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APPLICATII..�1 FOR CONSTRUC7 .JN PERMIT s <br /> everett <br /> �E���� e <br /> CITV OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEA E PRINT <br /> 259-8810 <br /> CI DEMOLITION IJ COMBINATION I 1 BUILDING p ECHANICAL I I PLUMblNG ❑ SIGN <br /> Ep M�ILADDRE55 C�TY . ZI PIIONE <br /> �Q-j►�;�_n��m r� 291"1 P['amaV��,�' �l�d �veno�' `�203 353 •51� <br /> IENANT MAILAOORESS CITY 21P ��E <br /> �RCHITECTORDE61GNEN M�IL�ODi1E55 CITY 21P PHONE <br /> OENER�LCONiP�CiOR MAILADUPESS CI1Y ZIP PNONE LICENSE/ <br /> MECII/JlICALCONTRIICTOR M�IIA�DRE55 CIIY, ZIP PIIONE LICENS SUNLOW7�4{�,T� <br /> �um I..o K I Iq 1'� t 24 �� N&. Wv�.l�Clamd 9`b0.3H S2l •N54 ) <br /> PLUAIBINOGONIRACTOR MAIL�ODPE55 CIIY IIP PHONE IICF.N � <br /> CIASS OF YI011K � <br /> I_) NEW ❑ ADDITION �AITERATION I-I REPAifi l I DEMOLITION I 1 WOODSTOVE/FRPIINSERT ❑ BUILDINORELOCATION I <br /> iENANI IMPROVEMENT ON RITERqR PEMWEI.M1lV CONUCT PERSON ANO PIIONE NO. <br /> CUNiR�CiPRICEOFVf011K: �'3I ' OU <br /> pES[CR�jIB�E�WOR�R�11�N,U S�W���N�E,F.�OOT��.O�E�INVOIVED <br /> � �rnoroseouseoceu�irwN µw � I HEREBY CERTIFY THAT I HAVE PEAD AND E%AMINED THIS � <br /> � '5.�,( . OJyyU, APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> �F.pµpEBCRIPTIDNOFP rr�s�� BELOWORAI �CHFOU�COPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINOTHISTYFEOF ��� <br /> WORK WILL BE COMPLETEU WIiH WHETHER SPECIFIED HEPEIN OR <br /> iot e�ocK or NOT. 'fHE GRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY �- <br /> OTHER STATE OR LOCAL LAW REGULATINa CONSTRUCTION OR THE ` <br /> — '— PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2E0 BV THE , <br /> OWNER OF THIS PROPEflTV TO PERFORM TNE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE ; <br /> CONTPACTORS LAW 7827 FiCW AND 296200 WAC. <br /> Si6N�IUNEOFCONtMCTOROR11UT110111iED�0ENT OQE <br /> Iµ,c� o�/o� 3'Iz (((]]] 'M ����y.�� <br /> PPQIECTAOMIEB! �W 1,�/ �V KA`/M �n � �'�I��� 7 � 'C • �/�^�^ • ' ^--'- " ' <br /> L�V` �PPIICANfSGIiYBIlS�NESSLICENSENO./�NDBU51NE9SNMIE <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT � FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> �i BATHTUB ; FORCED AIR SYSTEMS—B.tU. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER <br /> � CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP �_ VENTILA710N FAN i <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNORVTRAY � WATERNEATER � <br /> � <br /> CLOTHES WASHEF � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEV ' <br /> DRINHINO FOUNTAIN i FIREPLACE INSERT � <br /> ----�' <br /> FLOOR DRAIN <br /> � HEATPUMP ' <br /> GAS PIPING � <br /> BACKFLOW PREVENTERS � �— <br /> ROOF DRAINS—RAINLEADERS �— E%HAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) i � <br /> i <br /> � <br /> i <br /> � ---- i <br /> � ' <br /> � — � <br /> � <br /> SUB TOTAL S ; SUB TOiAL S <br /> PERMIT S � PERMIT S I � <br /> TOTALFEE 5 ' TOTALFEE S ' <br /> FRONTSETBACK IIEARSEIB�CK SIDESE78�CK PL�NCIIECKNUMBEO FEE RECEIPTNO. <br /> USEZONE IOI�REA VAC�NTS�IE FEES VALUATION FEE <br /> I I VES �! No euaowc ' <br /> lYPEOFtONSt�ILOW�BLE IYPEOFCOHSI.ACill�l occururcr xodovrt�u�uxns i <br /> rawr p�UMBING � <br /> ----r— <br /> � <br /> SQEOFBLO(i. N�.OFSTOIilES B�SEMEN� MECIIANICAL � <br /> IJ YES I I NO ' <br /> � <br /> OCCUP�NCYIO�D FIOESPRNI(LE115REOD ��E�GIITLIMIiAIION 0��{ER � <br /> i <br /> I_1 YES I I NO STAfE BUILUING SURCH�RGE ' <br /> � <br /> REASONFORSPRINNLERS � � <br /> STME ENEfIGY SUtiCHAfiGE � <br /> i <br /> errucerror+�cc.er PLANSAPPOOVEDBY CITYOFEVERETT PUBUCWORKS ; <br /> LOCAL SRLES � <br /> TAX CODEIS 3105 TOTAL � <br />