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APPLICATIO� FOR CONSTRUC�N PERMIT everett <br /> �E���� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: 0 GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> i�� DEMOLITION Ci COMBINATION L' BUILDING Li MECHANICAL !�LUMBING ❑ SIGN <br /> OWNER MAILADDRESS CITV ZIP PHONE <br /> �e �•_.s__+ ��k ,M�Ik �qaa G ,a S� Evue++.l�� �yu3 �si- SSS3 -- <br /> TENTMIT M LADDRESS CITV ZIP PHONE <br /> 1 -�� <br /> ARCNITECTORDESIGNER MAILADDPE55 QTV 21P PMONE <br /> .! N�C� �ut 9 i �l 5 �L�lc�abl �Y�o 1 -S3� �F <br /> GENEfUL CON CTOR MAIL ADDRE55 CITV ZIP PHONE LICENSE� <br /> MECHANICAL CONTRACTOF MAIL ADDRESS CITY 21P PIqNE LICENSE• <br /> ��- ,'.� Olw�.bins �I�k 3:�8 S Pc���. 'l�ild 4utrul� ,w� 9`��� '1v s-S�S �a*r£0 iKY QF <br /> PLUMBINGCONTMCTOR MARAOD 55 CITY 21P PNONE LICENSE� <br /> ' CLASSOFWOPK <br /> � NEW �I ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION �.J WOODSTOVE/FRPL INSERT G BUILDING RELOCATION <br /> CONTACT PcRS'7N M1D PHONE NO. <br /> CANTRACT P1110E OF NiONf <br /> • DES 9E AND SIXNfiE FOOTA�E INVOLVED <br /> . �J � v� '""� <br /> � pqoroseouse au�ort� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ., � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �E(LLLDESCqIPT10NOFPROPERT'�SNO�NIBELOWORATTACHFWRCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINCaTHISTYPEOF <br /> s WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> f ipT e�xK � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL UW REGULATING CONSTRUCTION OR THE <br /> � PERFURMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ( OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> � CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> 4 <br /> SIGNATUPE�)F CONTMCTOli di AUTIIOi1RED�6ENT O�TE <br /> i <br /> ( <br /> � ci �' S4. �tv ut.� X �(} M <br /> PRO.IECTADDRESS qppLIGANTSCITVBUSINE LICENSENO.MIDBUSINESSNM�E <br /> } ����� MECHANICAL <br /> Np. 7ypE OF qXTURE OR REM FEE NO. TYPE OF EGUIPMENT �E <br /> id WATER CLOSET(TOILET) !SO �O A/�A'HNDLG UNITS—H.P. ' <br /> I gpTM7Ug o ;o o FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> UVATORY(WASH BASIN) .�p �OO UNIT HEATERS--B.T.U. M � <br /> �i SHOWER ' CIOTHES DRYERS ' <br /> � KITCHEN SINK 6 DISP S �� VENTILATION FAN � <br /> ' DISHWASHER ��00 RANGEHOOD � <br /> ' LAUNDRYTRAY ; Z WATER HEATER <br /> �� CLOTHES WASHER O �O WO�D STOVE ' <br /> ' URINAI ' METAL FIREPLACE 8 CHIMNEY ' <br /> i DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> � FLOOR DRAIN � HEAT PUMP � <br /> I BACKFLOW PREV�NTERS ; GAS PIPING � <br /> ' ROOF DRAINS—RAINLEADERS S W EXHAUST FAN ' <br /> I. SINK(SERVICE—BAR,ETC.) � � <br /> i i ' <br /> I ' <br /> i <br /> i 1 � <br /> I � <br /> SUB TOTAL S a.p ' SUB TOTAL $ / ' <br /> PERMIT 5 (O �p[� PERMIT S � <br /> TOTAL FEE $ ' TOTAL FEE S —�—'� <br /> FOR OFFICE USE ONLV: <br /> FRONTSETB�CK REIASETBACK SIDESETBRCN <br /> PUJICHECKNUMBER FEE RECEIPTNO. <br /> IOTAREA VACANTSITE FEES VALUATION FEE <br /> USE ZONE i <br /> BUILDING ' <br /> IYPE 0�CONTS.�LLOW�BLE 7VFE Of CONST.PLTUAL attpa�+ Mo O�VMwNGUYrtS ` � � <br /> PWMBING v�. <br /> 2 i y� <br /> SIZEOFBLUG. NO.OFSTORIES BASE�AENT MECHANICAL J J�OC/ <br /> i <br /> ADDITIONAL PLAN CHECK � <br /> OCCUPANCY LO�D FIRE SPflNNlERS RE09 MEIGNT LIMITATION i <br /> i <br /> OTHER <br /> REASON FOR SPRINNLERS � <br /> STATE BUILDING SURCHARGE <br /> i <br /> INTAKEBY PUNSAPPROVEDBV CITYOFEVEREIT PUBLICWORNS � <br /> LOCAL SALES S�3 ;� <br /> iAX CODE IS 3105 �TAL <br />