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APPLICATIO� FOR CONSTRUCT JN PERMIT everett <br /> �E�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cm oF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLI710N ❑ COMBINA710N C BUILDING MECHANICAL ❑PLUMBING ❑ SIGN <br /> ONMER MAlLA0DRE5S CITY ZIP PHONE <br /> t��� � 3�.K.�,�K ���t� zMa sl. w,u.,fys�,/ip u 9��-70 �s S- Z-z�S� <br /> 7EN�1N7 MAIL/�DDRE55 CIN 2�P P�E <br /> �J o-tie <br /> •M:MITECTqiDE51GNEfl AUILADDRESS CITV ZIP PHONE <br /> �� � <br /> GENC:RALCONTRACTOR /MIL/�ODRESS CITV ZIP PMONE 7�'S-pj�LICENSE� <br /> � G vq,ra ,�'�« � IMYJ�e��1o.J �SS 2929 G�,¢s�N�/f' �Ur�f�f 1✓u S�2al (r�NAn� F['/ZikY <br /> MECMNJICAI.CONTMCTON M�ILADURESS CITY ZIP PlIONE LILENSE� <br /> ,. PLUGBMO CONTRI1CTOfl 1MIL MDRESS CITY ZIP PHONE LICENSE� <br /> VYORN <br /> NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br /> CONTACT PERSON AN�PlIONE NO. <br /> �r���� bp M�14 or an,el+.l(.. acvtl'i � <br /> pESCqIBE yIp7RK AND Sp1ME FOOT�OE INVOLVED ,I I q f.� <br /> � 0.$ 11N� r/CM Ml�tl � ry � WS+tr �4..�CS �S / - ZZ7 1 <br /> � PROPOSEDUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br /> , �,� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEMLDE9CHIP7qNOFPPOPERTVI`+MOWNBELOM�OR�TTACHFWRCOPIES) PROVISIONSOFLAWSANDORDINANCES60VERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � ioT e�ocK oF NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO OIYE <br /> �/ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � O � c. lcC���G /Nt Or OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTFiORIZED BY THE <br /> � q ��e � / OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> '� / �t APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �� ,��j /1 4c CONTRACTORS LAW 1827 HCW AND 296200 WAC. <br /> �I�l C C� �T • /a �� SIGNAIURE OF CONTFUGT(Ni OR AUfHORRED�OENT WTE <br /> l � /�'�/ L��A/ � l 1 \ <br /> � PNO.IECT SS � LrX�J <br /> � .�n^� �pPLICN7T3 CITV BUSINESS LICENSE NO.Ml0 BUS ESS NM1E <br /> v� �d i�R <br /> k �� MECMAIMCAL <br /> ! N0. TYPE OF FlXTUNE OR REM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE� � N�MiNDLG UNIT�Fi.P. � <br /> � BATMT�B � FORCED AIR S`!STEMS—B.T.U. M E.A. ' . <br /> f� LAVATORY(WASH BASIN)� � UNIT HEATERS—B.LU. M � <br /> •� SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 6 DISP I VENTIUTION FAN � _ <br /> � DISHWASHER RANOE HOCD ' <br /> � UUNDRY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEV ' <br /> � DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> �� FLOOR DRAIN � WEAT PUMP �_ <br /> Y BACKFLOW PREVENTEHS ; GAS PIPING �� � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> � <br /> i SINK(SERVICE—BAR,ETC.) � � <br /> _ � <br /> 1 _ i � <br /> i <br /> — i � <br /> i <br /> — � � <br /> � SUB TOTAL S ' SUB TOTAL S /S' <br /> — PERMIT S PERMIT 5 � <br /> � — TOTAIFEE S ' TOTALFEE S ' <br /> � <br /> ' FOR OFFlCE USE ONLY: <br /> � FRp:TSET&�CN REARSE7B�GK SIDESETBACK PLANCHECKNUMBER FEE <br /> RECEIPTNO. <br /> 3So� <br /> us�=q�E LOTAREA v�cu+rsire FEE9 VALUATION FEE <br /> BUILDING ' <br /> ' �ypEpiCONTS.�LlOWABLE TYPEOiCONSi.ACTWLL acaw�Nq' MonuMuixcuxrts ' <br /> i <br /> cnaP p�UA181NG � <br /> g�(FBIDG. NO.OFSTORIES BASEMENT MECHANICAL � � <br /> � <br /> pGCUFNlCV LO/�D FIRE SPRNKLERS REOD HEIGHT IIMITATION ADDITIONAL PUN CHECK � <br /> OTHER i <br /> RE�$pp FOR SPRINKLERS i <br /> STATE BUILOIN6 SURCHARGE <br /> INTAKE B\ PUNS�PPROVED BV CITY OF EYERETT PUBLIC WOflKS � <br /> LOCALSALES � <br /> TAX CODE IS 3105 Tor�� ; — <br />