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� <br />.�.� <br /> • I <br /> �,-� : '� <br /> F�•.:..,. � I <br /> �� APPLICATI6� FOR CONSTRUCTrONi PERMIT everett , <br /> e � <br /> �heEve�green TO BE COMPLETED IN INK—PtEASE PRINT <br /> CIiV OF <br /> ,��� ., everett HEATING SYSTEM: C7�GAS ❑ELECTRIC ❑ I . <br /> BUILDING DEPARTMENT .- <br /> Q •"'; 259-BB10 � ""'� � <br /> � t _ ❑ DEMOLITION COMBINATiC�+ BUILDiNG "�MECHANICAL L'' PLUMBING i _ SIGN � <br /> 1(/, M�ILAD RE55 � tt V J21P PHONE <br /> ��� �� ���`\�/<. C 4��i � �Y � � ` � l_. ! .�_1 L_�)-� <br /> � � ,-=-�C C%��r.�, ,, �. �r�.4�- i't�3 s�_ _ <br /> F T VR �rL�OCRE55 GITV 21P � PHONE <br /> ��� ��� <br /> rim - <br /> (ip �HGHITEGTOROESIGNER M�ILADORE55 CITY 2iP FNONE <br /> �� <br /> Q � GENEF/�LCONTRIGTOR M�ILADDFE55 /��TY') Z�P PM�E LILENSE� <br /> FJ �� �JC <br /> MEGlLY^�ICONTR�L�y��MMLADD,P�,>S, / Utt ZIP PH)fNE UC6NSEI ,� <br /> �"�� l/�)'1�S �/7=� /��.:��1� � �s% �rt�l��• i�f>%'- '7f�-�1��`� �� �� �Y(iC"J , <br /> g{(v � ZIP PMpNE IICENSE� <br /> M PIUMBINACONTRACiOR M�2AU�RE55 � <br /> �y ^ <br /> i <br /> �� C1A550FW0iiK — . ._. — . <br /> �� ;.i NEW iJ ADDITION � LTEHATION � REPAIR _. DEMOLITIDN WOODSTOVFJFRPL INSERT ':J BUILDING RELOCATION <br /> _/ ��1 CONTRCi�ERSON RND PIION'_ O. <br /> � � I <br /> CONTRIIGT PPIGE OF WORK <br /> DESGRI6EWORKA. DS�EF007(�GEINVOlVEO , <br /> /) <br /> -- � � � i� i '�iT' a Ci�""i..Ll!< <.,�'� � <br /> paoroseouseoFem�owc I HEREBY CERTIFY TF,.4T I HAVE READ AND EXAMINED THIS � <br /> -. APPLIC4710N AND KNOVJ THE SAME TO BE TRUE AND CORRECT.ALL � <br /> r LE6AL DESLHIPTION OF PROPERTY ISHOWN BEIOW OR A1 UCM FOUR GOPIE51 PPO'+ISIONS OF LAWS AND ORDINANCES GOVEHNING THIS NPE OF �, ' <br /> � Y�r'riK WILL BE C.OMPLETED WITH WHETHER SPEGFIED HtREIN OR <br /> - � � � '' iot e�ocK oc NOT. THE GRANTING OF A PERMIT DOES NOT PReSUME TO GIVE <br />� - � - �/�+� j�j� AUTHORITY TO VIOLATE OR CANCEL THE PR(iVISIONS OF ANY <br /> � � �� ' � ,.7�1� ,( i'�- -'z:—[i(��� OTHER STATE OR LOCAL LAW REGULATING CON`iTRUCTION OR THE I <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE i <br />�� ' - � . � � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />�-. t , . , . � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />. � �; CONTRACTORS LPW 1827 RCW AND 296.200 WAC. <br /> � S�GNANREOFCONTPACTOROR�UTMORREDRGENT OATE <br /> � A y/ ,�l/��n �i <br /> PROJECTADDRE55 ��- �—"�'���/� • �"' "�� lil�.Y-�'1��/' �l � <br /> � -� ` Y� � �� r�/� . , L �PPCICANTSCITYBUSINESSII ENSENO.AND INE �ME / <br /> yr�, p y / ��l" <br /> `�� PLU ING MECMANICAL � <br /> , I � Np, TVPE OF FIXTURE OR ITEM FEE , NO. TVPE OF EOUIPMENT— FEE ' <br /> : <br /> WATER CLOSET(TOILEn NC—AfHNDLG UNIT�-H.P. /l 'z� <br /> BATHTUB , () FORCED AIR S`.'STEM B.T. . E.A. <br /> t . C� LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. i <br /> i , � SHOWER � CLOTHES DRYERS ' . <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; � <br /> IDISHWASHER RANGE HOOD <br /> .�:1 ' LAUNDRYTRAY WATER HEATER � I <br /> �� <br /> CLOTHES WASHER WOOD STOVE � <br /> . I URINAL METAL FIREPLACE&CHIMNEY � <br /> � ` DRINKING FOUNTAIN i FIREPLACE INSERT i <br /> _ '� FLOOR DRAIN � �T PUMP � <br /> I � <br /> � <br /> I � � BACKFLOW PREVENTEFlS IiAS PIPING I , <br /> 1 ROOF DRAINS—RAINLEADERS EXHAUST FAN � i <br /> Y 1_ � SINK(SERVICE—BAR,ETC.) � � <br /> I �'�� � � <br /> i , <br /> �t� _ SUB TOTAL $ _ SUB TOTAL 3 � <br /> � PERMIT $ PERMIT $ i <br /> . ' TOTALFEE $ ' TOTALFEE 5 � <br /> FOR OFFICE USE O�'LY: <br /> FRONT SETBACK Rr.RR SETO�CN SIpE SETBRGN PIAN GNECK NU!d�ER FEE FECEIPT NO. <br /> J <br /> •-.«;.:'. - � use zor�E itr naen VACRNT SITE FEES VALUATION FEE <br /> ���'�'i� 9UIL�ING <br /> �' tVPf Oi CON75.AILOWABLE rvP!Of CONST�CiOAI oc[uwr¢r No d v6mroGuxrtS i <br /> �1 �t cnouv PLUMBING i <br /> � ' i <br /> � i�"' SIZEOFBLDG. NO.JFSTORIES BASEMENT MECHANICAL <br /> } � <br /> iv <br /> EI�-` ' OCCUPANGVLOAD FIRE:iPRNNLERSREO'D HEIGNTIIMITATION AODITIONALPLANCHECK � <br /> t� �t . - .- OTHER � <br /> -. . - `�'�"^ °.•''��.' � REASONFORSPRINNLERS <br /> STATE Bl11LDING SURCHARGE i <br /> INTRKEDY PLRNSRPPROVE�OV CITYOFEVERETT PUBLICWORKS � <br /> LOCAL SALES T- <br /> TAX COUEIS 3105 rorn� � <br />