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� v <br /> S APPLICATION FOR CONSTRUCT ON PERMIT everett <br /> in�E,re.�,ee„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ctrv oF <br /> everett HEATING SYSTEM: GAS ❑ELECTRIC D <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> ; DEMOUTION ; COMBINATION J BUILDING �!ECHANICAL !__ PWMBING : '. SIGN <br /> OWNER MAILA��RE55 CITY ZIP PHONE <br /> -��B1�E �L�S[C� SdZZ. F1rr15� EVf 2SZ•.S�i/3.5� <br /> TENRNT MAILADDRESS CITY ZIP PHONE <br /> AFCHITEGT OR DESIGNEB MAIL ADDRE55 CIN ZIP PHONE <br /> GENERAICONTRACTOR MAILADDRESS CITV ZIP PMONE LICENSE• <br /> MECHANICALCONTRACTOR MAILADOPESS CITY 21P PHONE L.U..C,-EN_J,Ef p.� <br /> PLUMBINGC�OyTPAG OR � �M�I�AD�RESS � ���y � Z��S-�33y% L/�/�E iy J�d� <br /> � CUSSOFWORK <br /> � �NEW :�.1 ADDITION i-1 ALTERATION ,_�i REPAIR . �'�. DEMOLITION l-i WOODSTOVE/FRPL INSERT '� BUILDING RELOCATION <br /> GONTqCT PERSON AND PHONE NO. <br /> � C(NITRACT PRICE OF WORK GOO� a� I <br /> ' DESCRIBE WORK AND SOURRE FOOTAGE INVOLVED <br /> f .l�As w,4u �.,� <br /> PROPOSEOUSEOiBUILUING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � LECa�I UESCRIPTIONOF PPOPERTY(SHOWN BELOW OR AT7ACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> '. WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � �or o�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> . AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> - OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED 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 iB.27 RCW AND 296.20C WAC. <br /> ' SIGNA7URE OF CONTRaCTOR OR AUTHOFIIEO RGENT DATE <br /> i <br /> , PROJECTRDDRE55 h � � <br /> �{/�Z �m ST AP �CANTS TY INESSLICENSFJ .�NDBUSINESSNAME <br /> / <br /> � PLUMBING MEC AL <br /> i NO. TYPE OF FD(TURE OR REM FEE NO. TYPE OF EQUIPMENT FEE <br /> ' WATER CLOSET(TOILET) NC—fUHNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> � SHOWER � CLOTHES DRYERS � <br /> � KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD <br /> � LAUNDRY TRAY ; WATER HEATER <br /> � CLOTHES WASHER � WOOD STOVE ; <br /> UFINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FI OOR DRAIN � HEAT PUMP � <br /> rBACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � <br /> i � <br /> SUB TOTAL $ ; SUB TOTAL S O ; <br /> PERMIT $ PERMIT $ / ; <br /> TOTAL FEE 5 ; TOTAL FEE $ f^ <br /> FOR OFFICE USE ONLY: <br /> FNONTSETBFCK REARSETBAGN SIDESETOACh PIANCHECKNUM�ER FEE FECEIPTNO. <br /> 3s"s s� <br /> uSezoNe LO7AREA VACANTSITE FEES VALUATION FEE <br /> BUILOING i <br /> 7YPEOiCONiS.AILOWABLE iYPEOFCONS7.RCTUAI atUw.N[r Noorrnv[lUNtuxrts � <br /> �°°°' PLUMBING <br /> 52EOFBLDG. NO.OFSTORIES B�SEMENT h�ECHANICAI �� � <br /> i <br /> � OCGUPANCYLOr1D FIRESPRNNLERSREO'0 HEIGNTIIMITATION ADDITIONALPLANCHECK � <br /> O7HER � <br /> REASON FOR SPRINKLEFS � <br /> STATE DUILDING SURCHARGE ; <br /> INTAKF 9Y PLANSAPPROVED BV CITY OF EYERETT PUBLIC WORKS � <br /> LOCALSALES ' <br /> TAX CODE IS 3105 TaTA� cf S'� �� <br />