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APPLICAT�� FOR CANSTRUC�N PERMIT everett <br /> �E�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> cin oF <br /> everett HEATING SYSTEM: O GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION f-! BUILDING ❑MECHANICAL i�PLUMBING ❑ SIGN <br /> p q MAIL/�DDRE55 CITY ZIP P�E <br /> r� iL4l�N W �O <br /> � PlIONE <br /> TENA M L 0lRESS CITY IP . <br /> � ���7 [�vcl <br /> � ARCMITECTOR SIGNER M�II�DDilESS GITY 21P PNONE <br /> GENERALCONTMCTOR MAILAODRE55 CITV ZIP PIqNE LICENSE� <br /> .r Gda�aNTccN,. -- � � n•� -si � - : �sr�9hZo � � �s- 6oscs �-uRkRt�ia/-t'L <br /> 7'�;/ ]Llr�)n J f %�v ZIP PXONE IICENSE� <br /> MECMANIGILCONTMCTOR MAILADDRE55 ��TY <br /> - CITY ZIP PMONE UCENSEt <br /> PLUMBINGCONTRAGTOR MMLAWRESS <br /> . CUSS OF WORK <br /> ;L7�q� ❑ ADOITION G' ALTERATION i� REPAIR C DEMOUTION ❑ WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br /> CONTACT PERSON N1D P110NE NO. <br /> WNTAIIGT PfiICE OF WONK <br /> DESCRIBE WORK ANO SOU�NE FOOTAGE INVOLVED <br /> � vaoroseo oFeuRo I HEREtSY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ' APPLICP TION AND KNOW THE SAME TO BE TRUE AND 'ARRECT.ALL <br /> - �Ery�p��p�pppN pF pqppEq7y�5lqWN BELOW OR�TT�CH FWR COPiESI PROVISI�NS OF LAWS AND ORDINANCES 60VERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT e�aK oF NOT. THE GRANTING OF A PERMIT DJES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �, PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOFi WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTORS UW 7827 RCW AND 296200 WAC. <br /> i; SIGN�NRE OF CONIN�CTOR ON KRMOR�ED AOENT D�TE <br /> { <br /> � PROIECi ADDHE55 �� �/�����/ <br /> — AP%ICANTS CITV BUSINESS IICENSE NO.ANO BU5INES�/fAME /A_ � <br /> r� V <br /> � �� ' MECHANICAL <br /> � TYPE OF FlXTURE OR REM FEE NO. TYPE OF EWIF'MENT FEE <br /> � N0. � <br /> WATER CL0.SET(TOILEn � M�NHNDLG UNITS—H.P. <br /> �' BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � LAVATORY(WASH BASIN)� � UNIT HFJQERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ' <br /> ��' KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER i RANGE HOOD � <br /> � LAUNDRYTRAY , WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE ' <br /> � METAL FIREPLACE 6 CHIMNEY ' <br /> ;. URINAL ' — <br /> DRINKINC FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN ' HEAT PUMP � <br /> � BACKFLOW PREVENTERS ; GAS PIPING ' <br /> �; _ ROOF DFAINS—RAINLEADERS � EXHAUST FAN ' <br /> r SINK(SERVICE—BAR,ETC.) � � � <br /> i <br /> i, � --r— <br /> H <br /> t � _— ' <br /> ) i <br /> Y' <br /> i <br /> SUB TOTAL E ' SUB TOTAL S ' <br /> ' PERMIT $ � PEFiM1T S � <br /> - TOTAIFEE S ' TOTALFEE S ' <br /> FOR OFFlCE USE ONLY: Aeceivr rro. <br /> - FAONT SETBACK REAR SETBACK SIDE SETBACK PIAN CHECK NUMBER FEE <br /> ` USEZ(N�E LOTAFEA <br /> v�cu+rsrte FEES VALUATION �E <br /> , BUILDING �`�� � � <br /> i <br /> TYPEOFCONTS.ALLOW�BLE ttPEOFtONST.ACN�L ��� 'ba�«'�uxrt5 i <br /> _ cnav p�UMBING ' <br /> 1 <br /> S�QF�W NO.OF5T0lilE5 B�SEMENT MECHANICAL <br /> i <br /> ADDITIONAL PLAN CHECK ' <br /> OCCUPANCVIOAD FIRESPRNNLERSREO'D MEIGHTLIMIT�TION � � <br /> i <br /> OTHER <br /> i <br /> � qEA$ON FOR SPRINKLERS STATE BUILDING SURCHARGE ' <br /> � <br /> IIlT�E BY PLANS APPROVED BY CITY QF EVENEIT PUBLIC WOPNS � <br /> LOCAL SIILES ' <br /> TAl(CODE IS 3105 �TAL �� � � <br />