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. . :...r' ... .:.. .... .:'.'_"n.�..n :�..�..t u ...:: ' ._ ��:..�......� r._ r. .v:. .::.s ��_ <br /> , . ... . ... . _ <br /> . . . .:w...a.. _...i..�... .� .. . . . � <br /> '`� t <br /> ' APPLICATIOIr` FOR CONSTRUCTI'�%N PERMIT everett f <br /> �E��� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC 0 � � <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> ❑ DEMOLITION ❑ COMBINATION I i BUILDING I 1 MECHANICAL yD PLUMBIN(i ❑ SIGN <br /> py/��p(C+p�/_ �c'NiFCA� MAILADDRE55 CITY ZIP P�NE Ii <br /> ' /�/oR � F) N 9i3 ��7'��s 1'l �uT 98,�� �' :33 �- %on� _ <br /> �N� M�ILADDPE55 GITV 21P PHONE <br /> Ba v Saaes as�s E- G PAn.A �uT -?.s.7- /3 S7 _ <br /> �pCNITECTORDE5IGNER M�IL�DDRE55 CITY ZIP PMONE <br />�_�•� GENER�LLCONTR�CTOR M�ILADORE55 CITV ZIP PHONE LILENSEt <br />�L � <br /> �1� � MELN�NICILLLONTR�CTOH M�RAODRE55 dTV ZIP PIIONE LICENSEI <br /> PLUMBIN�GONTP�CiOR MAILADDRE55 CITY ZIP PMONE LICENSE� <br /> (,`j�A ir/L-'7� <br /> CtASS OF WORK <br /> ❑ NEW 17 ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />. CONTACT PEHSON AND PHONE NO. <br /> CONTNACTPRICEOFWORK O N �/N 7 ' �SOI <br /> DESCRIBE WOfiK AND SOU�XE FOOTA6E INVOLVED '/ ���. pOD �.j <br /> � o �"en.,fe n Nn m A n. � a <br /> PROPOSEDUSEOFBURDINO I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> s APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEMLDESCRIPTIONOFPROPERTVI�OWNBELOWORATT�CHfOUNCOPIES� PROVISIONSOFUWSANDORDINANCESOOVERNINOTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or 7'S' "���e�ocK S�j oF M J T'l�el/ L Ati NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> y IM p��ov e�tt�n�f .n• F/R'sT ��'N r° E vr pERFORMANCE OF ONS RUC ION�THAT�I AM AUTHORI ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTFACTORS LAW 1 B27 RCW AND 296.200 WAC. <br /> SIGNATUNEOF NTR�GTORORAUTHOi112EDA6ENT D�TE <br /> X <br /> PRO.IFf.��ODRESS <br /> APP AN 5 sE�T����M��'� <br /> sisy -fA� r G.�atiy' <br /> PLUMBINO MECHANICAL <br /> Np. TYPE OF FIXTURE OR REM FEE NO. TYPE OF EGUIPMENT FEE <br /> N'4TER CLOSET(TOILET) � N�AIHNDLG UNITS—H.P. � _ <br /> / BATHTUB �/ENT I- �4TS���� ;� FORCEDAIRSYSTEMS—B.T.U. M E.A. ' <br /> LAVATORV(IYASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRVERS ' <br /> KITCHEN SINK d DISP � VENT�LATION FAN � <br /> RANGEHOOD ' <br /> DISHWASHER ' , �.i <br /> LAUNDRY TRAY ; WATER HEATEF ,� <br /> —�— WOOD STOVE � � <br /> CLOTHES WASHER ' <br /> � METAL FIREPLACE 8 CHIMNEY : I <br /> URINAL � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � i <br /> HEAT PUMP ' � <br /> FLOOR DRAIN � � <br /> BAi:KFLOW PREVENTERS ; GAS PIPING � � <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN ' � <br /> , � I <br /> SINK(SERVICE—BAR,ETC.) i <br /> � ' <br /> i ' <br /> � � I� <br /> � � <br /> � � <br /> SUB TOTAL $ SUB TOTAL S ' �' <br /> �du I <br /> PERMIT S iU ��' PEP.MIT S � . <br /> TOTAL FEE $ /J' 'o� TOTAL FEE S ' � <br /> FOR OFFICE USE�NLY: � <br /> FRONT SETBACK REAR SETBACK SIDE SETBIICK PLAN CHECN NUMBER FEE RECEIPT NO. �� � .,� <br /> ( � <br /> USE ZONE LC7 ARE� V�CANT SITE FEES VALUATION FEE � � ' <br /> i ,i <br /> BUILDING � il ' <br /> IYPEOFCONTS.ALLOWABLE TVPEOFCONST.�CTWL occur�xc� xoabMwrrGuxas � � <br /> �A�P PLUMBING �i dU <br /> 11 <br /> 1 ' <br /> SIZEOFBLD(3. NO.oFSTORIES B�SEMENT MECHANICAL � <br /> i f <br /> OCGUPANCYlOAO FIRESPRNKLERSPEO'D NEIGHTLIMITATION ADDITIONALPIANCHECK � ` <br /> i <br /> d <br /> OTHER � <br /> � � <br /> NEASON FOR SVRiNKLERS � I� <br /> STATE BUILDIN6 SURCHARGE � � <br /> � � <br /> INTAKEBV PUNSAPPROVEDBV CITYOFEVERETT PUBLICWORKS i ' � <br /> LOCALSALES � <br /> TAl(CODE IS 3105 TOTAL r; �a � <br />