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APPLICATIO J FOR CONSTRiJCT�JN PERMIT ��`�e" <br /> tn�Eve�g�ecn TO BE COMPLE7ED IN INK—PLEASE PRINT � <br /> qTV OF <br /> everett [ HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MAILAODRE55 CITV ZIP PHONE <br /> �C I c"�iZR� i Wet�t�T t 4315 t i 3�3��,� �R �"'f7'w�4- �2.o S _ <br /> TENPNT MAILR�[1FE55 CITY ZIP PMONE <br /> nRCHITECTORCESIGtlEfi MAILADORE55 pTY ZIP PNONE <br /> • <br /> GENERALCONTRPCTOR MAILAGDRE55 CITV ZIP PHONE LICENSEY <br /> .�-$t �� <br /> I ��n. Z�p PHONE LICENSE M <br /> MECHANICALCONTRAGTOR MAILADORE55 <br /> PLUMBING CONTFAGTOR MAIL PODRE55 CITY ZIP PNONE LICENSE< <br /> CLASS OF WOFK — <br /> �.�. NEW . . ADDITION � �. LTERATION . �I REPAIR . . DEMOLITION . WOODSTOVE/FRPL INSERT .�: BUILDING RELOCATION <br /> GONTAGT PERSON AND PNONE NO. <br /> CONTRACTPRICEOFWORN LJ✓� ' <br /> OESLFIBE WGRK AIJD 50 APE FOOTAGE INVOLVED <br /> PROPOSEDUSEOFBUIL ING M4S I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANCi CORRECT.ALL <br /> LEGRL DESCRIPTIONOF PROPERN ISt10WN BELOW nR ATTAGN FOUR COPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERNWG THIS TYPE OF <br /> WORK WILL BE COMPLETED WITVi WHETHER SPECIFIED HEREI4 OR <br /> �oT ���K ov NOT. THE GRANTING OP A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AtJY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> UWNER OF THIS FRUPERTY TO PERFORM THE WORK FOR VlHICH <br /> APPLICATION IS M D I PLY WITH THE STATE <br /> CONTRACTORS LAW .27 RC N 296.2 WAC. <br /> SIGNAT E OF LONi FI . AGENT DATE <br /> � ( i� '�... X <br /> �OJ TAD�flE55 � � � <br /> qPPLIGANio CITV BU51 'LI ENS[I . B SIYE55 NRME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. PE E�UIPMENT FEE <br /> WATER CIOSET(TOILET) NC—NHNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIR S`!STEMS—P T.U. M E.A. <br /> LAVATORV(WASH BASW) _ UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN �_ <br /> DISHWASHER RANGE HOOU __ <br /> LAUNDRY TRAY PJATCR HEATER _ <br /> CLOTHES WASHEP. � WOOD STOVE <br /> URINAL ' METAL FIREPLACE&CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE If::;•-HT T_ <br /> FLOOR DHAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING — <br /> ROOF DRAINS—RAINLEACERS EXHAUST FAN <br /> SINK(SERVICE—BAF.ETC.) � <br /> — - � — <br /> � <br /> SUB TOTAL 5 SUB TOTAL $ <br /> PERMIT 5 PERMIT 5 __�_ <br /> TOTAL FEE 5 TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: ReceiPrno. <br /> FRONT SETBACK REAR SET6AGN SIDE SETBACK PLAN CHECK NUMBER FEE <br /> VALUATION FEE <br /> USEZONE LOTANEA VACANTSITE FEES C_ � '� <br /> OUILDING -�C�� <br /> iYPEOfGONiSALLOWFBLF n'PE�NSi.ALtUAL ecuaamcr x�orowuuxewus i <br /> /}`" PLUMBING � <br /> r•c <br /> SREOFBLDG. NO.OFSTORIES BASEMEM1T MECHANICAL <br /> ADDITIONAL PLAN CHECK �_ <br /> OCCUPANCYLCA� fIRESPRNKLER5FE0'❑ MEIGNTLIMITATION � i <br /> GTHER <br /> REASON FOR SPFINKLEFS �� <br /> STATE BLIILDING SURCHARGE _�_��.�� <br /> INTAKE i3Y PIANS APPROVEO BY CITY OF EVERETT PUOLIC WORKS ' <br /> LOCAL SALES <br /> TAX COUE IS 3105 TOTAL <br />