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� <br /> APPLICATION FOR CONSTRUCT�N PERMIT <br /> � m,E�ro,�,� everett <br /> � ���oF e <br /> � everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ; fJ DEMOLITION IJ COMBINATION i I BUILDING ! 1 MECHANICAL ! I PLUMBING ❑ SIGN <br /> �/(tp Sr'�u y26�,�/ S�s R-. 6y�� :�P 3Sf-7253 , <br /> �T M�ILAUORE55 CITV ZIP PHONE <br /> .` <br /> AflGHITECTOPDESIONEN M�ILADDRE55 CITY ZIP PNONE <br /> � OENERALCONTMCTOR MAIlA0DRE55 qTY ilP PNONE UCENSE� <br /> � I MECM�NICALCONTR�CTOR IA�IL�UUflESS CITV ZIP PHONE IICENSE� <br /> � ���ye�«'Iti� 3110- Ilw� .41tt L✓f 9Y�1 LSf-t77/ I�Ju.-fiwl� /37 k 1" <br /> PIUMBIN(iCONThGCTOR AUILADDRE55 CITY ZIP PIIONE LICENSE� <br /> CUSS OF WOHK <br /> � �NEW ❑ ADDITION I J ALTERATION I I REPAIR I. I DEMOLITION I I WOODSTOVE/FRPL INSERT 1-I BU�LDING RELOCATION <br /> TEIUNT IMPROVEMENT Oq INTERIOR REMODF�L ONLY CON��CI PERSON ANO PNONE NO <br /> � <br /> CONTMCT PRIGE OF WORK: <br /> ' DE6CRIBEWORNANDSOU�REdFOOTA/OE_I-NVOLVEO (� <br /> 1 �P0.S,'/EO USE O�I�NO Y 4'� �Y� I'✓��4'fiN...�// <br /> � <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> . APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> + LEOALDESCqI IONOFPR ERTV�SHOWNBELOWORATTACHFOURCOPIES� PqOVIS10NSOFLAWSANDORDINANCESGOVERNINGTH157VPEOF <br /> WORK�JILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ; �or e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> .i AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.TFIAT I AM AUTHORIZED BV THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> I SIGNAfUREOFCON7P�CTORORAUTHOPIZEDAGENT UATE <br /> I �/ D <br /> + PROIECT AUDPESS ^ � /�.G M'�'L`�/ <br /> ' � C� ��.,� '- APPLICANTSGINBUSINES ICENSENO.RNDB�SINESSNAME <br /> PLUMBINO MECHANICAL � <br /> �;i NO. TYPE OF fll(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> .� WATER CLOSET(TOILET) � A/C—AIHNDLG UNITS—H.P. , <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> � � <br /> LAVATORY(WASHBA^IN) � UNITHEATERS—B.T.U. M ' <br /> � SHOWER � � <br /> CLOTHES DRYERS i <br /> :� KI7� HEN SINK 8 DISP ; VENTILATION FAN ' <br /> � <br /> �+ DISHWASHER � RANGE HOOD � <br /> ! LAUNDRYTRAY ' WATERHEATER � <br /> � <br /> ,i CLOTHES WASHER � WOODSTOVE � <br /> � URINAL � METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> � BACKFLOW PREVENTERS ; GAS PIPING � <br /> ' ROOF DflAINS—RAINLEADERS � EXHAUST FAN i <br /> � SINK(SERVICE—BAR,ETC.) ; � <br /> i <br /> � <br /> , <br /> � � <br /> . � <br /> 1 ' i <br /> i � - i <br /> ! _ SUB TOTAL $ ; SUB TOTAL $ O ' ^ <br /> � PERMIT $ � PERMIT S ; � <br /> TOTAL FEE $ ' TOTAL FEE $ Op <br /> i FRONTSETBACN REAflSETBACK SIDESE7BACN PUNC11CdKNUM�ER FEE RECEIPTNp, <br /> �� usezorre IOTAPEA VACANiSITE FEES VALUATION FEE <br /> ; I.I YES I] NO BUILDING � ' <br /> ' 1YPEOFCONSiALL01VABlE lYCEOFCONSi.ACIURL aCCUruKy Hoa0Mt0.iNGUNnS <br /> cnnur pLUMBING � <br /> � <br /> ' SIZEOFBLDO. NO.OFSTOf7lE5 BASEMENT MECHANICAL �— <br /> . f I YES I J NO � ; <br /> OCCUPANCYLOA� FIqESPRNNlER5RE0'U HEIGHiLIMITpTION OTHER � <br /> � ( I YES I .I NO STATE BUILOING SUitCNAqGE � <br /> i <br /> REASON FOR SPflINNLERS — <br /> STAiEENERGVSURCHARGE � <br /> � ' <br /> , APPLICQIONACC.BV PLANSAPPROVEUBY CITYOFEVEflETT PUBLICW0f7HS � <br /> � LOCALSALES ' <br /> � TAX CODE IS 3105 rora� ; <br /> i - <br />