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� � <br />APPLICATION FOR CONSTRUCT�JN PERMlT everett <br />me e�e�y�een TO BE COMPLETED IN INK—PLEASE PRINT � <br />CITV OF <br />everett HEATING SYSTEM: GAS U ELECTRIC ❑ _� <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION '�COMBINATION !�BUILDING Ci MECHANICAL ! PLUMBING SIGN <br />OWNEfl MAILADORESS CITV ZIP PHONE <br />�pONA�(D C'D.(�'An'E �/�'A C�iCENCvOD�j C'd��Pe�T Gu/9 9��03 3s1=9-�7/ <br />TENRNT NAII. ADORE55 CITY T ZIP � PHONE <br />RPGNITECi OR DESIuNEfl MAIL ADORESS CITY ZIP PHONE <br />TiriP�essi.�.� DE�/6N C�A•C/�O.PN�A. L UL�EiT u�R, .t��-3aoo <br />GENEflALCONTP'1CTOR MAILAODRESS CITY Z�PMONE�� LICENSE• <br />OWN�_ R. <br />MECHMlICAL CONTRACTOR MAIL ADDRESS CITV ZIP PHONE �ICENSE R <br />PLUMBINGCONTRRI;TOR MAILA�DRE55 CITV ZIP PHONE �ICENSE� <br />C� �OF WORN <br />,_✓i NEW �� ADDITION �,. �. ALTERATION .��. REPAIR ! J DEMOLITION !. WOODSTOVFJFRPL INSERT J BUIIDING HELOCATION <br />�.Qrn c �y �~ CONTACiPERq50N^ANDPHONENO. 3r�_l���f� (Nf <br />CONTRACTPRICEOFWORK /��i0 , / y �Q� `. U���� 3s�a�rYi?a� /u>) <br />PPOPOSED USE OF BUILDING I <br />Ou>NcRS.t�erae.veL .s�.�je <br />LEGAL DESCRIPiION OF PROPEflTY �SMONM BELOW OR ATTACM FOUR COPIESI <br />�oT_� a��K oF cn�cr�ae�Q /f7 <br />Sc c. T. � s� Ti,v P. a 9i►' .PN� f��' �c <br />. <br />SNo.�fo�is.� C�D.. tu.f�. uo�. i.cs- <br />P� . � �.� � a � � <br />k r Ao ue�R s T Eve�Perji <br />PRQIECTA00RES5 � <br />�l9io �oue � 9��� <br />PLUMBING <br />NO. TVPE OF FlXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) o'lp � <br />� BATHTUB ' <br />LAVATORY (WASH BASIN) � <br />- SHOWER S�� <br />- KITCHEN SINK 8 DISP � <br />DISHWASHER %� <br />LAUNDRYTAAY ' <br />CLOTHES WASHER � <br />URINAL ' <br />DRINK�NG FOUNTAIN � <br />/ FLOOR DRAIN � w �a�J .� <br />BACKFLOW PREVENTERS ; <br />ROOF DRAINS—RAINLEADERS � <br />SINK (SERVICE—BAR. ETC.) � ; <br />� ric�r Si.✓� ,✓ 6...es6� ' � <br />SUB TOTAL $ ; <br />PERMIT $ <br />TOTALFEE $ iJ! <br />FOR OFFICE USE ONLY: <br />FRONTSFTB�CK REARSETBACK <br />2 � �_ <br />USE20NE LOTAREA <br />R s 2 1� <br />fYPEOFCONiS.All01YABlE TVPEOfLONST.ALTURI <br />4�� <br />SIZ�?/F'B�LDGs� * NO.OFSTORIES <br />z GA Z. <br />OCCUPANCV IOAD FIRE SPPNNLERS REO'D <br />�(O <br />REASnNFO SPRINKLERS <br />t HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW 7HE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS LR� ORDINANCES GOVERNING THIS T'PE OF <br />WORK INILL BE CGvIPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMI7 DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTHUCTION. THAT I AM AIITHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. G <br />SIGNATUREOfCONTRACTORORAUTMORIZEDAGENT DATE 7 /18I7 � <br />� X��l,�� �.s-�•--�-� _ <br />��1 APPLICANTS CITV BUSINE55 LICENSE NO. AND BUSINE55 N�IAE <br />MECHANICAL <br />NO. TYPE OF E019PMENT FEE <br />- Al�NHNDLG UNITS—H.P. � <br />- / FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br />- UNIT HEATERS--B.T.U. M ; <br />CLOTHES DR'/ERS � <br />VENTILATION FAN ' <br />- RANGEHOOD � <br />WATER HEATER <br />WOODSTOVE ' <br />METAL FIREPLACE 8 CHIMNEY � <br />FIREPLACE INSERT ; <br />HEAT PUMP � <br />�/ GAS PIPING ; <br />EXHAUSTFAN � <br />— AS F� R EP.t �9 e E � <br />- vn %. ��r 1J �- C7� 00 <br />� <br />- sue Torn� s v� o 0 <br />PEiiMIT $ _:.- <br />. Tl1TAI FFF 4 i)�A�1 <br />SIDE SETBACN <br />� %Z <br />VpCANT SITE <br />acur+xcr • qo� <br />�W�_� <br />BFSEMEIG <br />/((U <br />HEIGNT LIMITATION <br />2)� <br />IN1An: �Y � PUNS APPROVEO BY CITY OF EVEREIT <br />��� gl LOCALSALES <br />i y �� TAl( CODE IS 3105 <br />PLAN CHECK NUMBEfl <br />y�/.��s� <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CNECK <br />OiHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />E RECEIPTNO. <br />sa Y�9f �3iP�- <br />0 <br />�.,� pia.� e,ca � i� _ �a, <br />� <br />�3 <br />� <br />� <br />