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f <br /> pPPLICATI�..�l FOR CONSTRUC1.dN PERMIT everett <br /> tha E�nrpreen � <br /> CIiY OF <br /> ��� everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEA E PRINT <br /> D x 259•8810 i I BUILDING 7 ECHANICAL f 1 PLUMBING ❑ SIGN <br /> ; y t~i� f ] DEMOLITION fl COMBINATION cTY Z�P P110NE /� ('7� <br /> ty OYMER M�ILADOPESS ^ �� (� 1 �� Cu� . .� �nJl. 01�20� ,_J��'-14�� <br /> N�'� /� • �vll„ �nm P� C l.��JU(s�S <br /> KC1 �17�''1 1�Q,L,'71,1,1f)� 7 1 L-1 V�s' � w ��` cin zir PN�N E <br /> F3�.0 TENANT M�ILRDOFlE55 <br /> ��� CITY 21P PNONE <br /> y� � �RGIItECTOR0E510NER MRILADORESS . <br /> x Z�P PIIONE LILENSE� <br /> O� � CITY <br /> GENEMLCONiRACTOfl MA���DO�E55 <br /> PHONE LICENc 1 <br /> ���5' 1 ^ 1 ('7� {� (,� ��TM. 141amd G�0.3H 82l •N5y suN�owr�46.7� <br /> M[LII�NIC/�LCONIRAC70fi Mn���oo�Ess 2 Ry �� � <br /> �� n ��� {J.J K { I-1 I �J • I 1 PIIONE IICENS � <br /> �y� PLUMOIN6COIIiHPCTOR M�ILAODNESS <br /> QTV ZiP <br /> HH anssoFwo�K <br /> ��y C 1 NEW U ADDITION Ix ALTERATION l 1 REPAIR I I OEMOUTION I I WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCAI"10 <br /> GONTACTPERSONRNOPNONENO. <br /> (j � tEll�NTIMFpOVEMENTONINTERqRNEMODEL(�Ml� �/'� <br /> W <br /> ��, CONiPACiPRICEOFWOf!K: ��0�� <br /> yO� DESC�N.�PEWOItR�^NO50UAREf00U0E1NVOlVEO <br /> � � ���`� I`�"�� '- I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF DUI wc �� APPLICATION AND KNON!THE SAME TO BE TRUE AND CORRECT.ALL <br /> �I PROVISIONS OF LAWS AND ORDINANCES GOVEHNING THIS TYPE OF <br /> lEG4l0E5GRIP7MJNOFPR �v1s� OELOWOAA CNFW�COPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> oiaK NOT. THE GRANTING OF A PERMiT OOES NOT PRESUME TO GIVF <br /> ior °F AUTNORITY TU VIOLA7E OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTFiUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM TIIE WOHK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SIGNATl1FlEOFCON111AC10RO0�Ut110RIZEDAGENT OATE <br /> �,,i,G� �Z-0312+ <br /> X 5ulph�oK. 4nC . `�� "��,�l,o0�n <br /> PR0.IECTA�ORE55 `� /�/� /� h�� APPUCRNISCITYBUS����SSUCENSENO.ANOBUSNFSSNAME <br /> � Wll \.lA`' <br /> '�1 MECHANICAL FEE <br /> pLUMBIN6 FEE NO. TVPEOFEOUIPMENT <br /> '_f NO. TVPE OF FIXTUHE OR ITEM q�C-/�HNDLG UNITS-H.P. <br /> WATER CLOSET(TOILET) FORCED AIR SVS7EM5-B.T.U. M E.A. <br /> f�' BATHTUB �� � UNII�HEATERS-B.T.U. M <br /> LAVATORY�WASH BASIN) � CLOTHES DRVERS <br /> 1 ' � __ SHOWEP � VFNTILATION FAN � <br /> _ i i <br /> KITCHEN SINK 8 DISP RANGE HOOD � <br /> f�1 DISHWASHER � __ yyATER HEATER , <br /> i � <br /> LAUNDRY TPAY � y�ppD STOVE <br /> 1 ' _ i <br /> CLOTHES WASHER METAL FIREPLACE 8 CHIMNEY � <br /> � URINAL � FIREPLACE INSERT � <br /> � � <br /> �1 DRINKING FOUNTAIN � HEAT PUMP - <br /> � FLOOR ORAIN i GAS PIPING � <br /> e BACKFIOWPREVENTERS � " E%HAUST'rA�_ �,`- <br /> � - - <br /> ROOF DRAINS-RAINLEADER � <br /> - �---- �- <br /> '_1 SINK(SERVICE-BAR,ETC.) � — <br /> �— <br /> : <br /> ' 1 i <br /> � <br /> � <br /> ---T— <br /> �1 sus Torn� s � 'W <br /> � <br /> � SUBTOiAL $ ,�__ pERA71T S I <br /> ' PERMIT $ ' TOTALFEE S 1 v <br /> � TOTALFEE S � <br /> FEE RECEIPTNO. <br /> ��- S�OESETORCN PL�NCIIECNNUMBGR <br /> P�ONTSE7BRCN REPBSEIOPCN . <br /> VALUATION FEE <br /> yq�RNT 517E FEES � <br /> USE2011E LO7APEA �__ <br /> l 1 YES LI NO BUILOING � <br /> IX{U�WC� IbdNNIIiNGUN115 � <br /> ��� <br /> ttffOiCONSt.AIIOWIBIE 7Y1'EOiLONSi.AGIUAL �aa. p�UMBING <br /> NO.OF STORIES BASEMENT MECNANICAL � <br /> 9ZEOFBLDO. I I YES f� NO � <br /> OIHER i <br /> FlRESP(iNNlEFl5AE00 XEIGNTLIMITATION i <br /> OCCUPANCYLO�D � <br /> fJ YES �-� NO SiA1E0UIlritiGSUR� � <br /> i <br /> FlEnSONFOnSPaiNKlEnS ' STA?cENERGYSURCHAFGE � <br /> �---� <br /> pPPUCRiION�CC.BY PlAN5�P7R0VED0Y CITY OF EVERETT PUBLIC WORNS i <br /> LOCAL SALES � TOTAL <br /> TA)(COUE IS 310.� <br />