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IF <br />tJ Cyy*1� <br />H <br />9SH9cn <br />H x3 <br />K n <br />Hx <br />oxo <br />?1 H'il <br />1-3to171 <br />O H ZJ <br />y, Y cam•] <br />aH <br />CHy <br />In <br />H <br />C) t7 y <br />2 H3 En <br />1-30CA <br />APPLICATIO.4 FOR CONSTRUCTbJN PERMIT `°" <br />TO BE COMPLETED IN INK —PLEASE PRINT f <br />It* Emr9wa <br />CITY OF <br />everett HEATINGSYSTEM GAS ❑ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />21P <br />CI`HONE <br />TY � <br />TENANT <br />FE <br />MAIL <br />7< <br />ARCHITECT OR DESIGNER MAIL AUUKtea --- <br />CItt 21P PHONE LICENSE A <br />GENERAL CONTRACTOR MAIL ADDRESS <br />oe <br />CLASS OF WORK . £ - -- wnnncTnVF F:RPL INSERT G BUILDING RELOCATION <br />NEW LI ADDITION nALItHAIIUN... <br />....... <br />CONTACT PERSON AND PHONE NO. <br />CONTRACT PRICE OF WORK /�� <br />DSO REFOOTAGEINVOLVED/ <br />�DLE,S.C�RIBEWORKA <br />Y/�oAS F((2yE,TL�t <br />E READ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED USE OF BUILDING <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROP[ Rtt ISIIOWN BELOW OR ATTACH FOUR COPIE51 <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT_ BLMK of <br />AUTHORITY TO VIOLATE ORTHE PROVISIONS OF ANY <br />7= ® <br />OTHER STATE OR LOCAL LAWW REGUt EGUI AT ATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION, TWAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW f�NDGENT DDATE <br />ROR UT O <br />SIGNATURE OF CO TRACTOR OR ALIT OR oAGENT OATS <br />X _ <br />PROJECT ADDRESS <br />APPLICANTS CITY BUSINESS LICENSE NO. AND BUSINESS NAME <br />PLUMBING <br />FEE <br />MECHANICAL <br />N0. TYPE OF EQUIPMENT FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />AIC—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEM BTU M E.A. <br />BATHTUB <br />UNIT HEATERS—B.T.U. <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />' <br />SHOWER <br />I <br />VENTILATION FAN <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />URINAL <br />_ <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />EAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />_ <br />SINK (SERVICE —BAR, ETC-' <br />i <br />SUBTOTAL S <br />SUBTOTAL $ <br />'D <br />PERMIT 5 <br />PERMIT S <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />_ .. n..unuenv uiinPcn FEE REf,CIP1 NO <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />•cw <br />-� - <br />�—�-- <br />BUILDING <br />TYPE DE CONTS. ALLOWABLE <br />TYPE OF CONST ACTUAL <br />OUVPM<Y <br />NcamUmUNU5 <br />— <br />G9WP <br />PLUMBING <br />SIZE OF BLDG. <br />NO.OF STORIES <br />BASEMENT <br />MECHANICAL <br />f <br />PLAN CHECK <br />, <br />' <br />ATIQN <br />OCCUPANCY LDAFIRE SPRINKLERS NKLERS REHEIGHT LIMITATION <br />i <br />OTHER <br />� <br />STATE BUILDING SURCHARGE <br />' <br />' <br />REASON FOR SPRINKLERS <br />INTAKE BY <br />PLANS APPROVED BV <br />CITY OF EVERETT <br />PUBLICWORKS <br />, <br />LOCAL SALES <br />�1 <br />TAX CODE IS 3105 <br />1 TOTAL <br />