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. .. . . . � J .. . � . . � .. .. . . . .. .. �.. .. .. _ ..i�l .. .. .. . .. '1 ' _ .. . . :YJ .I^ _ <br /> f <br /> APPLIC�.�ION FOR CONSTRV�TION <br /> PERMIT <br /> f�s Ewrpnsn � <br /> CITY OF everelt . <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259•8Bt0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> MML�ODRE55 CRY ZiP PIIONE <br /> �LIA�r'L't-tN ,��l i� ,u��,,, �r, �✓��Ce,tl- rf&�� 2�-z.— yz�y <br /> IENNIT M�IL�DDPE55 CItY ZIP PMONE � <br /> ANLHREGTOflDE510NER M�ILAD�RE55 C17Y 21P PHONE <br /> OENERALCANTN�CTOR MAILAOORE55 LITY 21P PNONE LICENSE• �' <br /> MECHANICALLONTR�CTOP MAIL�DDRE55 �IiY ZIP PHONE LICENSE• <br /> �uar..��1� � <br /> PLUMBINOCONTRAGTOP M�IlA0DPE55 CITY 21P PHONE IICENSE� <br /> ClAS9 0F YqPM <br /> ❑ NEW ❑ ADUITION ❑ ALTERATION ❑ REPA�R ❑ DEMOLITION WOODSTOVFJFRPLINSERT ❑ BUILDINGRELOCATION .. <br /> IEN�NT IMPROVEMENT ON INTEqIOR REMODEL ONIY N�ACT PEPSON�ND PHONE NO <br /> CONTRACT PIi10E OF WOPK <br /> DEBCRIBE� WO�NIVlOWUARE�TA�V�VED ���r .� <br /> �_ .I <br /> .i�ri-rnr��� � <br /> PIqPO6ED U!E OFlUILDINO .. <br /> . � I HEREBV CERTIFV THAT 1 HAVE REAU AND EXAM�NED THIS APPLICATION AND <br /> S� � � Sl��f1�� KNOWTHESAMETOBETRUEANDCORRECT.ALLPpOV1510N80FUWSAND <br /> �[o��oeacni NOFPPOPEPtt�9MOWN �owo RTACMFOUflCOPIES� ORDINANCESGOVERNINGTMISTYPEOFWORKWILLBECOMPLETEDWITH ' <br /> � �� �� WHETHERSPECIFIEDHEREINORNOT.THEGRANTINQOFAPERMITDOE3NOT <br /> , ���{�b 9�p�K S�JLL oF r f PRESUMETOGIVEAUTHORINTOVIOLATEORCANCELTHEPpOVIS10NSOF ' <br /> ANYOTHERSTATEORLOCALLAWpEGULATINGCONSTRUCTIONORTMEPEiF � <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF � <br /> . THIS PROPERTV TO PERFORM THE WORK FOR WHICM APPLICATION 19 MADE � <br /> AND I COMPLV WITM THE STATE CONTRACTORS LAW 1827 RCW AND � <br /> 296200 WA : <br /> SIGN�TUR�CTOFOR iHOflIZEDAGENT D�TE <br /> X �/�/� <br /> PIqJECTMDNESS <br /> �PFLIC�NTS GITY BlI51NE55 LICENSE NO AND BUSINE55 NAME � <br /> �"3�/z7 o,fi�C,a Ln/� &Z� <br /> PLUMlINO MECHANICAL <br /> � <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF E�UIPMENT FEE <br /> WATeR CLOSET(TOILEn q/C—A/HNDLG UNITS—H.P. !' <br /> BATHTUB FORCED AIF SYSTEMS—B.T.U. M E0. •• <br /> LAVATOqY(WASH BASIN) UNIT IIEATERS—fli.U. M <br /> SHOWER CIOTHESDRVEFS <br /> KITCHEN SINKB UISP. VENTILATION FAN � <br /> DISHWASHEF RANOE HOOD <br /> LAUNORY TRAY \NATER HEATER ��� <br /> CLOTHES WASHER WOOD STOVE �` <br /> 1' <br /> URINAL METAL FIREPLACEB CHIMNEY <br /> ORINKIN6 FOUNTAIN FIREPLACE INSEFT � <br /> FLOOR DRAIN HEAT PUMP �, <br /> — �: <br /> BACKFLOW PREVENTEHS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> 91NK(SERVICE—BAR,ETC.) �� <br /> SUBTOTAL S SUBTOTAL S '"� <br /> PERMIT E PERMIT S � <br /> lOTAL FEE S TOTAL FEE S � , <br /> FRONTSETBI�LK REARSEfB�CN SIDESETB�CK PLANCHECNNUMlER FEE pECE1PfN0. ' � <br /> t <br /> USE20NE LOTARE� V�G�NTSITE FEES VALUATION FEE <br /> ❑YES ❑ NO <br /> TYPEOFCON9T. OCCUP�NCYGAOUP NOOFDWELLINGUNItS BUILDING .� <br /> AILOW�BIE/�CTU�L ' <br /> PLUMBING <br /> 91ZEOFBLDO. NOAFS�ORIES &SMT. OCCLOAD � <br /> ❑v MECHANICAL . <br /> ❑N i <br /> HEIQHTlIM1U710N OTHER f <br /> 1 <br /> FIRESPRINRLEFS REOUIPED n res ❑ No STATE BU�LDING SURCHARGE i <br /> STATE ENERGY SURCHARGE I, <br /> �PPLIC�TION�CGBV PUNS�PPRBY <br /> PUBLIC WORKS �� <br /> TOTAL _ � <br /> �. <br />