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i <br /> �, APPLICATIOI:FOR CONSTRUCTI�N I�ERMIT everett <br /> �� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ffiJ E�JlLIdJl1 •• <br /> � C] � r�TY OF <br /> �� y eve rett HEATING SYSTEM: � GAS ❑ELECTRIC ❑ <br /> � � H BUILDING DEPARTMENT <br /> � Hx cn 259-8810 <br /> H y � DEMOLITION i�C,COMBINATION �BUILDING ❑MECHANICAL iJ PLUMBING [� _ ��S�GN <br /> H x H ` [ PHONE rA /✓I 1 �Tt1 T7/—�� <br /> � y � OWN M�IIADORE55 �. yUzo n�`k���� J`A(�'.�Ci z_��,// / �� /L4'� ����>�� <br /> � H �3I TENANT rK ��US " ���;�J 21P PHO E <br /> MRIL ADDRE55 <br /> V1 H <br /> � xQ� nRCMrt^ECYTOF0E51GNE,,Ry.� • AUILA00RE5fi J �yiT�Y/ �] (� <br /> � HC D1� Q��1/Fi ArII�I�� �..Ir/ 1(� �� PHONE���� I /�/ <br /> �y GEH �LCONTRPGTOR MAILADOflE55 CITY ZiP PHONE LICENS • <br /> "7�+[ �l'urr�rk �ndus - -T�'(,�m 1���/�"fl <br /> �� C] CITV 21P PI/ONE LILENSE• <br /> !AEG�ANICAICONTRACIOF MARAD�PE55 � <br /> y CITV 2iP �itiNC LICENSE• <br /> � H _...— <br /> H y GLUMBINGCONiR�CTOR MAILADDRESS —_ <br /> � �N��[yyy ti <br /> � SOFWOFR <br /> �" �NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FAPL INSERT u BUILDING FE'ACATION <br /> C6JIIAGLCEA50� ANDPWJryENO. . ' � <br /> zy� �7C/='� � lt'C�r :�%-�= �53�fG'�-�� <br /> H O [n cor+ra.cran�ceoFwoaK � vr ��Q��u <br /> DESCRiBEwOFNANO50UAREF00TAGEINY9�VE�D �� _ ��\. F n.._3�3-y.����� <br /> ' )� i')P!L ) ( k�'J�/ ���cic7r� <br /> PROPOSEDUSEOFew�oi • I HEREBY CERTIFY THAT I HAVE FEAD AND "cXAMINcD THIS <br /> � � n ] APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> S PFOVISIONS OF L\WS AND ORDINANCES GOVERNING THri Tt?E JF <br /> IEGALDE PiPTIONOFPROGERtt�5N0 NBELOWOR TTAGNFOURCOPIES� ., 11 ` y�OHK WILL 6E COMPLETED WITH WHETHER SPECIFIED Y,_�1EIN OR <br /> ji J <br /> �or e�aK oF <br /> 4 V � NOT. THE GRANTING OF A PERMIT DOES NOT PRESIiM_ TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISICNS OF ANY <br /> ' OTHER STATE OR LOCAL LAW REGULATING CJNSTRUCT:ON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I A61 AUTHORIZED BY THE <br /> � � -�� ^ y / ' 1 OWNER OF THIS ?ROPERTY TO PERFORM THE WOFK FOR WHICH <br /> .ry��� / /���'� 'J /`/ W✓� APPUCATION lu A1AOE AND I COMPLV WITH THE STATE <br /> y�=� F— �I CONTRACTORS'I.F.W 1827 RCW�nAND 296200 WAC. <br /> SIGNATURE���T��T�RfR��T�j/-EG�HT �ATE <br /> / <br /> � ��'>. 4 <br /> � <br /> �Sl D �far�Vi�u1 G4�?� ������� �`�—(, <br /> '�1 �OIECTADORE55 �A SCINBUSINESSLI�NSEKO.��BUSINESSNAUE <br /> I�' PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM fEE N0. TYPE OF EOUIPIAENT <br /> FEE <br /> '�1 WATER CLOSET(TOILE'n I f� AJC—NHNDLG UNITS—H.P. _ <br /> � BATHTUB �' FORCEDAIRS`!STEM175—B.T.U. A1 E.A. <br /> I�' � LAVATORY(WASH BASIN). UNIT HEATERS—B.T.U. M <br /> SHOWEfl / � CLOTHESDRYEPS <br /> ' 1 � KITCHEN SINK 8 DISP , VENTILATION FAN <br /> OISHWASHER � RANGE HOOD ' <br /> 'aI 'LAUNDRY TRAY ' <br /> WATERHEATER � <br /> CLOTHES WASHER WOODSTOVE _ <br /> '� AIETAL FIREPLACE 8 CHIMNEY <br /> URINAL ; <br /> � DRINKING FOUNTAIN FIREPLACE INSERT <br /> '�' fLOOR DRAIN HEAT PUM11P � <br /> '�' BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINI.EADERS EXHAUST FAN <br /> 'a' SINK(SERVICE—BAR,ETC.) � S� � ' <br /> 'a i <br /> �' � � <br /> � SUBTOTAL $ � � "• SUBTOTAL 5 <br /> ` - PEfiM1T S � PERMIT 5 <br /> TOTALFEE 5 ' TOTALFEE S <br /> FOR OFFICE USE ONLY: aeceiPrno. <br /> Fe0NT5ET0ACK REMSETBACK .��.' SIOESETBACH PLANCHECNNUAIBEF FEE • <br /> � �� Zc�'Fr�nr u` r. 5� 3� i ` 3a �o Cj' <br /> LOiAREA YACANTSITE FEES VALUATION FEE <br /> USEZONE � <br /> �' � � 7 3� y� BUILOING �f U <br /> ttPEOiCONi5.Al0V/I.BU ttPEOiCON57.ALN11 oam� tioqawfuix4wu5 �i <br /> / PWMDING � <br /> SiZE0F8lDG. ND.OFSTOBiES OASEMENT AIECHANICAL <br /> /v�n Se+ ,� Z o -�- <br /> ADDITIONAL PLAN CHECK <br /> OCCUP/JiGYIOAD FIRESPPNKLEHSPEOD HEIGNTII ITnT10N T— <br /> No orr+En I <br /> REASON FOR SPNWi(lERS <br /> STATE�UILDINq SURGHARGE D <br /> MTIJ(EBY PUNSAPPPOVEDOY CITY OF EVERETT PUOLIC WORKS JU� � <br /> LOCAL SALES ,, � - <br /> -�� S�ZI�12 TAXCOOEIS3105 TaTA� /i �; �./�� <br />