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• �APPLICATIOI.. �OFi CONSTRUCTI.,t�1 PERMIT �Vef��t <br /> mee�e�gmr�� TO BE COMPLETED IM INK—PLEASE PRINT � <br /> GTV OF <br /> everett HEATING SYSTEN: ❑GAS � EI_ECTRIC ❑ —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION �OMBINATION �UILDING MECHANICAL PLUMBING SIGN <br /> OVJNEfl 1AAILAODRE55 � CITY 21P PMONE <br /> CJ�c,J,v:/,' TIJEI�Gc,: ��:.?�1r.- �2iC r=��:��',.;,c�N �..ea tc✓T. s�=Z�y ,Z.S�7-7x�0 <br /> TENANT MAILADDRE55 Clf� ZIP PHONE <br /> ti�/�= <br /> ARCHRECTCRDESIGNER MAILADDfiESS GIT' 21P PHONE <br /> /�Sr�� C✓rc.f's /572 -� /CT� Cl F,e v /i. GJA . �i'R,1.�o L•Sr/-//Fa <br /> GENEPALLONTqACiOR MAILADORESS CIN ZIP PHONE LICENSE:1 <br /> GJ <br /> �G�,�^.c rOF_iYLP� Cc....l, .2;�c- cI2/CG'1/i.CGie�:a'N Lu.Fy F.(/% 9c.tc-Y � s .-'i _7Xr CiC.:w.�/o�.!>Y ML <br /> MECMANICAICONLflAGTOR MAILFC7RES5 CITY ZIP PHONE LIGENSEN <br /> PLl1MdINGCONTRACTOR MqILADDRESS CITY ZIP PNONE LICENSEY <br /> CLAS�.OF WORN - I <br /> I�'�NEW :_.I ADDITION ��. .'� ALTERATION ; ! REPAIR (_7 DEMOLITION !..! WOODSTOJE/FRPL INSERT i_i BUILDING RELOCATION <br /> CONTACT PERSON AND'PH1ONE ND. ' <br /> CONTRACTPRICEOFWORK � ���Q(/{- C/ uNN�rC ".�5-1 '77CC I <br /> DESCFIBE WOFK Ak0 S�l1ARE FOOTAGE INVOLVEO <br /> )r' /- F.v�1 S Ic._ .n I Oe n->ni l Sr' <br /> aaoPoseouSeoFew�oiN� ' ' HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> p S � ,,,, ,r. APPLICATIpN AND KNOW THE SAME TO BE TRUE AND CORRECT.HLL <br /> LEGALDESCRIPTIONOFPROPERTV�SMOWNBELOWORATihCHFOURCOPIES� PROVISIOtvSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLFTED WITH WHETHER SPECIFIED HEREIN OR <br /> i.ar BLOCH oF NOT. THE GRANTING OF A PERiVl1T DOES NOT PRESUME TO GIVE <br /> AUTHJRITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> S�e icT.�c G�� OTHER STATE OR LOCAL LAW HEGULATING CONSTRUCTION OR THE <br /> np PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> N�/"���SS/� OWNEfi 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 296.200 WAC. � <br /> SIGNA EOFWNTFACTOFORAUTNOflREOAGENT DATE �'-�� - II <br /> PFOJECTADOPESS � �"\%!'��( ��r.r <br /> , � J APPL::qNTS LITY B1151NES5 UCENSE NO.AND BUSINESS NAME <br /> PLUMBING MECHANiCAL <br /> NO. TYPE 6F FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> — WATER CLOSET�TOILET) NC—A/HNDLG UNITS—H.P. <br /> ; BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> /,s LAVATORY(WASH BASIN) NIT HEATERS—B.LU. M <br /> /3 OWER ��.rn_'uS. CL THES DRYERS <br /> /� KIT EN SINK&DISP ; i,j VENT TION FAN <br /> J3 DISHW HER g RANGEH D <br /> LAUNDRY Y ; WATER HEAT <br /> CLOTHES WA R � WOODSTOVE <br /> URINAL ; METAL FIREPLACE 8 IMNEY <br /> DRINKING FOUNTAI ' i FIREPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADER � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � <br /> SUB TOTAL S ; SUB TOTAL $ <br /> PERMIT S PERMIT 3 � I <br /> TOTAL FEE $ TOTAL FEE 5 � <br /> FOR OFFICE USE ONLY: ' <br /> FRONTSETBACK qERRSETpFCN SIOESETBFCN PLA�iC CNNUMOER FEE FECEIPTNO. I <br /> � � Zo� 3 � C 27' ,Z, 7 �, 3 ._5�.��>L �. <br /> usezoNe LOT�REA VACANTSITE FEES VALUATION FEE <br /> �� ��� BUILDING �� � � !� � <br /> ` i� ;�L7 <br /> TYPEOFG011t�ALLOWAeIE TYPEOJCO�S:.AC70AL occ�vArper xo��ow'Ll'ncuxrts PLUh181NG <br /> iyr� •rt 1�-� � <br /> 1 �� ..V— 111� �� ` ' <br /> 5'ZEOFBLOG NO.OFSTORIES BFSEMENT MECHANICAL T <br /> 10 �f11,ro `� 3 A�U <br /> OCCUPANCY LOA� FIRE SPRyN�NLEflS REO'0 HEIGHT LIldIT�ION ADDITIONAL PLAN CHECK � <br /> 37 YLf S OTHER � <br /> PEASON FOR SPFMKLEPS �— <br /> .»�;NN�'�� S7ATE BUILDING SUFCHARGE �� � ; - <br /> U��' <br /> INTAKEBY PLANSAPPROVE�BV CITYOfEVERETT PUBLICWORKS <br /> LOCAL SALES <br /> � � n� J� TAX CO�E IS 3105 TOTAL � ,� � ; <br /> {. _ <br />