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APPLICATION�OR CONSTRUCTIO".� PERMIT everett <br /> Mn Everg:eon TO BE COMPLET K= SE PRINT � <br /> CITY OF <br /> everett HEATING S STEM: �GAS O ELE RIC U <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> ` DEMOLITION i COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MAILADDRE55 CITV 21P PNONE <br /> (YI a�► B�Y i ooS �I- �nz� 0� �-v��"� �8zo� zS'Z-� i g �1 <br /> TENANT MAILAOORE55 CIP' ZIP PIIONE <br /> ARCMITECTORDESIGNEP MAILPODRE55 CITY ZIP PNONE <br /> Ra��o�� ►hlua�w �z�lz3 -i�tw r#�e.s����� � 9���� �.�I� -�S�l� <br /> GENERALCONTRACIOR MAILADORE55 CI7V ZIP PNONE LICENSE� <br /> �� a� (.�,►c, �1121� -12��Sr T � ��~,: 9 �z�t� 3��-i�ilS ���vrBc��i�n�s <br /> M CHANICALCONiR4CTOF MAILADDRESS LITV ZIP PNONE LIGENSEr <br /> 6 <br /> PIUMBINC CONTNRCTOR Mdil,pDORE55 CITV ZIP PHONE LICENSE� <br /> 1 <br /> ' C A550!WORR <br /> �NEW ! � ADDITION � ALTERAT�ON . REPAIR . � DEMOLITION WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br /> p�� Mg3 7� �� GONTACTPER,S^ON`ANDPNONENO p <br /> � GONIPACTPqICEOF WORK �/W�.� — lT 11C2�C <br /> DESCRIBE N'ORK AND SOUr1HE fOOTAGE INVOIVED <br /> 2`� � 7SL-41A�1 or 3�(v-�38� <br /> . PROPOSEDUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORqECL AlL <br /> LEWLDESCRIPiIONOFPROPERTV�SHOWNBELOWORATTACHFIXIRLOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOP <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or�� BIOCK OOO oF — O NOT. THE GRANTING OF A PERM�T DOES NOT PRESUME TO GIVE <br /> . AUTHORITY TO VIOLATE OR CANCEL THE PflOVISIONS OF ANY <br /> , � Q����Wl OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> �� ,1 OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � ��e-�� � � �f+ APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNATUFE OF CONTP�CTOR OR�UTHORIZED AGENT DRTE <br /> � PR0.1�RESS` , � _��_/����f(/� r`^�" � 1 1� �O <br /> ��0 APPUCANTSCITYBUSMESSLIC'cN5EN0 ANDOUSINESSNAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM FEE NO. TYPE OF EOUIPMENT fEE <br /> WATER CLOSET(TO�IET) A/�NHNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> ' SHOWER o ' CLOTHES DRYERS <br /> , KITCHEN SINK 8 DISP 3 VENTILATION FAN <br /> � DISHWASHER r ' RANGE HOOD <br /> LAUNDRY TRAV � ; WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> � URINAL METAL FIREPLACE 8 CHIMNEY <br /> ORINKING FOUNTAIN FIREPLACE INSEFT ; <br /> F100R DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> •-..--. e.,..f - enn.i'i a i oa <br /> SUB TOTAL S d � SUB TOTAL 5 � <br /> PERMIT 5 PERMIT 5 <br /> TOTAL FEE 5 60 ' TOTAL FEE 5 li O <br /> FOR OFFICE USE ONLY: <br /> FR011T SETBFGK RERR SETfiACK SIDE SETBRGK PIAN GNE N NUMBER FEE � AECEIPT NO <br /> �� o � �• 3�0� l � <br /> USEId+E ioT en /� VRCAIJT'SiCTE FEES VALUATION FEE <br /> Z �.�+ 7 T/! BUILDING B7�% ,�(c7 ' s'p <br /> IiPCOfCONiSALOWABIE fYPE0LON5iRL1U�L occuv�Ycr eoa[m[u�.c�hi15 i <br /> QPpJ° PLUMBING ' <br /> � _ -3 � Oo <br /> 5�2iBO�LDQF � NO OF SiORIES BASEMENT MECHANICAL 60 �n a <br /> s ES <br /> Sf A ' <br /> OGCUP�NCV LOAD FINE SPRNNLENS REO'0 HEIGHi�ndli�ilON ADDITIONAL PLAN CHECK � <br /> N NJ OTHER � <br /> REASONFORSPBiNNLLRS — �' <br /> STATE BUILDING SURCHARG[ i S CJ <br /> INTRKEBv PLANSAPPROVEDBV CITYOFEYERETT PUBLIC�YORKS .�O �U�� <br /> yyy� Q'� LOCAL SALES <br /> /'" ' - ( �% TAX COOE IS 3705 TOUL -7( 3 ;aQ <br />