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APPLICATION FOR COPISTFiUCTIc�N PERMIT � <br /> e��e�eu <br /> �n„i,�,,,,,,.,� <br /> cirv or <br /> everett � <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT I <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING i MECHANICAL PLUMBING SIGN � <br /> owr+ea r.in�inounss mrr zu� �1�/� �1� � I <br /> � ro JA('1� l�IS�SL - ��2� �l�'1� �1-'�- ,.A� �����a - � � <br /> � N ���� MAIL D ES�� CITV ZIP PMONE <br /> i0 A tC <br /> t' mmmH U1 � <br /> „ � � MGHIiECTOND[SIGNEP MAILADDRE55 CITY ZiP PNONE <br /> K � 3._, <br /> H G E CONTR�GTOR MAi OPESS Cli ZIP PHONE �ICEN °/ <br /> m H m — r C �.Q �` l-1� I ���, � `� � <br /> N M <br /> � � � MEGHANiCALC Rr1GTOR ,MAILApOHESS QTY �,21PI PHO LIfENSE+ <br /> �!��. ����S�L.� �—��`7� <br /> PLUAIDiNGCONTRACIOR I.INLAD�RESS Citt ZiP PrIt�NE LICENSE� <br /> °z n I <br /> � � � – i <br /> G1R550F WOBN <br /> � �'7 z � . NEW � ADDITION �ERATION . REPAIH . DEMOLI1lON WOODSTOVEIPRPL INSERT ' � dUILDING RELOCATION ��,, <br /> ~ y tENANTIR�PROVEAI[NTORINTERIORREM1IO�ELONLY CONiACiPEP50NAtlOPNONENO. <br /> y �� . �� <br /> ~ CONTRACTPRiCEOFWOIiM: <br /> O N <br /> OESGn',pE WORN Np 5 U AF F iPGE INVOLV D 1 <br /> � � � �ln ��-�� �.(��'� . 2P-� <br /> N <br /> y PROPOSEDUSEOFBUi:01NG �� �--�� I NEREBY CERTIFY THAT I H�VE READ AND EXAMINED THIS <br /> �J�� APPLICATION AND KNOW THE SAh1E TO BE TRUE AND CORRECL ALL <br /> LEGALDESGRIPiIONOFPROPERTYISNOWNBElOWG9ATTACHFOURGOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or piaK oF NOT. THE GRANTING OF � PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> OTHER ST�TE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COh1PLV WITH THE STATE <br /> — CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SiGNAiUPEOFCO4tRACTORGRAl1T�10RIZE0�GENT ��iE <br /> /� , / ��s�u���—'�. .��,�►a� d� <br /> PRQIECT.\pDPESS � ,( �,V A PL�CnNiSCItY0U5�M1[SSLiCEIJSENU.RN�Bl15MES5N\IdE <br /> �.. � J�5 14h--�c ti� ,� <br /> I ��� PLUMB�NG MECHANICAL , <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE i <br /> 1 WATER CLOSET(TOILET) _ A C—NHN�LG UNITS—H P. <br /> , �� BAl HTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> !�I LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M , <br /> SHOWER CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN ' <br /> '�� DISHWASHER ; RANGE HOOD . <br /> � � � LAUNDRY TRAY �_ WATER HEATER � <br /> i ' WOOD STOVE � � <br /> CLOTHES WASHEF <br /> URINAL MEiAL FIREPLACE 8 CHIMNEY ' <br /> FIREPLACEINSERT � �� <br /> � DFINKING FOUNTAIN j <br /> FLOOR DRAIN — HEAT PUMP <br /> ��� — 7— GAS PIPING � ' <br /> � BACKfLONlPREVENTERS I �� <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> � SINK(SERVICE—BAR,ETC� � � � ' �� <br /> I��I — _— <br /> — �— <br /> i <br /> '�� SUB TOTAL S _ SUB TOTAL 5 / ` �� <br /> �' 1� PERMIT S PERMIT 5 ) � I <br /> .. TOTAL FEE 5 TOTAL FEE $ 30 ' ' <br /> FRONTSETBACN REAli5ET0ACN Si0E5ET0ACN �'LANCMECKNVMOER F[[ REC[IPTNO. I <br /> USEZONE LOTAREA VFCANTSIiE FEES VALUATION FE�_ I <br /> � YES : NO eui�oinG ' <br /> TYPEOfC0114.ALlOWABLE iYCEOFGONSIAGiUAI oc[ursvcr r.omJ.viu�•„�ti�s � <br /> :=o��v p�.Uh101NG i �� <br /> n � I <br /> SREOFOIDG. NO�OFSTOf11ES �ASEh1ENt MECHANICAL �J V � <br /> ' �. YES . �. NO � <br /> O7HER � <br /> � OCCUPANGYLOAD f18E5PPNNLEflSREOD ��EIGNTLiMrtAT10N I <br /> �, . YES . NO STATE L7UILOING SLIRCHARGE <br /> --T— <br /> RERSONi0R5PflINNlERS i <br /> S1A1E ENERGY SURCHAfiGE <br /> narucnnoNnccm rinr+snPanovennv CITYOFEVEREIT puoucwoaKs <br /> LOCAL SALES T�rA� 3 v � Ov I <br /> TAX CODE IS 3105 <br />