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c;! , <br />APPLICATI��'w�l FOR CONSTRUCTI�N P,ERMIT <br />everett <br />nb ewro� � <br />aTv oF <br />everett <br />' BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION C� BUILDING ❑ MECHANICAL ;� PLUMBING ❑ SIGN <br />ONNER MAIIMDRE55 \ CITV ` ` ZIP PlqNE <br />VP W� �Oo�ho�, c�SOYI � S�S \�I��CY�C. �pM'1 L. � S S " � � �S <br />¢�µ{ �- MARADDRE55 CITY ZIP PHONE <br />I I1qCNIlECTORDE5IGNER MARADOPESS CITY 21P PNONE <br />OENEMLCONTMCiOR 1.UILADDNESS CITY 21P PIIONE LICENSEI <br />MECIUNIGIL CONTRACTOR AUIL ADDRESS CITY 21P PHONE LICENSE / <br />PLWBMqCON11U1CTOR MAp.ADDRE55 CIN 21P PHONE LICENSEI <br />'SaTc.�n,-. �\�,w.�c, .., a S G I �} - IZL n�' cyJ . C—�w, � �'l � w�z.'C'o� 'k' \\ao`� <br />CU59 OF NORK <br />O NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOIITION ❑ WOODSTOVFJFRPLINSEHT ❑ BUILDINORELOCATION <br />lEW W T MPROVEMENT Ofl INiERIOf REMOOEL ONIY <br />� <br />CONTPIICT PI110E OF V/OiIX: �Qy <br />OEBCRIBE WORK AND SOUARE FOOT�OE INVOLVED <br />PIqPO5E0 USE q" BUILDINO <br />LfML DESCRIPTpN OF PNOPERTY (SIIOVM BELOW ( <br />lAT BIOGK OF _ <br />I' <br />i.�. , <br />( <br />. NIOJECTAOd1E5S � <br />a s� r ,�,e..�,. �� <br />.. PLUMBINO <br />��� NO. TYPE OF FlICTURE OR R <br />��"� N'ATERCL0.5ET(TOILEn <br />' ����+' BATHTUB <br />!+ • � LAVATORY (WASH BASIN) <br />� �;:'�- SHOWER � <br />; r KITCHEN SINK 8 DISP <br />..i'"� DISHWASHER <br />. �7'�' UUNDRYTRAY ' � <br />�; �'� CLOTHES WASHER <br />,;�'r URINAL <br />� f i - DRINKIN6 FOUNTAM � <br />. ��", FLOOR DRAIN <br />��^' BACKFLOW PREVENTERS <br />ROOF DRAINS-RAINLEADERS <br />I � SINK (SERVICE-BAR, ETCJ <br />.� <br />FIIONT BETBACK <br />U8EZONE <br />1VPF Oi COMSL I1LOW�BLF <br />� M2E OF F DO. <br />OCCUPANCYIOAD <br />' REASONFORSPRINKLERS <br />� APPLICATpN ACC. BY <br />COPIES) <br />PHONENO. <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICAT�ON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING iHIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOHIZED BY THE <br />OWNER OF'fHIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS U1W 1827 RCW AND 298200 WAC. <br />i SqNA flIRE OF CONTRI1CT011 OR �UTMORIZEO �OENT D�TE <br />FEE NO. TYPE OF EOUIPMENI <br />� AIC—AlHNDLO UNITS—H.P. <br />; FORCED AIR SYSTEMS—B.T.U. <br />� UNIT HEATERS—B.T.U. M <br />� CLOTHES DRYERS <br />; VENTIUTION FAN <br />� RANaEHOOD <br />� WATER HEATER <br />� WOOD STOVE <br />� METAL FIREPL7ICE 8 CHIMNEY <br />� i � FIREPLACE INSERT�— <br />� HEAT PUMP <br />; GAS PIPIN6 <br />� EXHAUST FAN <br />SUB TOTAL S � <br />PERMIT S —r <br />TOTAL FEE S ' <br />REAR SEiBACK SIDE SETBRGK <br />LOTANEA VACANTSITE <br />❑ YES ❑ NO <br />TVPEOiCOxSt.�CfuAL aawar �roaownur�ci <br />anaw <br />NO.Of STOFiIES <br />FIRE SPRNKlEPS REO'D <br />❑ YES O NO <br />BASEMENT <br />❑ YES ❑ NO <br />HEIOHT tIMIT�TION <br />PlANS�PPROVL'DBY CITY OF EVEflE7T <br />LOCAL SALES <br />TAX CODE IS 31D5 <br />PIANCHECNNUMBER <br />BU�LDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILOING SURCHARGE <br />STAiEENER6VSURCHARGE <br />PUBLIC WOPKS <br />TOIAL <br />SUBTOTAL S f ' <br />PERMIT S J � <br />TOTAL FEE S o ' <br />FEE RECEIPTNO. <br />VALUATION FEE <br />i <br />� <br />i <br />