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APPLICATI4.J FOR CONSTRUCT.�N PERMIT everett <br /> ,,,a E„�ro„�„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OF <br /> everett HEATING SYSTEM: O GAS ❑ELECT�iIC ❑ —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> � DEMOLITION ❑ COMBINATION �Q BUILDING L�MECHANICAL C PLUMBING � 1 SIGN <br /> OWNER MAIL�DDRE55 CITY ilP PMONE <br /> B�� %a�e.��.� 460$ Da�w�.( �ve:P� Lc�.r,� Q13 Z o3 L S�'—L 6 3 3 <br /> TENANT MAILADDRESS CITY 21P VMONE <br /> ARCHITECTORDESIGNER MAI��DDRE55 QTV 21P PlIONE <br /> �� ;��� � ��� oi,,;� w�, #5� .��-�ro �8�or G y.t-3 3�F <br /> GENERALCONTRACTOR MAIL/�DDRE55 CITY 21P PlqNE UCENSEI <br /> k/ow(a n� C'e�� P,o.f�`�S� �✓e,.-A�fF 7�SEi-4(41 �w�+t� � 3�F3L0 <br /> MECMANIC0.CONTpACTOR MAILADDRESS CITY 21P PHONE LICENSE/ <br /> PLUMBINGCONTRACTOR MAILADDRESS GITY 21P PNONE LICENSEI <br /> ClASS OF WORK <br /> ;�NEW f.l ADDITION f 7 ALTERATION ❑ REPAIR CI DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> � O O�L� -�/��r�-/-.� CONT�CT PERSON A/�ND PHONE NO..�,(� ) � `� <br /> CONTR�CTPRICEOF WIXiK i "G1 �IO 5� IK�R SI�'� I!r L.�tl � L�� � <br />� ' DESCRIBE WORN ANO SOU�RE FOOTAGE INVOLVED <br /> L�-r�u <br /> PROPOSEDUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALl <br /> LEOIILOESCRIPTqN OF PROPERTV�SHOWN BEIOW OR ATTACH FWfl COPIES� PROVISIONS OF IAWS AND ORDINANCES GOVERNIN6 iHIS TVPE OF <br /> �or L'� e�ocK S37 oF drS C WORK WILL BE CAMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> Y�d f'd�.fU< OTHER ST TE OR LOCAL LAW REGUUTINO CONSTRIUCTION OR THE <br /> PERFORMANCE OF CONSTAUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TNE WORK FOR WMICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> - CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SKiNATURE OF CONTP�CTOR OR AU RED IIGENT �UTE <br /> '�� � V SEP�Q � 68-qo x /��/ Q <br /> �, PROJECT/�Dq1E5S �" �/��/`/ <br /> /9� / ��N J APPLICANTS CITY BUSIN LICENSE NO.AND BUSMESS NAME <br /> 01 <br /> PLUMlkq MECHANICAL <br /> N0. TYPE OF FlKTURE OR ITEM FEE NO. TYPE OF EQUIPMENT fEE <br /> WATER CLOSET(TOILET) � N�AMNDLG UNIT�H.P. � <br /> BATHTUB ; FOHCED AIR S`!STEMS--B.T.U. M E.A. � � � <br /> LAVATORV(WASH BASIN)� � UNIT HEATERS—B.T.U. M ; � <br /> SHOWER ' CLOTHES DRVERS � <br /> KITCHEk SINK 6 DISP � 1 VENTIUTION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> --�-- <br /> UUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 C NEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> fLOOR DRAIN ' HEAT PUMP � <br /> BACKFLOW PR NTERS � GAS PIPING ' ; <br /> ROOF DRAIN fiA1NLEADERS � EXHAUS AN � <br /> SINK(SE CE—BAR.ETC.) ; ' <br /> � � <br /> � � <br /> � <br /> � � <br /> � / � <br /> . SUB TOTAL S ; � SUB TOTAL S ' <br /> PERMIT $ PERMIT S � <br />�y� ; � TOTAL FEE S ' TOTAI FEE E ' <br /> . FOR OFFlCE USE ONLY: �a s'Y. P.? -� <br /> FRONTSETB�CK REARSE�B�CK SIDESETHACK '�� PLANCH LKNUMBER FEE RECEIPTNO. <br /> 'G� ?,o' ' .� n� 9/ � 7 D Sa / �'Y�. 3� 3�_ <br /> i USE20NE LOT M VACANTSITE FEES VALUATION FEE <br /> � WV BUILDINC� ��p G,2O 3 �/70 � .� <br /> TYPEOFCONTS.ALLOWABLE 7VPEOF ONSn7.�LNAL LCtuonMtr xoawlFUMcuxrtS i <br /> ' I ��I�, � I 1� �L PLUMBING � <br /> SIZE OF BIDG. NOAF STORIES e�.SEJ.�ENt MECHANICAL � <br /> ,ZS �,i 5 sQ.r� 3 �r S , <br /> OCCUPA—NCIY LOAD FIRE SPRNKLERS REO'0 HEIGNT L�J�j�ITA�TI� ADDITIONAL PLAN CHECK � O 9 � � <br /> . I '2 Y'L,'S � / OTHER ' _ <br />� � ' - REASONFORSPRINKlEHS 1 <br /> py�� '. -�' Ua �' STATE BUILDING SURCHARGE Q i� <br /> i�+�'� MTAKE B1' PLANS R VED BY CITY OF EYEREIT PUBLIC WORKS � <br /> � � LOCAL S11LES � <br /> TAX CODE IS 310r TOTAL � C�QO �� / <br />