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� APPLICATI�..� FOR CONSTRUC7,ON PERMIT everett <br /> �� e <br /> rn�,e�re,y,een TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITV OF <br /> ,� everett HEATING SYSTEM: GAS ❑ELECTR�C ❑ <br /> BUILDING DEPARTMENT <br /> � 259-8610 � � <br /> Ci DEMOLITION �/COMBINATION BUILDING CI MECHANICAL ` : PLUMBING _I SIGN <br /> � ENANT��� yqI�DDRES� � CITM ZIP PHONE <br /> �1 ��/ Z"�Z-�il3cy/, <br /> � � r CIiV 21P PHONE <br /> M•-• <br /> � ARCHITECT OR D J�'� MAIL ADDRE[S dTV ZIP PMONE <br /> l+ GENERALCONTRAC MAILADDRE55 CITV ZIP PNONE LICENSEI <br /> - ���,e <br /> M MECNRNIGALCONTRASTOR MAILAODqESS CITY ZIP PHONE �ICENSE• <br /> o( _ S��r' <br /> � PLUMBINGCOI{TqA�p� MAI AD�RESS CITV ZI� ��pHONE LICENSER <br /> 5� r ��n, ►r�F e Ia Za,A� � <br /> CUSS OF WORN <br /> 3r�o� <br /> �Cl NEW �DDITION ;__I ALTERATION . I REFAIR i I DEMOLITION ' .' WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> p CONTACT PERSON ANO PHONE NO. <br /> T�r CONTRACTPRICEOFWORK - ��C�' .�a �/�'� <br /> R �ESC I � ORKAND OUARE OOTAGEINVOIVED z <br /> � 1 l <br /> ROPOSED S OFBUILDiNG � .{� ZSs I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> 'S� � � �� APPL�CATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � LEGAL OESCRIPTION OF PRO RTY�SHOWN BE W Ofl ATTACH FOUR COPiES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �or 77•� g e�ocK�F WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> „� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> .� CONTRACTORS LAW 18.27 RC 9620D WAC. <br /> SIGNATUREOF A TORO AUT RIZEDA ENT DATE <br /> PROJECT AD�������� � � / //ii <br /> � S/(/`� < <br /> APPIICANTSCITYB SINESSLICENS[NO.ANDBl151NESSNAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIICTURE OR ITEM FEE N0. TYPE OF EOUI�MENT �E <br /> WATER CLOSET(TOILET) � lUC--qiHNDLG UNITS--4.P. <br /> BATHTUB � ' <br /> , FORCED AIR SYSTENS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS--B.T.U. M � <br /> SHOWER � CLOTHES DRYERS <br /> KITCHEN SINK&DISP ; VENTILATION FAN � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY ' WATER HEATER � � <br /> CLOTHES WASHER � � WOODSTOVE � <br /> � <br /> I AL ' METAL FIREPLACE 8 CHIMNEY —�— <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DFAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> flOOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � <br /> � , <br /> � ' <br /> SUB TOTAL $ !— SUB TOTAL $ � <br /> PERMIT $ PEAMIT $ ' <br /> TOTAL FEE $ /(' � � TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: <br /> FNONTSETBRCK PEAflSETBACK SIDEScET6?CK PLANCNECNNIpIMBER .FEE ^v/ �3 �qECE1PTN0. �/ <br /> USEZONE�' �• J �7S/U O�`'f)C• �� �� J <br /> LOTAREA VACANTSITE FEES VALUATI FEE <br /> �� � �� BUILDING / � <br /> TYPEOFCONiS.AILOWABLE IVPEOF NSiACIUAL occuPeHCr HoarV�vRUNGUNns � S�tO 3�4 ' S� <br /> • _N -� cao� 1 PLUMBING �s';O O <br /> SI�pF,�g�pGF NO.OFSTORIES BASEMENT � <br /> Y�� S �Ne/ 2 � MECHANICAL � <br /> 1i <br /> OCCUPANCV LOAD F!RE SPRNKLERS HEO'0 HEIGHT LIMITATION ADOITIONAL PLAN CHECK �( p � q <br /> / � <br /> �'� OTHER ' <br /> PEASON FOR SPPINKLERS , � <br /> �T <br /> STATE BUILDING SURCHARGE Y �S G <br /> INTANE BY PLANSAPPROVED BY CITY OF EYERETT PUBLIC WORKS � <br /> � LOCALSALES J� � DO <br /> , Q�2 TAX CODE IS 3105 rora� � <br /> 39 � 7:>' <br />