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�� <br /> r'" - ,� Y <br /> APPLICATI� FOR CONSTRUC�ON PELRIINIT everett <br /> � � . <br /> ' ' TO BE COMPLETED IIJ INK—PLEASE PRINT <br /> 1he Evergreen <br /> CIT'!OF {.+ <br /> eVerell HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION [� COMBINATION C J BUILDING MECHANICAL ❑PLUMBING O SIGN <br /> � �ER r� � ��M IL D�P���/�D�� ���21 ' PHONE �l �� <br /> L-� <br /> _J <br /> TENp� MAILAODflE55 CITV 21P PNONE <br /> � / \ /5 <br /> �i�'vV/:/:4_�L <br /> AFCHITEGTORDESIGNEN MAILADORESS ��TY 21P PHONE <br /> , l�Ji1R//�--�1111J�--t1� . <br /> � NE CNTNACTOgS9.�9,z MAILBpo���_74Z 29� � � CITY ZIP � MO�E� LICENSE R <br /> 355 <br /> ��� ��a1qn�a Mnphn <br /> MECNlJIICALCONTflACTORiV�l�t[� YV��RII1j�Of1 QBYOZ �IiY ZIP PHOSE UCENSE� <br /> � PLUMBINGCONTR�CI'OR MN�A��RE55 CITV ZIP PHONE ULENSE� <br /> gy ClASSOFWORN <br /> '�1 ❑ NEW ❑ ADDITION �_ EFATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> '� /���)�/�,���^ �AII�1 GONiACT P[NSON ANO PNONE NO. <br /> CONTHACT PRICE Of WOFN�`�C� � L "' v <br /> OE�LG�PIpE�WON AN�SOU EF 7AOEINVOlVEO <br /> 1Y-1 / <br /> PROPOSEDUSEOFBUIIDIN� I HEREBV CERTIFY TNAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRtCT.ALL <br /> IE��L�ESCRIPTIONOFPROPERTY�SMOWNBELOWUFAT7KNFOUNCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISNPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocn oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTF;ORITV TO VIOIATE OR CANCEI THE PFiOVISIONS OF ANY <br /> OTHER STATE O(i LOCAL LAW REGUL.4TING CONSTRUCTION OR THE <br /> PERrOPA1ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TC PEFFORI.i THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> .,) CONTRACTOHS LAW 18.27 fiCW AND 296200 WAC. <br /> SIGNA7UREOFCONTRACiOfi0RAU7HOPREDAGENT DRTE <br /> � PR0.IECTADDHE55 � ��� 1�� <br /> �1 A rWiSCITY8U51NE5 IG SENO.ANDBl151NE55N�ME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENi FEF. <br /> WATER CLOSET(TOILET) � A/C—NHNDLG UNITS—H.P. i <br /> � BATHTUB FORCED AIR SYSTEMS—B.T. E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B;f.U. M i <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEN SINK 8�ISP VENTILATION FAN ; <br /> OISHWASHER pANGE HOOD <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> � CLOTHES WASHER � WOOD STUVE <br /> URINAL ' METAI FIREP!�CE 8 CHIM�IEY <br /> DRINKING FOUNTAIN FIqEPLACE INSERT <br /> —i— <br /> FLOOR ORAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING � ; <br /> flO4F DRAINS—RAINLEADERS ' � EXHHUST FqN i <br /> SINK(SERVICE—BAR,ETC.) ; ' <br /> i <br /> --�— <br /> _ � <br /> � T <br /> � 1 1 <br /> � SUBTOTAL $ ; SUBTOTAL $ � <br /> '{� PERMIT S � PERMIT $ <br /> d TOT�LFEE 5 TOTALFEE S � ' <br /> f <br /> � FOR OFFICE USE ONLY: <br /> '� FRO4TSETB�CK REARSETflACN SIDEEETBACK PUNLNECNNUMBER FEE RECEIPTNO. <br /> � uSEionF LOTAREA VACnNT51TE FEES VALUATION FEE <br /> � <br /> 4 <br /> BUILOING <br /> 7YPEOFCONIS.ALIOWABLE iYPEOitONSi.�CNAI afururcr xOo�bAtwM4uwR <br /> �°a° PLUMOING <br /> { 6REOFBLDG. NO.OFSTORIES BASEMEN� MECHANICAL <br /> �i � <br /> � OCCUPANCYLO�D FIRESPPNKLERSPEO'0 NEIGHiLIAI'iAT10N ADDITIONALPLANCNECK <br /> O7HEfl � <br /> flEA50N FOR SPRINNLERS � <br /> S7ATE BUILDING SURCHARGE ; <br /> INTFNEBV PLANSAPVROVEDBY CITYUFEVERETT PUBLICWOFIN$ ' <br /> LOCAL SALES —� <br /> TAX COOE IS 3105 TOTAL d r ;� <br /> � <br /> ;�a.,. ��., ..�,.. .. .. .. . . .....,. _ ,... .. .. ... . .. . . ......_ .... . . . _ . . . <br /> r <br />