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'��APPLICATION FOR CONSTRUCTION PERMIT <br /> �n�E�ro.�� <br /> everett <br /> cm oF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOLITION I 1 COMBINATION i I BUILDING �CHANICAL I I PLUMBING I I SIGN <br /> ER M�ILADORE55 CIT` ZI7 PNONE �—� <br /> � �l. — - �3 � ` �.�. � . — - �--- -��'�--- � � �� �� <br /> TEN MML RD�flESS CITV 21P PIIONE <br /> � <br /> APCHITECTORDESIGNEq MPIL�DDRE55 CITY ZIP PIIONE <br /> GE E LCONTNAGTO M�( ` DRESS ' �. � ' C�. CI �� � � ZI� J q E �JLICENSE��� <br /> . / <br /> MCHMlICALCON ACTOR MAI �DDRESS CI1Y — .,ZIP,���'��i��E'� �l pICENS �I�^ <br /> V ji J <br /> PWMBINGCONTRRLTOR RIAILADDBESS CITY ZIP PHONE UCENSEI <br /> CLASS OF WOP✓. ) <br /> ❑ NEW ❑ ADDITION .� tTERATION I I REPAIR I I �EMOUTION I I WOO�STOVE/FRPL INSERT l 1 BUILDING RELOCAT{ON <br /> TEN�NTIAIPROVEMENTOpINTE ORPEMO ELONLY I GONTACTPERSONRNUPlIONENO. <br /> CONfR�CTPNICEOFKORN: JL .C��� <br /> D SCqIBE WORN�N_O SO.U�RE F O A E IrVOLVEO <br /> ' �tZXX. ��'i�'Y 1(�C'_.L <br /> PROPOSEDUSEOFBIIIIDING I HEFiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> l�� - APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> lEOAL DESGNIPTIONOF PROPERTY�SNOWN BEIOW ORAiTAL11FOI1R COP1[5� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or eiocK oF NOT. THE GRANT�NG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHURITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION CR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PEflFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 PCW AND 296.200 WAC. <br /> SIGNRTUREOFGONTRRCTORORAUTMORRED�GENT DRTE <br /> PROJECTADDRESS /� �/ � _ �� Q /`J�/ '/` r I.���� / <br /> ��., f II� APPL��NTSGTYBUSINESSLI NSENO.ANDBUSINESSN�ME <br /> t� <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EUUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—AIHNDLG UNITS—H.P. , <br /> BATHTUB _ ; FORCED AIR SYSTEMS—B.T.U. E.A. � <br /> UVATORY(WASH BASIN) UNIT HEATEqS—B.T.U. M ; <br /> SHOWER � CLOTHESDRYERS ——� <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER --�— RANGE HOOD —T <br /> LAUNDRV TRAV ; WATER HEATER � <br /> CLOTHES WASHER �— WOOD STOVE ; <br /> UR�NAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS � ; GAS PIP�NG � <br /> ROOF DRAINS—FAINLEADERS —T— � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � —� <br /> — � <br /> � <br /> — — —T— <br /> � � <br /> SUB TOTAL $ r— SUB TOTAL S ' <br /> PERMIT $ � f'ERMIT S � <br /> TOTAL FEE $ ' TOTAL FEE $ � <br /> FRONTSETBACK pEARSETB�CK SIOESETBRCK PlANC11ELKNUMOER FEE RECEIPiNO. <br /> 11SEZONE LOTAREA VACANTSIiE FEES VALUATION FEE <br /> I l YES I 1 NO BUILDING i <br /> TYPEOFCONST�LLOWABLE iVPEOfLONSi.ACNAL ocwvewcr HOaowFluNGUHitS <br /> tp�P PLUMBING ' <br /> 1 <br /> SREOfBLDG. NO-0PSTORIES �ASEMENT � <br /> MECHANICAL i <br /> I I YES I I NO ; <br /> OCCUPANCYLO�D FIRESPRNRLERSAEO'U IIGGIITUMIiATION OTIIER � <br /> I I YES I I NO STATEBUIL�INGSURCIIAHGE i <br /> ASON FOR SPRINNLERS — <br /> � <br /> SIATE ENEflGY SURCI IARGE � <br /> APPLIC�iIONACC.BY PUNSAPPROVEDBV CITYOFEVEflETT pl18LICWORK$ � <br /> LOCAL SALES ' <br /> TAX CODE IS 3105 T0TI1L ; <br />