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.�. <br /> ,��, <br /> APPLICATION FOR CONSTRUCT.JN PERMIT <br /> everett <br /> f�e Ewryreen <br /> � CITV OF <br /> � everett <br /> b�� � 259 881N�G DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> .�,�w '7 DEMOLITION ❑ COMBINATIVN �(BUILDING C_'MECHANICAL �1'PLUMBING , SIGN <br /> ~ ,�,� OWNEF MAILF�DRESS Gltt ZIP PHONE <br /> ����..]]]0 955i5TA�1cE tb94u�- i9i� NEr�uTT AG�E' cZ%�E;T u� , <br /> ��i� TENRNT MRII ADORESS CITY PNONE <br /> �' S�4�E <br /> � <br /> RRCHREGTORDESIGNEfl MqRA0DRE55 COY 21P PHONE <br /> �o� "'G�li�S <br /> H GENERALCONTR�CTOR MAILRDDRE55 CITY ZIP PMONE LIGENSE• <br /> ,�y� �S�G/✓ TE'ci/ C4JSirlrlio�.L '�L'9Ue .Uu iga S5✓�ut� 651-722z L�'siGrc�1GGJ <br /> W' y MELMANiC��CIXiTA�CTOR M�ILADDFE55 CIN Z�P PHONE IIGENSE/ <br /> �H <br /> S H PWMBIYGCONTPACTOH M�ILAODHE55 CITY 21P FNONE IICENSE� <br /> I <br /> � HA.J svnl Pca:Ml3 inIl. <br /> cuss oF wnqrc <br /> ��A �. i NEW �i ADDITION �G ALTERATIOL -.1 REPAIR I-i DEMOUTION ', .� WOODSTOVE/FRPL INSERT ; I BUILDING RELOCATION <br /> � TEWINTIMPROVEMENTORINTERIOqqEMODEIONLY - CONTAGTPERSDNANDPNONENO. <br /> � CONTfl�CTPHIGEOFWORN: <br /> fi 8Q d `-� /��i,cE� ��,acaY - �sz- 7z2z <br /> _ OESCPIBEWORK�NDSOVAREFOOGGEINVOIVED �a � <br /> — - lv��Y. /m{' �• curS crc Ti 276d � �, <br /> PROPOSEDOSEOFBUILOING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS � <br /> � T 2/F/Y �SNQF � O�T� U APPL�CATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL '. <br /> LEG�LDESCRIPTIONOFPROPERtt�SMOWNBELOWORATTACHFWRCOPIESI PROVISIONSOFLAWSANDOFDINANCESGOVERNINGTHISTVPEOF <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 /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEii STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOPRED BY THE i <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH �, <br /> APPLICATION IS MADE AND � COMPIY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SIGNANREOFCONTPACTONORAUTHORIZE��6ENT DATE <br /> PHQIECT�DORE55 }� � "` t��'� ` 't'�I�� <br /> ' 1 � �+' • � d v� APPLCANiSCRVBUS�NE55ll SENO.ANDBUSMESSNAME <br /> /! <br /> PLUMBING MECHANICAL <br /> '�' NO. TYPE OF FIXTUflE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> '�t WATER CLOSET(TOILET) AiC—NHNDLG UNITS—H.P. <br /> BHTHTUB FORCEDAIRSYSTEMS—B.T.U. M E.A. <br /> '_' LAVATORY�WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWEFi CLOTHESDRVERS <br /> ' KITCHE�SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> ' LAUNDRV TRAV � WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> '� URINAL METAL FIREPLACE 8 CHIMNEV <br /> � ORINKING FOUNTAIN FIREPLACE INSERT ; <br /> ' FLOOR DRAIN HEAT PUMP � <br /> � BACKFLOW PREVENTERS GAS PIPING <br /> i <br /> � ROOF DRAINS—RAINLEADERS E%HAUST FAN � i <br /> i�' SINK(SERVICE—BAR,ETC.) i � <br /> _ T <br /> � <br /> �, SUBTOTAL 5 SUBTOTAL $ � <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ TOTAL FEE $ � � <br /> FRU:TSERI�CK RWRSETBACH SIDESETO�CK PUNCN CNNVA�BER FEE RECEIPTHO. � <br /> � � r �+ 3� 02 .3�0��� oZ <br /> usez�"e-� �OT�RE� VAGRNi51TE FEES VALUATION FEE � <br /> � <br /> � G YES �NO BUILDiNG �S� � <br /> 1VPEOFCONS7.AllOWABIE fYPEO(GONSi�C1UAl Occuwq[v xOqOwuuncuxns <br /> V_� ���� °PW0 $— PLUMBING <br /> SIZE�BIOG. NOAFSTORICS BASEMENT MECHANICAL � <br /> 5�5a SF- � f] YES ❑ NO <br /> OGLUPR1CVl0 D FIRESPPNNIEPS1R'EO'0 NEIGNTLIMItATION OTHER <br /> �O L! YES �Y NO r STATE BUILDING SURCHFRGE _� <br /> /\ <br /> RE�SONF SPPINNLERS <br /> STATEENERGVSURCHARGE i <br /> APPLIC�iIONPCL.BV PLANSRPPROVEOBY CITYOFEVERETT PUBLICWORK$ � <br /> ►Y6 W, �� TAl(COD IS 3105 roT�� � <br />