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APPLICAT16n1 FOR CONST{;UCT�JN PIERMIT <br /> everett <br /> rrre Evorgreen � <br /> qTY OF <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOUTION COMBINATION BUILDING �MECHANICAL PLUMBING SIGN <br /> ��l✓ \VW • C✓� pMW VS� �V1 I O v 4f�4.�N1� 1 � V IP L V � P�"�a _ �c� 3y <br /> ��� TfNANT MAILAD�8ES5 CITY ZiP PHONE <br /> L9 �Q ARCHRECTORDESIGNER MRILAO�RE55 GITY ZIP PHON[ <br /> ��� GE AL C NTRACTOR � �l ODRE55 CIL ZIP —� P�ON ' NS�� / � <br /> i ` <br /> n � <br /> ��� MECHAN�CALCONTR GTOR MAIL �DR[SS CIT1 ZIP PMONE LICENSE� _� <br /> �� PLUMOINGCd�TRACTOR MRILA�DRE55 CITY ZIP PNONE IIGENSEI <br /> YRi <br /> �J ClASSOFWORN <br /> Q��.y �,_i NEW Ll ADDITION ._. ATION �. REPAIR . �i DEMOIITION �'�J WOODSTOVBFFPL INSEAT L BUILDING REIOCATION <br /> `o a CONTACT PERSON AND PHONE N0. <br /> TENANTIMPFOVEMENTO(11 qREMODEL_QKLY <br /> ,�,� l� ,ar� <br /> M CONTRAGT PRICE Of Y/OHN: <br /> �y OE$CRIBE W PK FND OUR FOOTRGE MVOLYED � l�� . <br /> M � <br /> Sf N H PROPOSE SEOFBUILDI c I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> O�� ^ APPLICATION AND KNOW THE SAME TO BE fRUE AND CORRECT.ALL <br /> � LEG4LOESCRIPt10NOFPROPERTVISM ELOWORATfACNFOIIRGOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WURK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �(p AUiHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � - r OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.TFIAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNAi OFCONTPFCTORORAUiHORIZEDRGENT �ATE <br /> PRQIECTR 0 55 � � ��� �� <br /> - - pP � ANTSCIttBU51 SSLICENSE DBUSINESSNAME <br /> �� PLUMBING MECHANICAL <br /> I C�� NO. TYPE OF FUCTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> ' WATER CLOSET(TOILET) � NCrA/HNDLG UNITS—H.P. <br /> � BATIiTUB ' FORCED AIR SVSTEMS—B.T.U. E.A. <br /> i� LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> 1 '�,�I SHOWER CLOTHES DRYERS <br /> I . KITCHEN SINK 8 DISP VENTILATION FAN <br /> � DISHWASHER RANGE HOOD <br /> �' �� LAUNDR'/TRAY WATEF HEATER <br /> I ��� CLOTHES WASHER VlOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> � DRINKING FOUNTAIN i FIREPLACE INSERT i <br /> FLOOR DRAIN � HEAT PUMP � <br /> �I �1 1 BACKFLOW PREVENTERS GAS PIPING _� <br /> . � ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> i <br /> � 1��j <br /> i <br /> I SUBTOTAL $ SUBTOTAL 5 U �� <br /> I l PERMIT S PERMIT 5 — � DU <br /> ; �� TOTAL FEE 5 TOTAL FEE 5 S ' <br /> � PRONTSETBACK REAFSETBACK � SIOESETBRCN PLANGMECNNUMBER FLE RELEIPTNO. <br /> USEZONE LOTPREA VRCr1NT51TE FEES VALUATION FEE <br /> '. i YES L�i NO BUILDING �� <br /> TVCEOiLON51ALlOWABLE iYPEOfCONSTACi11AL ocav�xr x0orowtiwcuen5 i <br /> �pW� PLUMBING ' I <br /> SI2EOFOlOG. NO.OPSTORIES BRSEMENT MECHANICAL S � DO <br /> I J YES �_; NO <br /> OCGUPANCYLO�D flRESPPNNLER5PE0'D MEIGNTIIMiTAT10N OTHER i _ <br /> :.l YES ❑ NO STATE BUILDING SURCHARGE � <br /> REASON FOR SPRiNNlENS � <br /> STATEENERGYSURCHARGE i � <br /> AP�LICRTIONFCC.BY PlANSRPPROVEUBY CITYOFEVEREIT PUBLICWORKS I <br /> LOCAL SALES �� �v� <br /> TAX CODE IS 3105 rora� <br /> , <br />