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APPILICATIO►� FOR CONSTRUCTCiN PERMIT everett <br /> lheEwr9reen TO BE CONiPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC 0 <br /> BUILDING DEPARTN�ENT <br /> 259•8810 <br /> ! ': DEMOUTION i I COMBINATION i : BUILDING I MECHANICAL PLUMBING I-1 SIGN <br /> pWhGN MRILADONE55 � C 21P PNONE <br /> � �c . , <br /> � � . , Gz J"' �' v .�:2-a v � J-' <br /> T ANT Mr1R�DDPESS iY ZIP PNONE <br /> �� � <br /> `� , _ � � ��,.� /� �1 /�J- 2�.2u3 �3Z- ao �� <br /> p � �RLNREGTOROE9�(� � A1 ILAOORE55 CITY 21P � PHONE <br /> q V <br /> ��� GENER�LCONTRACTOR MARAp�RE55 Gltt ZIP FMONE IICENSE� <br /> /l�i lQ/<.C� <br /> � MECNANICA�CONTRACTOR MRILRDDFESS CITY 21P PNONE IICENSE� I <br /> ��.{� PIUMBINGCONTHAtTOR M4ILAODRE55 CITV ZIP PNONE LICENSEI I <br /> � <br /> ��I ClA$SOF WORK <br /> L4Q r7 NEW L ADDITION i.' ALTERATION ' REPAIR r' DEMOLITION : WOODSTOVE/FRPLINSERT �.. BUILDINGRELOCATION <br /> �~� �r'p p LONTRCTPERSONANDPHONENO. <br /> � GONiR�CT PRICE Of WORK ��C� <br /> Y <br /> M � OESCRIBE WO P :AURRE FOOTAGE IN OLVED , <br /> �y . > <br /> _ rIL' � <br /> M PR POSE lISEOFBWL�ING �� vh� � ���, I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS . <br /> S'F� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �H �' ����� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> � IEGALDESCRIPTIONOFPROPEPTY�SMOV:NBELOWORATTRCNFq1ECOPIES) <br /> �� � � //,� WORK WILL BE COMPLETED WITH WHETHEfl SPECIFIED HERF.�N OR <br /> � �or�_ ��ocK U;� .�,peS�T�Y � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> w OTHER STATE OR LOCAL iAW REGULATING CONSTRUCTION OR l i�E <br /> PERFORMANCE OF CONSTFUCTION.THAT I AM AUTHORRED BY THE <br /> � OWNER OF THIS PROPEFiTY TO PcRFORM THE WORK FOR WHICH <br /> APPI.!CATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 7.98200 WAC. <br /> SIGNATUREOFCONTRACiORORAUiNOR2E01�GENT OnTE �4/Z/�� <br /> C /i <br /> PROJECTAOORE55 ���� � <br /> � i,�/; /1��� � p r1PPLICRNiSCIiVdU51NE55L�CE SENU AND9USME55 A E <br /> ` �� <br /> PLUMBING MECHANICAL '� <br /> � � N0. TYPE OF FIXTURE OR ITE�I FEE NO. TYPE OF E�UIPMENT FEE � <br /> I ��� WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—tI.P. �I <br /> i <br /> ' BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A �� <br /> 1 � LAVATORY(WASH BASIN) UNIT HEATERS--B.T.U. M ; <br /> ��r� � SHOWER CLOTHES DFYERS � <br /> � �_� KITCHEN SINK 8 DISP VENTILATION FAN ; � <br /> I DISHWASHER RANGE HOOD <br /> �� LAUNDRY TRAY WATER HEATER ' _ <br /> � CLOTHES WASHER - � WOOD STOVE i <br /> � <br /> � I I_I' URINAL � METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT ; <br /> ' FLOOR DRAIN � HEAT PUMp' '� <br /> i — <br /> _ i BACKFIOW PREVENTERS ; GAS PIPING �� <br /> � I' 1 ROOFDRAINS—RAW�_EADERS � E%HAUSTFAN ���. <br /> ' � SIKI,SEFiVICE—BAFI.cTC.) ' <br /> % i <br /> I I�1'_' � <br /> i <br /> SUB TOTAL $ SUB TOTAL S <br /> PEFMIT $ PERMIT 5 i <br /> '�1+� TOTAL FcE 5 ; TOThL FEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK RERRSETBACK SI�ESETBACN PIANCNECNNIIMBER FEE RECEIPiNO. <br /> usezor+e LO7AREA VRCANTSITE FEES VALUATION FEE <br /> BUILDING .� V�.�, — GU i o0 , <br /> iYPEOFtONiS.AIIONABIE iYPEOfGONSi.ALiUAI aavuxr �qpvnnuxtuxns <br /> 49WP PLUMBING ' <br /> 1 <br /> SIZEOFBIW. NOAFSTORIES BASEMENT MECHANICAL � <br /> AODITIONAL PLAN CHECN � <br /> Q:CUPANCYLOAD FlPESPPNNLENSPEO'D NEIGMTLIMITATION i I, <br /> i <br /> O7MER I <br /> RERSON FOP SPRiNNLERS —�— <br /> STATEBUILDINGSURCHARGE [� i f Z� � <br /> INTANE BY PLANS�PPROVEOBY CITY OF EVERETT PUBLIC WORK$ � � <br /> LOCAL SALES � <br /> TAX CODE IS 3105 TOTAL y y �� , <br />