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APPLICATIt�N FOR CONSTRUCI�ON PERMIT <br /> Ihe Eve.yraen everett <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ❑ DEMOLITION fJ COMBINATION ! BUILDIH3 I I �AECHANICAL f 1 PLUMBING Cl SIGN <br /> OWNER J wy:�p MAILADORESS CIiV ZIP PHORE <br /> p �,�.�� �ni,lC-si_ �3 �ny� .r-�R��{`�Q , 1?"r�.�c-���r- InZI�nUI =l S `�- 3493 <br /> TENANT MFILADDRE55 CITV ZIP PIIONE <br /> , �1C�GGL��Cht_�sti�'i1.�.4 -QAQ,t�lJl�' BI-dG .SUiTC IO2-III SE (-GY� N.ALc_Wy £z�-n- �A.98,�8-�Y7-71�i <br /> AflCHITELTOR0E51GNEfl MAILADOPESS C17Y 21P PHONE <br /> �; � .� ..� -k- ?s=I�i���fFt7r�'LG'�ECCr-�Iaf.=�rJ=�t—__�'$6�� `�-- `�17w <br /> G�lERRLGC9iRAGTC9 MAILAD�FESS GITY 2tP PHONE UCENSEY <br /> �ui -r-wr ('����,a�nlc, ti,� SS� 5r�i , r.,�A. -�/$/os 5,z��`�;o (�,��roslBaKA. <br /> M HMIICA�GONTRAGTOR MAILAOOFESS CITY 2u^ PNONE JLENSE� <br /> NQ.�t <br /> PLUMBINGGONiRFGiO(i MRILPpDFE55 CiTy ZIP PIIONf. �ICENSE� <br /> CUSS OF WORN <br /> I��1 NEW IJ ADDITION �ALTERATION I I REPAIR I I D[k10LITIOIJ I I WOODSTOVE/FRPLINSER7 I.I BUILDINGRELOCATION <br /> TENANTIMPROVEMENTOIIINTERIORREMODELONLY �y/ �D� S(,�Ow CONiACTPER501lI.NJPHONENO M- <br /> CONTqqCTPRICEOFWOflN: '� — _ �,C'/F .13o/.F�pr sa�l(X) <br /> OESLRI9E WOFK AND SOUARE FOOTAGE INVOLVED <br /> �ILDI�������� <br /> PROPOSEOUSE I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> - C- APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEMIDESCRIPTIUNOFPflOPERTY�SHOWNBE�OWORATTRCHFOUP.COPIES) PROVISIONSOFLAWShNDORDINANCESGOVERNINGTHISTYPEOF <br /> 0 �/� WORK WILL BE COMPLET�ED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT,�p__ etocK �� o= r LAT�OFZnfTlil�/�-7 NOL THE (3RANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> HUTh10RITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE GR LOCAL LAW flEGULATING CONSTRUCTION OR THE <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPEflTY TO PERFOAM THE WOPK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE CTATE <br /> C9NTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGN�tUFEOFCONIqACTOROR�Ut110Rt2E0AGENT DAiE <br /> PROJECTADDPE55 � �/ ^ �/ � <br /> ��- 1n�•erCr /� � ���iSCRYBU51NE55LICEN5EN0RNp0U51NE5SNAME <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C-NHNOLG UNITS-H.P. <br /> BATHTUB FORCED�IR SYSTEMS-B.T.U. M E.A. � <br /> LAVATORY(WASHBASIN) UNITHEATERS-B.T.U. M <br /> j SFIOWER CLOTH[S DRYERS —i— <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD i <br /> LAUNDRYTRAY ; WATER HEATER <br /> CLOTHES WASHER � WOOD STC�VE <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP —T <br /> BACKFLOW PREVENTERS GAS PIPING <br /> RGOF DRAINS-RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE-BAR,E-TCJ ; � <br /> � <br /> � <br /> — —f— <br /> � � <br /> SUBTOTAL $ SUBTOTAL 5 <br /> PERMIT S PERMIT $ i <br /> TOTALFEE $ ' TOTALFEE 5 � <br /> FPONTSETOALH REARSETOACK SIDESEIDRGK PLl�NCHECH UAfBE❑ FEE � �ECEIPTNO. <br /> , s n�c�- C � a <br /> usezoN�i �orn�en VACANTSITE FEES VALUATION FEE <br /> l� '�I I I YES ' i NO � � <br /> aui�oinc <br /> iVPEOFCONSLpILOWABIE IYPEOF�LON[LAG1UAl aturertr xooronrtt�v.cxns y����� � � i <br /> v - r�. �,M-` <br /> i PIUMBING ' <br /> SREOFBIDG. NO.OFSTORIES DASEMENi MECHANICAL <br /> �� S'}� I I VES ��NO <br /> : OCCUPANCY LOFD FlfiE SPflNNLERS P 'D HEtGHT UMItAt10N / OTHER i <br /> � CI YES I , NO �x�'� 1 �9 STATEOUILUINGSURCHPfiGE �� <br /> REASON FOR SPRINNLERS Y <br /> T <br /> STATEENERGYSUflCHARGE � <br /> ; '' '''""S"PP'�Q°E°°'' CITY OF EVERETT PU�LIG WORNS � <br /> ! �� /;(_ LOCAL SALES <br /> aaJ� TAX CODE IS 3105 TOTAL ��o ;� <br /> � <br /> LI 9 ��� .- <br />