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� � . <br /> APPLICATIVN FOR CONSTRUCI �ON PERMIT <br /> � everett <br /> theEvcrgreen ������ e <br /> CITV OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> ❑ DEMOLITION CI COMBINATION �BUILDING ! i MECHANICAL LI PLUMBING f7 SIGN <br /> OWNER MAILADURESS CITY ZIP PHONE <br /> Nl�t/Q!</�'e cUiLlq`tMy PUf�iX /C2 Nt¢iFYSN/dl� �1�ZTL� �3-397g <br /> TENRNT MAIL ADDRE55 CITY ZIP PHONE <br /> N�G'T' 1r�Yd/Ct1'�G� <br /> ..�AR/C�NITECT DESIGNER� MAILADORE55- CITV q�21P �y�j �P����/O�NE a/J�y�� �/��j/� <br /> �li ER�/ / �T�OF��("-rM�I�A NE I��f� //IfiVl[/� �p � Ii���Gl/Li1V PII"LiJI 'IZ'/f�L%ENSE�� - 7//`// <br /> � �� `�-��r?�17 <br /> MECHANIGALCONiR�CTOR MAILADDRE55 CIN ZIP PHONE LIGENSE� <br /> �� �� <br /> PLUMBINOCON7RACiOR AIAILROORESS CITV ZIP PHONE LICENSE� <br /> �J �� �'7�'�Tt�'t� <br /> CU55OF WOPK � <br /> � NEW LI ADDITION CJ ALTERATION CI REPAIR ❑ DEMOUTION L] WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br /> TEN�NTIMPNOVEMENTORINTEN RREMOOELONLY CONT�CiPE1150NANOP110NEN0. <br /> � ,ti �r, 2r�) <br /> CONTHACT PNICE OF WORK; �' ' <br /> DESGRIBE WORK�ND SOUARE FOOTAGE INVOLVEO �/��2��i�JJ�7\! <br /> /�ES/ `�"' / <br /> PROPOSEDUSEOFBURDRHI I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �j�,�/� �� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL UESCRIPTIONOFPROPER1V�Sf OWN BEIOW OR ATTACN FOURCOPIES� PROVISIONS OF LAWS AND OHDINANCES GOVERNING THIS TYPE OF <br /> —y���, WORK W�LI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �o'`."�Z�iocK �ZZ oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> A�THORITY TO VIOLATE OR CANCEL THE PROVI510NS OF ANY <br /> �j OTFIER STATE OR LOCAI LAW REGULATING CONSTRUCT�ON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF TNIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> . APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> r CONTFiACTORS LAW 18.27 f1CW AND 296200 WAC. <br /> � SIONAIUREOFCONIO�CTOROBAUIPpRRED�GENT UAIF <br /> �"CIYN� � ,6�t���GGG�_5 3-� <br /> PR���� (�v�-����� �� •�/T//� APPUCANT.^-CITV BUSINESS LICENSE NO.ANO BUSINESS NAME <br /> /i/!(/� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM F E NO. TYPE OF EOUIPMENT FEE' <br /> � WATER CLOSET(TOILET) NC—PiHNDLG UNITS—H.P. � <br /> BATHTUB ;� FORCED AIR SVSTEMS—B.T.U. M E.A. � <br /> LAVATOHY(WASH BASIN) �" UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTNES ORYERS � <br /> KITCHEN SINK 8 D�SP ;— VENTILATION FAN ; <br /> DISHWASHER r RANGE HOOD —i— <br /> LAUNDRYTRAV ; WATER HEATER � <br /> CLOTHES WASHER �� W000 STOVE ; <br /> URINAL ' METAL FIREPLACE& IMNEY � '— <br /> DRINKING FOUNT � FIREPLACE INSER ; <br /> FLOOR DRAIN � HEAT PUMP —�— <br /> BACKFLOW EVENTERS ; GAS PIPING ; <br /> ROOF D INS—RAINLEADERS � EXHAUS AN —�— <br /> SINK RVICE—BAR.ETC.) ; ; <br /> � ; <br /> —,-- <br /> � / ; <br /> � -- — <br /> SUB TOTAL $ ;^ SUB TOTAL $ �, <br /> PERMIT $ —r PERMIT $ 'T <br /> TOTAL FEF $ ' � TOTAL fEE 5 � <br /> POONLSE�lJOA�CK ' OEMSEIO�CN SIOESET��CN PL�NCIIECKNUMOBfi fEE IIECEIPINJ. <br /> 4ti �' S �d aYSY.3 �i3-3a �33�' Z <br /> use zoN LOi AREA I' VACRNT SITE / FEES VALUATION FEE <br /> '�Z .�7�yk�Zv ^ TSW LI YES /rI NO BUILDING 6S �(O "�"[� � <br /> 7VPC Of CONSf AIIOWABIE 7YPf OF CON57.AC7UAL o[cUrexcv xo IX Vx�uix6mvli5 <br /> �-' pW� ' PLUMUING ' <br /> i' <br /> SIZE OF OLDG. NO OF S10filE5 DASEMENT MECHANICAL �ry �� � <br /> Cl(o SF Z C7 VES _ NO r��— <br /> OTHER ' <br /> OCCUPAN V JPD FIPi SPRNNlERS f1E0'D HEIGIIi LIMITAiION � <br /> /} C] '��S D�NO �� <br /> STATE BUILOING SURCHARGE � <br /> RE�SON FOIISPRINNLERS � <br /> STATE ENERGY SURCI IARGE i <br /> nrrucnvor+ncaer PLANSRPPROVE�BY CITYOFEVERETf PU�IICWOPKS � <br /> Q� LOCAL SALES ' ' <br /> / ti ,- TAX COOE IS 3105 TOTAL l ^� <br />