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APPLICATIOI�i �OR CONSTRUCTI.�N PERMIT everett <br /> rr�e��y�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cirv oF <br /> everett HEATING SYSTEM: ❑GAS ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION i; COMBINATION �= BUILDING i-_ MEG�iANICAL ❑ PLUMBING :7 SIGN <br /> � `Oir.�// MAILADDRESS CITY 21P PHONE <br /> i p'Y�Ivn.. <br /> �* .ss,r,ur�vB�,r.,r�v�-� ?m. ao,r�� �ur 9�ao3 �o� a.�- -��zr <br /> TEN�NT MAILADL'RESS CITY ZIP �'YONE <br /> AflCHITEGTORUESIGNER MAILADDRESS CITY ZIP PHONE <br /> GENEH�LCONTARCTOR MAILADORE55 CITV ZIP PHONE LICENSEI <br /> .sitniE /9s �6ovF <br /> MECHRNICALCON'RACTOR M�ILADDRESS �ITY ZIP PHONE LICENSE� <br /> PlUM81NGCONTPACTOR MAIL�UDRESS CITV ZIP PHONE LICENSE• <br /> CLASS OF WORK — <br /> �NEW ❑ ADDITION ❑ ALTERATION �:J REPAIN ❑ DEMOLITION I 7 WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> CONTACT PERSON AND PHONE NO. <br /> CIXJTMCTPqICEOFWORK /� �J2Z L �- � /..L ,� S� <br /> .t.L <br /> DESCRIBE WOPK AND$OU�RE FOOTAGE INVOLVEO <br /> �G�w�' !l9ssoF'-f�/?�.lG,kz X 3 z .�585 o6f 3.�='� 7ZS <br /> PROPCOSEDUSEOFBUILDING I HEREBY CERTIFY TI1AT I HAVE READ AND EXAMIIJED THIS' <br /> �` R 3 2GN�� O?(SCS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT.ALL <br /> LEGAL DESCRIPTION OF PROPER'v�_MOWN BELOW OR ATTACH FOUP I;OPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or eiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � wI AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> Rt I I/4I o7 O� �/p'jS f"��F OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOHIZED BY THE <br /> N �/S'o� �'% ti�yy N�yx �� ' APPLICATIONISSRMADE A DPECOMPLY WI�HK HERSTATE <br /> L� l D S T']" f"" �/p D �� CONTRACTORS LAW 18.27 RCW AND 296200 WAC. /��q3 <br /> � SIGNANREOFCONTRACTORORAUTHORIZEDAQENT DATE / <br /> Le ss J" itf- P�''•v .x�F f},v y D So� .8�t� ,BP�/o LL <br /> L oF o / S ,,-p�� � <br /> PRQIECT AODRESS <br /> �rQ Q � ANTS CITY BUSINESS LICENSE NO.AND BUSINESS NAME <br /> ✓ <br /> PLUMBINO MECFiANICAL <br /> NO. TYPE OP FlXTURE OR REM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLGcET(TOILET) � NC—NHNDLG UNITS—H.P. , <br /> BATHTUB ; FORCED AIR S`!STEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � NIT HEATERS—B.T.U. M ; <br /> OWER � C THES DRYERS � <br /> KIT EN SINK 8 DISP ; VEN TION FAN � <br /> � <br /> DISHW HEH � RANGE OOD , <br /> LAUNDRY AY ; WATER H ER � <br /> CLOTHES WA ER � WOOD STOV ; <br /> URINAL ' METAL FIREPIA 8 CHIMNEY � <br /> _ DRINKING FOUNTAI � FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PFiEVENTER ; GAS PIPING � <br /> ROOF DRAINS—RAINLEAD S � EXHAUST FAN ; <br /> SINK(SERVICE—BAR,ETC.) ; —`— <br /> ' � <br /> ' � <br /> � � <br /> ' . � <br /> i <br /> SUB TOTAL S ; SUB TOTAL $ � � <br /> PERMIT $ � PERMIT $ ; <br /> TOTAL FEE $ ' TOTAI FEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBALK RE�RSETB�CK SIDESET^'�� PLANCMECKNUMBER FEE nyS/ RELEIPTNO. n <br /> � /UJ lL <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> ^ � BUILDING Z ' �-' T� <br /> IYPE FCONiS.�LLOW�BIE PEOftONSfACTOAt o[[uv�w:r x0orow[uixfubns <br /> � � cn v 3 PLUMBING —� <br /> I�bFBL � NO.OFSTORIES B0.5EMENT MECHANICAL � <br /> 2 NO <br /> UPANCVLOAD FIRESPRNKLERSREO'D MEIGHTLI,�ITATION ADDITIONALPLANCHECK � <br /> N/i` ti'o � � 0 30; — <br /> REASON FOR SPRINIfLERS —� <br /> STATE BUILDING SURCHARGE ��U <br /> INTANEBY PUNSAPPROVEDBY CITYOFEVEREIT PUBLICWOflKS O� i <br /> LOCALSALES ' <br /> JM 92� 93 TAX CODE IS 3105 TOTAL j05�; 90 <br />