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APPLICA�'ION FOF3 CONSTRI,.:T10N <br /> PERWIIT <br /> ihe Everg�een pverett <br /> CITY OF <br /> everett � <br /> BUILDING DEPARTN.'ENT <br /> 259•8dt0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MAILAODRESS CITt' ZIP PMONE <br /> ���✓/e �.�� O t� f? �� �o� / a 3 02 �� ��Yrf 9�ao/ .�5� �� a s <br /> TENANT MAILADOPE55 CITY 21P PHO4E <br /> ARCHITEGTORDESIGYER MAILAUORE55 CITY ZIP PIIONE <br /> G W�v ev� <br /> GENERALGONTRAGI'OR MAILA�ORE55 CItY ZIP PNOIJE �ICENSE+ <br /> �w�u -�v� <br /> MECMANIGLCONTRACTOP MRILADDBESS CITY ZIP PHONE LICENSEv <br /> PLUMBINGCONTfiACTOR MAILPDOFESS GITY ZIP PHONE ULENSE• <br /> CLASS OF WORN <br /> ❑ NEW ❑ ADDITION LA� ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSEPT ❑ BUILDING RELOCATION _ <br /> TENFATIMPFOVEMENTOFINTERIOoElAOOD�E'IONLY PS� �� CONTAG�Eu/NAN��NEryJ� �S/ ��OSO <br /> / / <br /> CONTRACTPRICEOFWORK � / '-� �� � <br /> DESCRIBEWORKANOS9UPREFOOTAGEIiVVOLVEO <br /> l���OCRY� Lud,�� <br /> PROPOSED USE OF BUILOING I HEREBY CERTIFY'HAT I�1AVE READ AND EXAMIN ED THIS APPLICATION AND <br /> 7{�p�e� KNOW THE SAME TO BF"i aUE AND CORRECT.ALL PROVISIONS OF LAW S AND <br /> LEGAL OESCRI TION UF PROPERtt�SHOWN IlE�OW OR ATfRCH FOUR COPIE51 ORDINANCES GOVEBN WG THIS 7YPE OF WORK WILL BE COMPLETED WITH <br /> WHETHERSPECIFIF.OHEREINOR NOT.THEGRANTINGOFAPERMITDOESNOT <br /> PRESUME TO GIVE P:iT110RITY 1 O VIOLATE OR C4NCEL 7HE PROVISIONS OF <br /> �or e�ocK oF ANYOTHERSTATE�.IRLOCALLAWREGULATINGCONSTRUCTIONORTHEPER- <br /> FORMANCF OF CO �STRi6T10N.THAT I AM AUTHO(i12ED BY THE OWNER OF <br /> THIS PROPERTYTO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY W1T4 THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296200 WAC. <br /> Si3NRtUflEOFCONTRACTORORNUtNORIZEOAG[NT DRTE <br /> 3a�s � ofs, d a� a X ���� I-3�-�� _ <br /> PROJECTAD�FESS APP4CANiSCiiY8U51NE55LICENSI O.N SINESSNAME <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEF CLOSET(TOILEn A/C-A/HNDLG UNITS-H.P. <br /> BATHTUB FORCED AIR SVSTEMS-B.T.U. M E0. _ <br /> LAVATORY�WASHBASIN) U�JITHEATERS-B.T.U. M _ <br /> SHOWER CLOTNES DRYERS __ <br /> KITCHEN SINK 8 DISP. VENTILATION FAN _ _ <br /> DISHN/ASHER RANGE HOOD <br /> LAUNDRY TRPY WATER HEATER _ <br /> CLOTHES WASHER WOODS70VC __ <br /> URINAL METAL FIREPLACE 8 ChIIMNEY <br /> DRINKIfJG FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEPT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> FOOF DRAINS-RAINLEADERS EXHAUST FAN _ <br /> SINK�SERVICE-BAR,ETC) <br /> SUBTOTAL 5 SUDTOTAL 5 <br /> PEFMIT 5 PERMIT � <br /> TOTALFEE S TO7ALFEE S <br /> FRONTSETBAGK PEARSETBACK SIOESETOAGK PLANCHEC NOM9EP Ff:E NF.CEIPTNO. <br /> �o t � �� �9 ,�i G �/S 1 �s � od <br /> usezo�� �orn��' O VACANTSiT�. FEES VALUATION FEE <br /> 2 ❑YES�'1(NO ��� <br /> BUILDING � <br /> TYPEOFGONST. �i OGCUPANCYGROUP NOAFDI4ELLINGUNITS �— <br /> ALLOWFBLE/FCTUA� �/-� � �� .-I��' PLUMBING <br /> ..Si <br /> 512EOFBLOG. NO.OFSTOP:iS 0 MT. OGGLOAD h1ECHANICAI <br /> i�7� �� � o N �� <br /> ' MEiGNTIIMIiATION OTHER <br /> FIRE SPRINKLERS REOUIRED ❑YES NO �� STATE BUILDING SURCHARGE �O <br /> STATE ENERGV SURCHARGE <br /> APPL'CATIONACG9V PLANSAPPR.BY PUBLICWORKS <br /> /� Toru � <br />