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,: �-� <br /> � APPLICATIOi�� �OR CON.STRUGT�IoI PERMIT everett <br /> ,� � . <br /> `� tneeve�preen TO BE bG`MPLETED IN INK—PLEASE PRINT <br /> �� ciroF + <br /> � eVere�l ' HEATINGSYSTEM: ❑GAS DELECTRIC ❑ <br /> � BUILDING DEPARTMENT <br /> 259-8810 �� � <br /> ❑ DEMOLITION CI COMBINA710N ❑ BUILDING �!'IoIECHANICAL 'ii}'PLUMBING ❑ SIGN <br /> `�p fl IMILND,D/R�E55 CITY ZIP PHONE <br /> ��iR-6 j J d- /y-SS O ' <br /> TENANT MAILADDRESS CITY ZIP PHONE <br /> ARCHITECTOROESIGNER MAILAODPESS CI7Y 21P PHONE <br /> GENERiU.CONTRACTOR MAILADORESS CITV 21P PHONE LICENS°� <br /> t <br /> MECHMIIGALCON=RACTOH /�MRILADOFESS CRY t 21P PHONE LICENSE/ <br /> ' ��r5�r,s�rAnr C.o . �G.z�/ - G7�Rus Nf.`I�.R.�✓sv�t�. g'8:Z7o (�7'"j-.3GSS' (.�(Srurell/lc/� <br /> PLUMBINOCONTPACTOF MNLA�ORESS CITV � ZIP PHONE LICENSEI <br /> CLPSS OF WORK <br /> NEW f I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPLINSERT fl BUILDINGRELOCATION <br /> CONT4CT PERSON AN�PHONE NO. <br /> CONTR/CT PRICE OF WORK <br /> DF�$CRIBE WORN AN�SOUARE FOOTAOE INVOIVED <br /> (�J <br /> PFOPOSEDUSEOFBUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TqUE AND CORRECT.ALL <br /> LEOAL SCflIPTIONOFPBOPERTY�SHOWNBELOWORATTAGHFOURCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILI BE COMPLETED WITH WHETNER SPECIFIED HEREIN OR <br /> ior oiocK oF NOT. THE GRANTING OF A PERMIT DOES NOl' 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 AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOPK FOR WHICH <br /> APPLICATION IS MADE AND i COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNATUFEOFCONTRqCTOflORAUTHORI2EDAGENi OATE <br /> PR0.IECT AD�HESS ��'•L��� <br /> /p � n� ' APPLICAt7T5CITYBUSINESSIICENSENO.AN00USINE55NAME <br /> / A`�r/ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> /�/ WATERCLOSET�TOILET) �— A/C—fVHNDLGUNITS—H.P. <br /> BATHTUB ;_ FORCED AIR SYS7EMS—B,T.U. M E.A. � <br /> LAVATORY(WASHBASIN)� �— UNITHEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES DRYEiiS <br /> KITCHEN SINK 8 DISP ; — VENTILAT!ON FAtJ ; <br /> DISHWASHER �.� RANGEHOOD � � <br /> i LAUNORYTRAY - � / - WATER HEATER ��p <br /> CLOTHES WASHER O � � WOOD STOVE ; <br /> URINAL � METAL FIFrpL:CE&CHIMNEY � <br /> �� DRINKING FOUNTAIN � FIREPLACE INSERT ' <br /> i <br /> 1 FLOOR DRAIIJ � HEAT PUMP � <br /> BACKFLOW PR�VENTEFS ; .^�AS PIPING ; <br /> � ROQF DRAINS—RAINLEADERS � EXHAUST FAN <br /> 'i <br /> SINK(SERVICE—BAR,ETC.) ; <br /> Ne.rE •o '�— � <br /> � , <br /> — � � <br /> i , <br /> � � SUB TOTAL $ <br /> ;-� SUBTOTAL $ �GU <br /> ; PERMIT $ � PERMIT $ / � <br /> TOTAL FEE $ 3 ' TOTAL FEE $ a �O d <br /> � FOR OFFICE USE ONLY: <br /> � FHONTEETBACK REANSETBACN SIOESET3RCK PIANCMECKNUMBEP fEE RECEIPTNO. <br /> 7 <br /> usezot+e LOTARE� VACANTSITE FEES VAIUATION FEE <br /> ! ' <br /> j BUILOING i <br /> TYPEOFCONiS.ALWWABIE TVPEOfCOtiSLACTUAL a[uv,�Vp HOamv[luNouNi15 � <br /> I GRpJP PLUMBINO <br /> { �/ )' �— <br /> � SIZEOFBLDO. NOAFSTOfl1E5 BRSEMENT i <br /> MECHANICAL �d G '� <br /> ! OCCUPANCVLOAD FIRESPRNNLERSRE00 HEIGMiIIMITATION ADDITIONALPLANCHECK i <br /> i <br /> j OTHER � <br /> 1 REAWNFOHSPPINNIEflS � <br /> � STATE BUILDING SURCHARGE � <br /> j INTAKEBV PlANSAPPROVEDBY CITYOFEVERETT PUBLICWORKS � <br /> � LOCAL SALES ' <br /> TAX CODE IS 3105 TOTAL ' <br /> _ .S"y;�on <br /> M;_,' <br /> r, e ,�, � <br />- .': `��,� 1 ����� „ �u' ; <br /> � •, <br /> �_. - . . ..- K-^"`a�, ��- _ _.,� , <br /> -�-nt w_.,... . . . ,u�ea <br /> ..,,t�c-+:r,:i. ' ...-.3�:i�*:t.i. ..___....�'.a:��i .C�sS`�,:..::�:..._. .: 't^' <br />