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,�-. �. <br /> L►PPLICATIO.J FOR CONSTRUCT...1N PEFtMIT everett <br /> 1he Evergreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: AS ❑ ELECTRIC O <br /> BUILOING DEPARTMENT <br /> 259-8810 <br /> QEMOLITION COMBINATION BUILDING �MECHANICAL PLUMBING SIGN <br /> OWNER 1AAILAODRE55 / CITY ZIP PHONE <br /> V1.=� ��f��V, � ( A / l� ��-.'• �` � ._ <br /> TEN�n� MAILA 55 ��' ��fITV 21P PHONE �S� —�� ^ � <br /> �v�-f�� d � � � _ �-I- `� <br /> �. � �n o <br /> ARCHITEGTORDESIGNER MAILADORE55 <br /> �— �ITy ZIP PHONE <br /> 'SNERALCONTFFCTOR MFiLADDRESS CITV ZIP PHONE UCENSEa <br /> MEGHANICALCONiRACTOR MAILADDRESS CiTY ZIP PHONE LICENSE� -,p <br /> �-Ct ��C].�rVl L �5�J� <br /> PLU�INGC�ON�FnCiOc MAILADDR�, l. �C� /] ICf�L1'f`(X-w�"� � � ���I�WIIQ_ LIS�S �G�G•� <br /> n. <br /> �-t.I�C V r�[� u.�, ��� �r <br /> GLASS OF WORN � . <br /> , � NEW �ADDITION �. ALTERATION � REPAIR . DEMOLITION �_. WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br /> /� ,^ GONTACT PEFSON AND PHONE NO. <br /> CONTRAGT PRIGE OF WORK�� % �-� ' V V M'— �� ' � � <br /> ' DESCRIBE WOFN AND SOUARE FOOTAGE INVOLVE� <br /> I�QA�1 , Z. � ✓- <br /> �ROPOSE�USEOFBUILCING � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �l �_������ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DESCRIPTION OF PROPERTP�SHOWN BELOW JR ATTAGN FOUF GCPIES� PROV�SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ���r BLOGK o= NOT. THE GRANTING CF A PERMIT OOES 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 CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWPIER OF THIS PROPEPTY TO PERfORM THE WORK FOR WHICH <br /> qPPLICATION IS MAD AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.2 CW AND 296.200 WAC. <br /> SIGNATUREOFCONTRAG FOR THOHIZEDAGENT DFTE <br /> � � 'l <br /> PROJ��fjE55� �� "— <br /> b� APPLIGANTS CITV BUSWES ICENSE N0.AND DUSINNESS NAME <br /> PLUMBING MECHANI AL �� , _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. OF E�UI T FEE <br /> WATER CLOSET(TOILET) Ai�OJHNDLG UNITS—H.P. __� <br /> BATHTUB FORCED AIR`i'.'STEMS—B.T.U. M E.A. ' <br /> LAVAT6RY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHES DRYERS <br /> KITCHEP:SINK 8 DISP VENTILATION FAN _� <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRV TRAY ' WATER HEhTEfi � <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLAGE 8 CHI�dNEY _ <br /> DRINKI�G FOUNTAIN � FIREPLACE INSERT _� <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTFRS GAS PIPING <br /> ROOF URAINS—RAI^lIEADERS � EXHAUST FA�' <br /> SII.K(SERVICE—BAR.ETC.) � � <br /> — � <br /> � — <br /> � _ <br /> � <br /> SUB TOTAL $ i SUB TOTAL S' i <br /> PERMIT 5 PERMIT S /�S� <br /> TOTAL FEE $ TOTAL FEE 5 �S ' <br /> FOR OF�ICE USE ONLY: <br /> REGEIPT NO <br /> FRONTSETBAGK REARSEiBACK SIDE59TBFCM. PLA4GHECKNUTABER FEE <br /> usezor+e �ornaen VACANTSITE FEES VALUATION FEE <br /> BUILDING <br /> TYPFOFCONi5AlL0'NRBIE 1VFEOFC@IST.AL704L o:Cuv4b;v NOO�mrtLLiNGUnrtS � <br /> r,aoo� PLUMBWG ( � _ <br /> SREOFPLDG NO.OFSTORIES BASEMENT MECHFNICAL "^� �Ov <br /> i <br /> i <br /> OCCU�ANCY LOA� FIRE SPRNK�ERS REO'D HEIGHT LIMITATION <br /> ADDITIONAL PLAN CHECK � <br /> OTHER i <br /> REASO�!FOR SPRINKLEFS � <br /> STATE BUILDING SURCHARGE ' <br /> INTAK[PY PLANS APPROVEOBV CITY OF EVERETT PUBLIC WORKS <br /> LOCRL SALES �jS--i�� <br /> TAX COOE IS 3105 TOTAL <br />