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.. — <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> everett � <br /> rne Eeeryreen � <br /> qtV OF <br /> ��� everett <br /> H BUILDING DEPARTMENT <br /> G .�.� '� 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT 'I <br /> ,�„►3� I:I DEMOLITION U COMBINATION �BUILDING [J MECHANICAL �'PLUMBING ❑ SIGN <br /> ONMER A141LA�01iE55 cnr zm rnorvE � <br /> ��� A55/STAucE Le�q�uF- i9/b N�aiTY AG'f. tZ�cx�T k/,U, <br /> ��w IEN�Nt M�ILAODRE55 ptY PIqNE <br /> ���yy 5�4ME <br /> �7�� ARCHITECTORDES�GNER MAIL�DDRE55 Cltt ZIP PIqNE i <br /> wi� �. <br /> q� �y�vs <br /> GENEMLCCW1fUCT08 MMLM�RE55 CIIY 21P PIIONE LIGENS[� <br /> ��� /�'siiN TE'tN c'a�s�ux.Tiuyr .i��c. /f��.�� .���� Aue'. N,w, iyA�-Ys✓r�c[ Gsz•72tz �'si�rt.1E P7 <br /> MECIUNiCALCONTMCTOIi M�IL��URE55 CITY 2iP P1qNE IICENSE� <br /> �~� PllIM01NOGONiP�Ci011 M�rt�OD0ES5 CIIY ]IP 1'IX)IIG �ICIINSC• <br /> H <br /> M �JSQ ce. inr <br /> �to� cussawonK <br /> �y�� I] NEW ❑ REP IR . DEM ITION l_1 WOODSTOVFJFflPI INSEflT ❑ BUILDING RELOCATION <br /> � TEN�NTIMPIqVEMENTqIMTERqqREMODELONLY CONUCTPENSONMlDPHONENO. _ <br /> �GO <br /> CONTMCT PRICE OF WqIK: � KE� CO S Z- ZZ Z <br /> �� DESCNIBEWJIi1tAN�SOUAPEFO0T1 MVOlVEO �/� ��w ��1 <br /> —_ _' ��/ . <br /> vnorosEouse rcq 1 HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> T ��F�r iTNQC � O�� << APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> lEOAIDESCFIPTqNOFVROPERTY�5110WHBElOWORAilAC11i0URfAP1[5� PROVISIONSOFLAWSANDOROINANCESGOVERNINGTHISNPEOF <br /> . WORK WILL BE COMPLETEO WITH WHETHER SPECIFIED NEREIN OR . <br /> ior e�ocK ov NOL THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY I <br /> OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE I, <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGN�TUREOFCONIpAGt0110R11UTHO11iZEDAGENT W1tE <br /> PnOJEGT�DDRE55 yp��i � �1,.(�f�t�l�� rt'��-dq .. <br /> -T'•�' d �PPLIC�NTSGtt9U51NE55U SENO.ANOBUSMESSN�M! <br /> '�1 C ,. /r�'f� . <br /> 1_' PLUMEINfi MECHANICAL <br /> NO. TYPE OF fl1ITUPE OR tiEM FEE NO. riPE OF EOUIPMENT fEE <br /> WATER CLOSET(TOI�ET) � NC—A/FiNDLG UNI7S—H.P. � <br /> f�1 BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. i <br /> '_' UVAIOHY(WASH BASIN) i UNIT HEATERS—B.T.U. M <br /> SNOWER � CLOTHESDRVERS <br /> KITCHEN SINK 6 DISP i VENTILATION FAN � <br /> ' DISHWASHER � RANGE HOOD i <br /> ' UUNDRY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE . i <br /> URINAL ' METAI FIREPLA E 8 CHIMNEY � <br /> f� � � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> � FLOOR DRAIN � HEAT PUMP � <br /> �' BACKFLOW PREVENTEFS i GAS PIPING ; <br /> '—' HOOF DRAINS—RAINLEADERS � E%HAUST FAN i <br /> SINK(SEqVICE—BAR.ETC.) ; ' <br /> / � <br /> i <br /> i <br /> � <br /> I 1 ' <br /> ' ' SUBTOTAL E ; SUBTOTAL E � <br /> � PERMIT S � PERMIT $ i <br /> �- "" TOTALFEE S TOTALFEE S � <br /> FRONTSEI&1CK REAqSETB�CK SIDESEiB4LK PIANCN CKNUMBER FEE �O RECEIPiNO. <br /> � <br /> ❑SE 20NE LOT AREA vncnqt sirE FEES VALUATION FEE � <br /> fl YES I I NO BWLDING i �� <br /> ivr�acoxsceuow�ei[ iYPEOiLONSt.�t1U0. �M�r ruavmu�x�u+��s � <br /> GRdT � <br /> PIUMBING <br /> SIZEOFBIMl. NO.OFSiOflIES 9ASEMENT MECHANICAL � � <br /> O.YES ❑ NO , � <br /> OCWPANCYLO�D FIRESPPNNLEPSREOU NEIGNTLIMII�TION OTHER � li <br /> ❑ YES ❑ NO STATE UUILDING SURCHARGE � I <br /> REASON FOR SPRMKLEIIS —T— <br /> ' STATEENERGYSURCINRGE i I <br /> APPLtC�TIONACC.BY PLANS�PPROVCDBY CITYOFEVERETT PUBUCWORKS ' <br /> 6� � LOCl1l SALES � <br /> r�� rax caoe is aio5 TOTA� ; <br />