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APPLICATI�iN FOR CONSTRUC7��1N PERMIT everett <br /> IM Ewry�sen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OF <br /> everett HEATING SYSTEM: ❑GAS O ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> G DEMOLITION � COMBINAT.ON CJ BUILDING i}CIUECHANICAL ❑PLUMBINI; ❑ SIGN <br /> ONTlER MAILAD�RESS CITV 21P PIIONE <br /> � W1 /KL _TREO�rP1C1�(' ( 75�� 1 �' �� /�ns-rH-c-roK, 9s3z�_ 3 GSs — os�s' <br /> TEN�NT MAILADDNESS CITY 21P PHONE <br /> ARCHITEGT OA DESIGNER MAII FDOFESS CITV ZIP PHONE <br /> GENERALCOAiTRACTOR MAILADDRE55 CITV 21P PIqNE LICENSE• <br /> AIECHMIICALCONTRACTOR MAILADDRESS CITY ZIP PIIONE LICENSEI <br /> / <br /> /l GJw�B2 S q-rf� jf_ <br /> PLUMBINGLONTMCTOR IMIL/�OORESS CITV ZIP PIWNE LICENSEI <br /> CUSS OF WORN <br /> � ;_i NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR i-�' DEMOLITION �I WOODSTOVE/FRPL INSERT ❑ BUILDINC,RELOCATION <br /> ^'� � CONTACT PERSON M!D PHONE N0. <br /> CONTMCT PRICE OF WORK L �� <br /> OE !E WORK AND SIXI�RE FOOTA6E INVd.VED <br /> / /�l � <br /> , PNOPOSEDUSEOFBUILDR!(3 I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> ,/ D T S APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LE611L DESCfliPT10N OF PR�iPERTY(SNOWN BELOW OR�TT�CH FWR fAPIES) PROVISIONS OF UWS AND ORDINANCES GOVERNIN�THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> . �oT e�c:K oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THF PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL U1W REGUUTING CONSTRUCTION OH THE <br /> ��, PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY 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 7827 RCW AND 296200 WAC. <br /> ( SICaN�TUflE OF CONTR�CTOR OR�UT110RIZED AGEM D�TE <br /> i <br /> I y <br /> I A <br /> � � <br /> PRO.IECT MORESS <br /> i / ."f • � p--�• APPLMANTS CITY BUSINESS LICENSE NO.N!D BUSINESS NNAE <br /> ! <br /> i p�{�Kq MECMAMCAL <br /> ; Np. TYPE OF FlIRURE OR REM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILEI] � A/C—NHNDIG UNITS—H.P. � <br /> �, gqh{7lJg ; FORCED AIR SYSTEMS--B.T.U. M E.A. ' <br /> UVATORY�WASHBASINj� � UNITHEATERS--B.T.U. M � <br /> ! grypyyEp � CLO'HES DRYERS � <br /> KITCHEN SINK d DISP � VEN',ILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> UIUNDRV THAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> • DRINKING FOUNTAIN � FIREPUCE INSERT ; <br /> . FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> � ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> i SINK(SERVICE—BAR,ETC.) ; ' <br /> i , ; <br /> � � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL S <br /> PERMIT $ PERMIT S � <br /> � TOTALFEE $ TOTALFEE S ' <br /> FOR OFFlCE USE ONLY: <br /> FIIONTSETHACK REARSETBACN SIDESETBACN PLANCNEGNNUMBER FEE RECEIPTNO. <br /> USE ZONE LOT ApE� VACANT SITE FEES VALUATION FEE <br /> BUILDING � <br /> 1YPFOFCONfS.AILOW/�BLE IVPEOiCONSI.�CIOAL octUrexcr ruaVMu�MGuxitS � <br /> �AWP PLUMBING ' <br /> SIZEOiBLW. NO.OFS7oRiE5 BASEMENT M'eCHANICAL �Q � �— <br /> OCCUP�NCY IOAD FIRE SPRNKLERS REO'0 NEIGHT LIMITRTION AOOITIONRL PLAN CHECK i <br /> i <br /> OTHER ' <br /> PEASON FOR SPRINKlERS � <br /> STATE BUILDING SURCHARGE i <br /> INT/J(E BY PIANS AVPROVED BY CITY OF EVERE7T PUBLIC WORKS � <br /> LOCALSALES � — <br /> TAX CODEIS 3105 T�T�� 30 ; — <br />