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!, 1 .,., <br /> i'' �, <br /> � APPLICATI`A FOR CONSTRUC7�.ON PERMIT <br /> �' 'ir�e,���„ <br /> everett <br /> CITV OF <br /> everett <br /> BUILDING DEPARTMENT � <br /> 259•8810 TO BE COMPLETED IN INK—PLE�A E PRINT <br /> I I DEMOLITION I I COMBINATION I I BUILDING '�.YMECHANICAL I I PLUMBING I 1 SIGN <br /> ownen Mennooness cnv zm PIIONE <br /> G��n�/J �'Y�1Q1t�.v�'1d C�.ln_ 2801 (�v�c�.v�a_J' `�G��enn �' q�203 3�-4,`l • 2y� <br /> TEN�NT MRII�UDiiE55 CITY 21P PNONE <br /> 11RCHIfECTORDE5IGNER MMLADDRESS GfY 21P PHONE <br /> OENEfUI CONTR�CTOA MAIL�DDflESS CIiY ZIP PNONE LICENSE� <br /> M��N���.K IIq�1��sst24 R� NEc�I�S.;n.ltlamclq`b0.3Hr�821 •H5�4E�� ) <br /> suN�owr146�`� <br /> PLUMBINOGONTR�CTOP M�1iL�DDRE55 CI1Y ZIP PHONE IICENS I <br /> CUSS OF WONN <br /> ' I_-I NEW LI ADDITIGN �ALTERATION Il REPAIR I I DEMOLITION I I WOODSTOVE/FRPLINSERT LI BUILDINORELOCATION <br /> ' TEN�NTIMPROVEMENTORMfERIOfiREMODELOHIY/'y� CONGCtPER50NANOP110NEN0. <br /> GONIf1�C7 PRICEOF WOqli: ���� •W <br /> � �O�ES�C.f,1�11.1�E W{O�11R�A/N�D 810,U�.O,E,f�O,O�1MMiE INVOLVEO <br /> � G'U'F9�'�PIR. IT""N �^�'�' <br /> �, �"I EOUSEOFBU xaY1 ^ 1 . I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � �I �q� •�U1YYIl�Vl.�/ APPLICATION ANO NNOW THE SAME TO BE TRUE AND CORflECT.ALL <br /> LEWLDESCRIP110NOFPP rv�sr� BELOWORA CH(OUnCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINOTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot etocK oF NOT. THE ORANTINQ OF A PERRIIT DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW HEGULATING CONSTHUCTION OR THE <br /> — PERFORMANCE OF CONSTHUCTION.THAT I AM AUTF1pRIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK POR WHICH <br /> � APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 298200 WAC. <br /> SIANIINREOFCON1f14C70�O11�UTHIXIIZED�OENT DATE <br /> ' y I,�.�� 0�.o3"Iz <br /> I ' PROJECT/iWRE89 ^ S1.V 1 �W K Y! �C • � <br /> 5�� � ��� APPLICANiSCITYBUSINESSLICENSENO.ANOBUSINES5NMIE <br /> �{ PLUMBINO MECHANICAL <br /> j ; NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT ' FEE <br /> ; � WATER CLOSET(TOILET) � NC—lVHNDLG UNITS—H.P. � <br /> �� �; BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> �' ' LAVATOHY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> �' ! SHOWER � CLOTHESDRYERS � � <br /> �' KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> I� � OISHWASHER � pANGEHOOD i <br /> �i � LAUNDRY TRAY � WATER HEATER � <br /> �� CLOTHES WASHER � WOOD STOVE � <br /> I! URINAL � METAL FIREPLACE 8 CHIMNEY � <br /> DRINKINO FOUNTAIN i FIREPLACE INSERT ' <br /> i — ' <br /> j FLOOR DRAIN ; HEAT PUMP �— <br /> � BACKFLOW PREVENTERS ; GAS PIPING � <br /> �� ROOF DRAINS—RAINLEADEFS � EXHAUST FAN � <br /> �I SINK(SERVICE—BAR,ETC.) ; ' <br /> '� �— � <br /> � i <br /> � — i <br /> — � — � <br /> � � <br /> j � ' <br /> i SUBTOTAL 3 ; SUBTOTAL S <br /> � PERMIT $ �— PERAl1T S � � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FRONTSE7B�CK REARSEtOACK SIDESETBACN PLnNC11ECKNUMBEB FEE NECEIPTNO. <br /> USEZONE tor�ne� V�C�NTSIfE FEES VALUATION FEE <br /> I I YES I I NO BUILDING . � <br /> TYPfOiLONSI.�IIOW�BIE lYPEOfCONSI.ACIUAL M���'Kr pod�xtwwnuxn5 ' <br /> G�qlf � <br /> PLUMBIN(3 i <br /> —�— <br /> SIZE OF BL00 NO.OF S10f11E5 9�SEMENI MFCIIANICAL � <br /> I I YES I I NO i <br /> OCGUP�NCYLOAO FIf1ESPfINNLE(IS�E00 IIEIGII7LIMIIAiION OIIIFfi � <br /> I_l YES I I NO STAIE BUILOING SURCHARGE � <br /> REASONfORSPflINNLEfl9 • <br /> STATEENERGVSUFlCHARGE � <br /> �pp�ICATIONACC.BV PLANSAPPROVEDBY CITYOFEVERETT PUBLICWORHS � <br /> �nca�sn�es <br /> TAX COOEIS 3105 TOTAL � <br />