 2 KITCHEN S�NK 8 DISP / � - VENTILATION FAN � <br /> 2 DISIiWASHER R�NGE HOOD � <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> 2 CLOTHES WASHER p �- WOOD STOVE � <br /> URINAL ' METAL FIREPLAJE 8 CHIMNEY ' _ <br /> DRINKING FOUNTAIN i FIREPLACE INSERT i <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW°REVENTERS � GAS PIPING � <br /> ROOF DRAINS-RAINLEADERS � EXHAUST FAN �_ <br /> SINK(SERVICE-BAR,ETC.) � � <br /> i "S '.-,) ,� �� a0 i 0 <br /> i ' <br /> i � <br /> SUB TOTAL $ ' - SUB TOTAL $ /aU; !!v <br /> PERMIT $ �—� PERMIT S � <br /> TOTAL FEE $ / p ' TOTAL FEE $ �U ' �?') <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETB K SIDESETBACK PLAhCMECKNUA�BER FE! RECEIPTNO <br /> .. 1�r P.�. ZO�E,�►r ,s��.�try N� i o`� 7(yS0 .3rJ 53'�i/ <br /> usezot+E LOTAREA VRCANT511E FEES VALUATION FEE <br /> t � <br /> �Z � GS BUILDING �7 7� ',`.�U <br /> iYPEGFCON75.AllOWABLF 7VPEOfCONSiPCfORI octUf`�hCv Hoaov.'FwrtUms - i <br /> ✓ � . / � �°�3 -�_ PLUMBING /3 v �lr� <br /> V <br /> SIZEO�y�Sf GAQ NOAFSTORIES BRSEMENT MECHANICAL aD � J� <br /> ? G S F a �-- qpDIT10NAL PLAN CHECK l i� <br /> OCCUPANCY LORD FIRE SPRNNlERS REOD HEIGHT LIMITr1TION <br /> /� ,00 Z ' � <br /> OTHEF i <br /> REASON FOR SPqINKLERS i <br /> STATE BUILDING SURCHARGE ���D <br /> INTANEOV PIANSAPPROVEDBV CITYOFEVERETT PUBLICWORKS IJ i �� <br /> � LOCAL SALES � <br /> TAX CODE IS 3105 TOTAL ��7 ; Q'� � <br />