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APPLICATIC.1 FOR CONSTRUCT�a�N PERMIT <br /> everett <br /> the Eveigmon � <br /> CITY OF <br /> � ��, everett <br /> BUILDING DEPARTMENT <br /> A x � 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> >y ti G DEMO!_ITION :1 COMBINATION �: BUILDING MECHANICAL : PLUMBING � SIGN <br /> OWNEF MAILADDFE55 CItV ZIP � PHONE l <br /> K�� „s� �T� �' � �y 1� ����c���' [,e�l�D, ���d� �i�'�d� <br /> F] �.0 TENANT MAILAD E55 GITY Z!P PNONE II <br /> '{I H "i1 -- , <br /> y �1"--�� APCHITEGTORDESIGNEP MAILRD�FESS QTV ZIP PMONE <br /> � xL�[S�] <br /> y� GENERALCONTRACTOR MAILADORE55 CiTY ZiP PMONE LiCENSEn li <br /> OH ! <br /> � �� MEGHANICl.LCONTRFGtOR MAILAD�qE55 LITV ZIP PHONE IICENSE� I. <br /> Mr C] .�� <br /> xy� PLUMBINGCONTPACTOR MAILRDDPESS Gltt ZIP PMONE LIGENSE� �� <br /> 0 <br /> �� <br /> ~y CUSS OF WORH <br /> y F"� ❑ NEW ❑ ADDITION �. : ALTERATION f_] REPAIR f-.i DEMOUTION iJ WOODSTOVE/FRPL INSERT '�..! BUILDING RELOCA710N i <br /> (��J V! <br /> q TENANTIMPPOVEMENTONINT[RIORqEMO�ELONLY CONTACTPERSONANOPHONENO. <br /> [�1 r <br /> t�l CONTPACTPPICEOFWOFN: � <br /> yO� �ES1�RNANOSOU�R7REFWTAGEINVOLVEq/t� .{/--�{� i <br /> Q'f7 11 �f', �� ��'���/�l A I!/�i <br /> J1G�� I <br /> PROPOSEDUSEOFBWLDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS , <br /> APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT.ALL I <br /> IEGAlDESCRIPTIONOFPROPEFTY�SNOWN BELOW ORATfRLH FOURCOPIE51 PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR I <br /> �or e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE � <br /> OWNER OF THIS PFOPERTY TO PERFORM THE WORK FOR WHICH � <br /> , APPLICATION IS MADE AND I COMPLY WITH THE STATE i <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 YJAC. i <br /> SIGNATIIPEOFCONTRACTORORAl1THORREDRGENT DNTE <br /> X ,����, ,��. ' <br /> PROJECTA�DPE55 ' I <br /> � � J , pPPIICANTSGITYBU5INESSLICEN5EN0. �BUSINESSNAME <br /> '`1 PLUMBING MECHANICAL � <br /> '�' NO. TYPE OF FIXTURE Ofl ITEM FEE NO. TVPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILE'� A/CrNHNDLG UNITS—H.P. <br /> '�' � BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> 1_f LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER CLOTHES DFiYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> 1 DISHWASHER RAi�3E HOOD <br /> ' LAUNDRYTflAY _ WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE �L%� <br /> URINAL METAL FIREPV+CE 8 CHIMNEY � <br /> �' , <br /> ORINKING FOUNTAIN FIREPL.ACEINSERT <br /> � FLOOR DRAIN � HEAT PUMP �— <br /> �' BACKFLOVJ PREVENTERS GAS PIPING �� <br /> �� ROOF C��RAINS—RAINLEADERS _ E%HAUST FAN <br /> SINK(SEFVIC[BAR,ETC.) <br /> e <br /> � � <br /> i � <br /> 1' 1 SUBTOTAL S SUBTOTAL 5 �--- � <br /> �' PERMIT 5 PERMIT S i <br /> �- � TOTALFEE S TOTALFFE 5 " L" � ' <br /> FRONTSET9RGN REARSETBACN SI�ESEI6RGK PLANCHECKNUMBER iEE BECEiPTNO. <br /> usEzorvE LOTRREA vncar+tsitE FEES VALUATION FEE <br /> :_i YES ] NO OUIL�ING <br /> iVPEOFC�NSi.ALLOW<6lE 7YPEOFCONSLACiUAL otavmcr r.00�mv[wb,v:n5 - � <br /> tvouv p�UMBING � <br /> SIZEOFBIOG. NO.OFSTOPIES BASEMENT �fECHANICAL `��!�`� <br /> ❑ YES '..'� NO <br /> OCGUPANCYLOAO FIRESPRNKLERSREOD MEIGNTLIMITATION OTHER i <br /> �_i YES L. NO S7ATE BUILDING SURCHARGE � <br /> RERSON FOF SPRINNlERS <br /> STATEENERGViURCHARGE <br /> APPLICATIONACGBY PUNSPPPROV[OBY CffYOFEVERETT PUBLICWORKS <br /> LOCRL SALES � <br /> TAX CODF IS 3105 T�TA� .:_j�� �C"�' <br />