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everett <br /> APPLICATIO. FOR CONSTRUCT .�N PERMIT � <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> rho E.�ergreen <br /> CITV OF <br /> everett HEATING SYSTEM� ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> DEMOLITION COMDINATION � BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MRhAODRESS CITV 2�P PNONE � �-, O <br /> � T �`c�u ai-'k- KOSS �.-,vi "Hs � _ /" _�a:'�I it7a. 1�.�.�]1 � <br /> TENANT MAILADORESS GITY 21P PMONE �� E/(�` � I <br /> ��n, Z�p PNONE <br /> qRCNRECTOR0E51GNE� MAILRDDRE55 .-�/s� <br /> �Q- . , . . �. : 7 ' ; <br /> GENERRL TPACTO� MRILAODR CITY Z�P PHONE LILENSEe <br /> �[�!' ' �, yc:� t '1-;-L �ri.e�f�c` 1L1-11 � � � C`�rrRo(i 111 �ff�'�/ ,�5��'�( ��i('�� C��F(µ� <br /> H l7 H LITV 21P P�.v�.c <br /> x�� M CMANIUI CON RGTOR MAII ADDAESS <br /> �i] y <br /> A�.� PW�IBMGCONIR�CTOA MARADORESS <br /> f.ITY 21P PNOt�E LICENSE• <br /> ayv <br /> CL�SS OF WONK <br /> � �� �..�� NEW �.�ADDITION �. �� ALTERATION : REPAIR . DEMOLITION � � WOODSTOVE/FRPL INSERT � . BUILDING RELOCATION <br /> G�Y J"' CONTACiPER50NRND?NONENO <br /> oxo � "` .w io,ro '� � Li�` �1 ��,r� `J �.`l- �Zi( <br /> � yH CONTR�GTFRICEOFWOR � U / <br /> OESCRIBEWORKANDSWAREF FGEINVOLVEO � <br /> � x� , ,� • ( yx�' <br /> �b PROP SEDUSEOFBWLD�NG I HEREBY CERTIFY THAT I HAVE 9EAD AND EXAMINED THIS I <br /> 0 �„� _ �l �1� � � APPLICATION AND KNOW THE SAME TJ BE TRUE AND CORRECL ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVEHNING THIS TYPE OF <br /> H [�i�J(� LEG�LOESLPIPTIONOFPROPERttI5H0 NBELOWORRTTALNFOIIRCOPIES� yyOFK WILL BE GOMPLETED WITH WHE7NER SPEGFIED HEREIN OR 'i <br /> x H 3 1OT eiOC� oF NOT. THE GRANTING OF A PERMIT DOES NO7 PRESUME 70 GIVE I, <br /> AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANV <br /> 9 H C+�7 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> t' H y PERFORMANCE OF COn:iTRUCTION.THAT I AM AUTHOR12E0 BV THE <br /> �y OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> y <br /> O H APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> n d y CONTRACTORS LAW 1827 RCW AND 296200 WAC. n q <br /> ��� SIGNRTUREOFCONiRACTORORRUiNO ED4GENt DA(TE� �/x�//� <br /> H y0 C�ir ��G�d� • ��`t`2 <br /> � u �-n����� 7",�C <br /> PPQIECTPDDRESS �y , ppp��pNTSCITY SMESSUGENSENOA;DBUSiNESSNPMP \ <br /> � n . - C ! l WC�� �L <br /> PLUMBING � MECHANICAL <br /> N0. TYPE OF FIl(TURE OR ITEM FEE N�' a�aHNDLG NFTS—H.p ENT <br /> FEE <br /> � WATER CLOSET(TOILET) ' <br /> �. � BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> �,I LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHESDFYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> ��' "'� DISHWASHER RANGEHOOD <br /> "� ! LAUNORY TRAV WATER HEATER <br /> CLOTHES WASH�R WOOD STOVE <br /> METAL FIREPLACE 8 CHIMNEY <br /> '.r � UfiINAL <br /> 1 I DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> �^'i ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> !II <br /> SUB TOTAL $ SUB TOTAL S ' <br /> PERMIT $ PERMIT S <br /> !I ' TOTALFEE 5 TOTALFEE S <br /> FOR OFFICE USE ONLV: aeceivr r�o <br /> �j FRONT SETDPCK PEAR SETBACK SIDE SETBRCK PUpC%EC2N'�S.aZ � D E�7' �� S� 9� <br /> / / <br /> useia+e LOT�RE� WC�NTSRE FEES VALUATION FEE <br /> 9WLDING $ �p� � - ' �'� <br /> IYPEOfCONiSAIIOWABLE IYPEO^CONS'i./AC1URl actuapr nOqP�mivGuxnS PLUMBING <br /> ' /V -?i � <br /> SREOFBLDG. NO.OFSiORiES BASEMENi MECHANICAL <br /> � uJ ADDITIONALPLANCHECK [ / � '{'O <br /> OCCUPANGY OAD FIf1E SPRNNLERS RE00 NEIGHT LIMITRiON � <br /> /`� Np OTHER �_ <br /> REASON FOR SPqiNKLERS <br /> STATE BUILOING SURCMARGE � '� <br /> INidNE�Y' P�ANSRPPl10VE�UY CITYOFEVEflE?T PUOLICWORK$ T <br /> LOCAL SALES ( <br /> ✓ TAX CODE IS 3105 TOTAL � � gG � <br />