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APPLICATIU(V FOR CONSTRUCT�dN PERRAIT <br /> �����« <br /> fhe EverO�ren � <br /> � CITY OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 , <br /> DEMOLITION i ' COMBINATION BUILDING �CHANICAL PL.UMBING � SIG <br /> ER MA".ADDRESS CITY Z�P ��, _n, _ � �. ��� �O�l.� T <br /> �����. 'SU. E1�JQ1'1 - �'l�a"�� ll) C-slenhn� �l �`C�L.�t'LC� � <br /> y n �.{ LENAN p /� � MAILAO�RE55 <br /> CIiY 21P PHONE <br /> � (f � �1.� W <br /> p �d � ABCHRECTORDESiGNER AIAILFDDFESS <br /> CITY ZIP PMONE <br /> C y <br /> � �y ��n. Zip HONE LICENSE� ��1jjj,,, <br /> '�' GENLRRLCONTRACTOP MRII D)PE55 ' _I� ����� ^^ ^ I�� r I rl��`_�/(.�� <br /> H � � �` I� �11 II i�w (�' 1 � � <br /> K v .,D lM X] ��� � icer+se� <br /> � (� p� MECHANICAL NTRACiOR MAILA RE55 CIttU V/ �N-f/j��'P..h.��� <��-'��-�/F�— <br /> N i�l P ONE UCENSE <br /> � � � CITY 21P <br /> PLUMOINGCONTPACTOH FUILA�DPESS <br /> CU55 Uf WONK <br /> N <br /> � ;b � �. NEW !-! ADDITION �ALTERATION ..-1 REPAIR i J PEMOLITION _' WOODSTOVE/FFPL INSERT -. BUILDING RELOCATI <br /> �„� _ CONTAC�PERSON PND PHONE N0. <br /> y' M 1EN�N7IMPROVEMENTORINTERIONREMODFJ..ONLV <br /> � � � (�� <br /> CONTPALTPRIC[OFWORK: ��� � <br /> � N OESCRIpE1Y0RNAND�e UAREFOOTPGEINVOLVE� � �� <br /> 7i o m �'`6'�1�� �-1'U/L� ' "' <br /> � � (-� PRUPOSEDUSEOFBU ni I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> H V7 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> � LEGRL DESCRIPTION Oi PFOPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) <br /> WORK WILL BE�(1MPLETED WITH WHETHER SPECIFIED HEREI <br /> int eiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL TF;E PROVISIONS OF ANY <br /> 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 FERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> C�ONTRAGTORS LAW 1827 RCW A�JD 296.200 WAC. <br /> SIGNATUPEOFCONTPALTOqORAUTMORREOAGENT DRTE <br /> PROJF.GTAODRE55 p ��pqNTSGT�II NESSIICENS� �A����ESSNAME �/� <br /> �I MECHANICAL <br /> ��"' PLUMBING FEE <br /> I . Np, TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> C� WATER CLOSET(TOILET) !i'C—A/HNDLG UNITS—H.P. <br /> ' FORCED AIR SYSTEMS—B.T.U. M E.0 <br /> � i ' BATHTUB 1 <br /> 1 LAVATORY(WASH BASIN) UNIT HEATERS—B T.U. <br /> '�� SHOWER CLOTHESDRYERS <br /> �� KITCHEN SINK&DISP i VENTILATION FAN <br /> � � �ISHWASHER flANGE HOOD <br /> WATER HEATER <br /> LAUNDRY TRAY WOOD STOVE ' <br /> . I ��� CLOTHES WASHER METAL FIREPLACE 8 CHIMNEY <br /> �I URINAL FIREPLACEINSEFT ' <br /> , DRINKING FOUNTAIN HEAT PUMP —�_ <br /> � FLOOR Df1AIN GAS PIPING <br /> ' � BACKFLOW PREVENTER� _ � EXHAUSTFAN <br /> �' I ROOF DRAINS—RAINLEADEflS <br /> SINK(SERVICE—BAR,ETC.) .�—— <br /> i <br /> � <br /> i <br /> i� ` <br /> i , SUB TOTAL S SUB TOTAL $ <br /> � PERMIT S �� <br /> I ' PERMIT 5 ' <br /> r'�1 TOTAL FEE $ ' TOTAL FEE S L� <br /> I PIANCHE6HNUh'.O[R FEE RECEIPTNO. <br /> \ FRONfSETBACN FEARSETOACN SIDESETpRCN <br /> \ <br /> FEES VALUATION FEE <br /> USE 20NE LOTl.:tER VRCANT SRE � <br /> L; YES - �'. NO pUILDING i- <br /> acuvr,utr NO ormvru�xGuxns — <br /> 7YPEOFCONS7.ALlUWI.n.0 TYCEOfLONSLAtiURI �y�p PLu^_ ,� <br /> SREOFOLDG. NO.OFSTOfiIES BASEMENT MECNANICAL _ C� � <br /> ❑ YES ❑ NO � <br /> OGGUPRNCYLOAp FIRESPPNNLERSREO'0 HEIGHiLIMITATION <br /> OTNER � <br /> �.: YES =1 NO STATE BUIL�ING SURCHARGE __� <br /> ' REASONFOnSPRiNKLEnS STATEENERGYSUf1CHARGE � <br /> ACPLICATIONACC.OV PIANSAPPROVEOBY CITYOFEVERE7T PUBIICWOPKS ' <br /> LOCALSALES � — <br /> TAX CDDE IS 3105 TOTp� 6 <br />