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, �.. . <br /> . � .. . . _ �-s . <br /> APPLICATII,N FOR CONSTRUCI _ON PERMIT <br /> ��E�ro�� everett <br /> ���oF e <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-88?0 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION p4 BUILDING ❑ MECHANICAL ❑PLUMBING ❑ SI(iN <br /> ONTIEfl MAILADDRE55 CITV 21P PMONE ZT <br /> DAvI� L. Johu�u io92z 5i5TAve n�E. M,�cusY��)Q, i�1n . rosa-�o34 <br /> TEN�NT MAIL AUUflE55 CITY IIP �PHONE <br /> ,,,� � � <br /> ARCNRECTOR DESIGNEfl MAIL ADDflE55 CIN ZIP PMONE <br /> John,�nu - sA►�v <br /> OENEflALCONTRACTOq MAILADDHESS CITV 21P PHONE UCENSEI <br /> ME���tCONT�To M�ILADDES'S� CITY ZIP PHONE UCENSE� <br /> � • <br /> If /� <br /> PIUMBINGGONTMGTOR MAILA�ORESA GTY 2iP PMONE tICEN5E1 <br /> li �� <br /> CUSS OF WORK <br /> ❑ NEW ❑ ADDITION D� ALTERATION ❑ REPAIR I 1 DEMOLITION I 7 WOODSTOVE/FRPL INSERT I7 BUILDING RELOCATION <br /> TENANTIMPROVEMENTORINTERIORREMODELONLY �y� GONTACTPEHSONANOPHONENQ . <br /> `C'- <br /> COHfFACT PRICE OF WdiK: S <br /> DESCRiBE WOflK AND SOUARE FOOTAGE INVOLVE , <br /> S� <br /> PROPOSEDUSEOFBU0.DIN6 1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS ! <br /> s APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL , <br /> LE(iA�DESCR i oFr PERTI�SHOWN BELO ORATTACM FOUflCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF � <br /> � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior IZ- e�ocK � oF f I 5 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> SC'CJM A�d 1 �D YI �{r� E v e re f� OTHER STATE OR LOCAL LAW EtiULATING CONSTR'COT ON OH THE . <br /> PERFORMANCE OF CONSTqUCTION.THAT I AM AUTHORIZED BY THE , <br /> S � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH , <br /> APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> � 11 ,.�^rn CONTHACTORS LAW 18.27 RCW AND 296200 WAC. � <br /> ��I S ' DO'} �DI Z.^OW d SIONATURE OF CONTflAGTOR OR AUTNORIZED�GENT OATE 'l,•LS—� D ' <br /> PRO,IEC�TAODRESS O � • � 1 ' '"`� <br /> �PP C�NTSGI USINESSLICE ENO.ANUBUSINESSNIJAE ' <br /> PLUMBINd MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSFT(TOILET) !VC—NHNDLG UNITS—H.P. � � <br /> BATHTUB ; FOHCED AIR SYSTEMS—B.T.U.�ASd E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' ' CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER � � � RANGE HOOD i . <br /> LAUNDRYTRAY ; WATERHEATER ' <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; , <br /> FLOOR DRAIN � HEAT PUMP —� <br /> BACKFLOW PREVENTERS ; GAS PIPING ' . <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � � <br /> SINK(SERVICE—BAR,ETC.) ; ' . <br /> � <br /> � i <br /> � i <br /> i � <br /> i i ' <br /> 1 1 � <br /> SUB TOTAL $ ; SUB TOTAL S ' i <br /> PERMIT $ � PERMIT $ I �� <br /> TOTAL FEE $ ' TOTAL FEE S � � <br /> FRONTSETBAGK REA�fl`SETBACR SIDESEIB�CK P NCN CKNIIM ER FEE � AEG TNO , <br /> �, w ' S <br /> USE ZONE l0T AAE� VACANT SITE f FEES VALUATION FEE � <br /> _I C��O.S ❑ YES i[i NO BUi�DING . ' 0,�0 Fjp�'Q � <br /> 7VPEOFCONST.ALIOW�BIE TYPEOFCONSI.AGiO�� aNPUCv NOIXmttluxGuxns � �C <br /> v. GR01� PLUMBING � <br /> SIZEOFBLDO. NO.OFSTORIES B�SEMENT MECHANICAL � , <br /> � � u ves !e No , <br /> OCCUPANCYLOAD FIRESPflNKLERSREdD HEIGHTLIMIiATION OTHER j . <br /> �_.. � ��/ 1 . <br /> ❑ YES NO STATEBUILDINGSURCHARGE � <br /> HEASONFORSPR:::riLF.pS � � <br /> STATEENERGVSURCHARGE i � <br /> APPL�CATIONACC.BY PUNSAPPflOVE09Y CITYOFEVERETT PUBLICWORK$ Z� �J � <br />