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i <br /> , ' APPLICATiO.I FOR CONSTRUC7 JN P'ERMIT everett <br /> InoEvarpieen TO BE CONIPLETED IN INK—PLEASE PRINT � <br /> CItV OF r <br /> x n �I everett HEATING SYSTEM:�GAS �ELECTRIC O <br /> C�J <br /> A � BUILDING DEPARTMENT , <br /> 259•BB10 <br /> �yryC+y � DEMOLiTION i�C COMBINATION �BUILDING ❑MECHANICAL ❑PLUMBING � _O �IGN <br /> H c � OKNRun�,�K ,���RESS CITV • ZiP PHONE �� <br /> z Y E'. �loZo n'�i�� S�U� .�;r��,��ti�f� �Z�L .s3�/-a��iY <br /> � �Q TENANT M�ILApDFE55 CITV ZiP PNO E <br /> M H '{1 <br /> f] AaCNIiECTOp0E51GNER • 1ARILAODiiE56 GITY ZIP PNONE <br /> VJ H <br /> � o � Dl� QrrhE�nina Y�'�rfls�n� Lc/f}� ���-17Z�/ <br /> O H � GEN�U��� ���R_SS Cltt � ZIP PNONE 4CEN5 � <br /> � [jy5 7,�C1/n �id`�-7.r�1 <br /> �� � MECHANIC0.CONTRACTOR IM�lA0DRE55 CIiY 21P PMONE LICENSE� <br /> 9 H t�] <br /> FIUMBINGCONTP�GTON MnIU�DFE55 pTY LP PMONE 4CENSE• <br /> r� z <br /> HH <br /> qy G SOFWORK <br /> n ty y '. NEW C ADDITION ❑ ALTERATION ❑ R[PAIR ❑ DEMOLITION � WOODSTOVEIFRPL INSERT G BUILDING RELOCATION <br /> �5 � CONTACT PERSON ANO PNONE N0. <br /> i•i q / <br /> z y � CONTRACT PRiLE OF WOPN G C � "� C 'f' ���/ �S 3�'6Ip�j <br /> H O U1 �ESGRIBEWORKANOSOUAREFOOT�GEINVqLVED � � — [/�/�� <br /> ... o ' � ,•, ;y 7 �. <br /> vaoroseuusEOFeuaoi� • � � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> S � I C'C n APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEWLDE RIPTIONOFPPOPcFTY(SHO nee�owon rucHFouncorie5l ., PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> a �-�z WORK WILL BE COMPLETED WITH WHETHEH SPECIFIED HEREIN OF <br /> �or etacK or NOT. THE GRANTING OF A PERh11T DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ' � � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEHFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> , � � OWNEFi OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � APPLIGATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 29b.200\VAC. <br /> $iGf�A7UAE0FCONTMCTOROFAUTHORIZEO�GENT ORTE <br /> �ilDa- � `�•� /������ <br /> � �'Ar�''i✓K'[J ?f� �� � �'rt�� <br /> �weer�ooaess — <br /> '�t APP ICANTSCIttBU51NE5SUCEN5EN0.µ08U5iNE5SNAME _ <br /> PLUMBING MECHANICAL <br /> 1�I N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE � <br /> WATER CLOSET(TOILEn /O � A/C—A/4NDLG UNITS—H.P. <br /> ' ' 7. BATHTUB /� . FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN�� �� � UNIT HEATERS—B.LU. M <br /> 1�' / SHOWER ^ / CLOTHES DFYERS <br /> KITCHEN SINK 8 DISP �"'; VENTILATION FAN <br /> ' 1 DISHWASHEH � / RANGE HOOD � <br /> 1f '�LAUNDRY TFAY WATER HEATER � <br /> � CLOTHES WASHER '— WOOD STOVE � <br /> �' URINAL ' METAL FIFEPLACE 8 CHIMNEY ..-'. � " <br /> DRINKIN6 FOUNTAIN i FIflEPLACE INSERT � <br /> �' �� HEAT PUMP � <br /> fLOOR DRAIN ' <br /> � BACKFLOW PREVENTERS GAS PIPING _ <br /> '� ROOF DRAINS—RAINI.EADERS E�HAUST FAN - <br /> SINK(SERVICE—BAR,ETC.) SI � � � _ <br /> � <br /> ' —_ _ <br /> �1 ; • � <br /> i � <br /> ' SUB TJTAL S � /Z � • SUB TOTAL 5 _ _ <br /> � PERMIT S PERM1tIT 5 <br /> �� TOTALPEE S ' TOTAIFEE . S ' <br /> FOR OFFICE USE ONLY: <br /> FPONTSETBACN PEAqSETBAGK SIDESETOACN PUNCIIECKNUMBER FEE RECEiPTNO.,- �� <br /> � C; ' � _i '�/.2 ?O " 7/G _ '� <br /> USE/ZONE7 � LOT�RE�Aj�,] VACANTSITE FEES VALUATION FEE <br /> e���(/ . �(/� 9UILDING J 13 �. / '7 'c' j <br /> iYPEOfCONIS.AIIOWABIE 1YPE0 CONS?.�LNAI OCWo�6x xoWCMunGwrtt <br /> _N a�j, I PLUhIBING yJ <br /> i <br /> 52EOFBtDO NO.OfSTORIES OASEMENi MECMANICAL I�(� ' <br /> Z'•;'�i s F`'�' z fJ� ; <br /> OCGUPANCYLOAD FIRESPRNKLENSflEO'D NEIGNTlIM1TAT10N AD�ITIONALPLANCHECK � <br /> A ��fJ OTHER <br /> NEA`ON FOF$FRiNKLERS <br /> STATEBUILDINGSURCHARGE ;�� J <br /> RIT�NE BY PLANS�PPROYED BY CITY OF EVEflETT PUBUC WORKS ; % � � <br /> J� �d,/„�i L TAX CO�E SL3105 TOTA� <br />