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. .. . • -� '`i <br /> . _ ___ . i <br /> _. � <br /> APPLICAT16r1 FOR CONSTRUCT�ON PERMIT <br /> everett i <br /> m.E�ero•ee� � <br /> cin oF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLE SE PRINT <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION [ I BUILDING , M HANICAL I I PLUMBING l 1 SIGN <br /> �� O� IMAIL�IR�J' l/� W 'y/� � 1 I�CIIv[ �1 ��IZIP �.�eiL�HONE ^� lX� �Ir:�-�!� C.J <br /> w <br /> TENA�NT q �� � MAILA DRES � CITY 21P PHOHE . <br /> �//Y lJL //7 �� -. <br /> ARCHITECTORDESIGNER MAILADOflE55 CIN ZIP PMONE � <br /> t <br /> GEN ALCONTRA�fl MA�L �5 C'iV ZIP � PHOy��— S,ys�{� i <br /> /1C1�.g ,� ��l�cLs !�J'k �.��.�1 4���� f �.t -��� � <br /> MECHANICALCONTRACTOfl M�ILA DRE55 CITV 21P PHONE LICENSEII � --�— i <br /> �t�GL�N�l5�(�� r �l-���u�'. <br /> PLUMBMGCONTHAGTOfl MAILADORESS CIN ZIP PHONE IICENSE� � I <br /> t <br /> t <br /> CU58 OF WORK � <br /> f_l NEW ❑ ADDITION �RATION I 1 REPAIR I�.1 DEMOLITION fl WOODSTOVEIFRPLINSERT f7 BUILDIN6FElOCATION � <br /> TENANTIMPROVEMENTORINT IORR ODE ON� LONTAGTPERSONANDPHONENO. ' <br /> I` <br /> CONTR�CT PRILE OF M/ORN: � I / :r <br /> DESCN�BEV/OflKAND �R T.A@ Eltl VED t <br /> U /V�QiI�"(�l�Q� - �fi'Yl.�-� � <br /> pppPO5EDU5EOFeUIL0IN0 ��'� 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS k <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEU�LDESCRIPTIONOF PROPEPTY�SNOWNBELOW OHATTACH FOURCOPiES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING TNIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or BLOLK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PRUVISIONS 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 PERFORM THE WORK FUR WHICN <br /> APPLICATION IS MADE AND I COMPLY WITH TF1E STATE <br /> CONTRACTORS LAW 18.27 flCW AND 296.200 WAC. <br /> SIGNAT i7E FCONTRRCTOHONAUTHOR2 DAGE DATE <br /> X � <br /> PRO.IELTADDRES ' � I L A� n i.I ` <br /> L /' , �J�` qP SC YBUSINESSLI NS NO AND USINESSNAME <br /> 1 <br /> pLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> i WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> � BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEN SINK B DISP � VENTILATION FAN � <br /> DISHWASHER <br /> � RANGEHOOD ' <br /> LAUNDRYTRAY ; WATER HEATER � <br /> � <br /> �� CLOTHES WASHER � WOODSTOVE ' <br /> � � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY <br /> , � ' <br /> DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � � - L�t� 1 <br /> � <br /> � � /f� (� � ' <br /> � ' <br /> � <br /> � ' <br /> i <br /> SUBiOTAL $ ; SUBTOTAL $ S� ' '— <br /> PERMIT $ � PER�d1T S S� �— <br /> TOTAL FEE $ ' TOTAL FEE S S.�' —' <br /> FRONTSETBRGK NEARSETB�CK SIDESETBRCK PLANCMELKNUMBER FEE <br /> NECEIPT NO. <br /> USEZONE LOTAflEA VRCANTSITE FEES VALUATION FEE <br /> lJ YES 11 NO BUILDING ' <br /> lYPEOFCON5I.ALLOWABIE tYPEOFCONST.ACIUAL ����' MoaownuKuxitS � <br /> LA0°P PLUMBING <br /> —�� <br /> i <br /> SIZEOFBLIX'i. NU.OFSTORIES BASEMENT MECHANICAL �S_ � <br /> f7 YES f_l NO ; <br /> FIPE SPRNKLEflS REO'D HEIGHT LIMITATION OTHER ' i <br /> OCCUPANCYLOAO � <br /> ❑ YES ❑ NO STATE BUILDING SURCHARGE i <br /> REASONFOFSPRINKlERS ' � <br /> STAiEENERGVSURCHARGE � <br /> � I, <br /> �PPUCATIONACC.BY PUNSAPPROVEDBV CITYOFEVERETT PUBLICWORKS � <br /> LOCAL SALES l <br /> TAX CODE IS 3105 Torn� SS� ' — � <br /> � <br />