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_. , ,.: . .. <br /> . . . . .... . . . . . : �... ._ �. . �.vw�: <br /> . . . . ,.._ . .i . ._ . . .... _ _. . _ . .. _. ... . ..:�.u_�:.:.:'i:.:r^. . . y,�c� <br /> APPLICATI�N FOR CONSTRUCI rON PERMIT � <br /> Ihe Everpieer everett � <br /> CIl'i OF � . <br /> everett <br /> BUILDING DEPARTMENT ' <br /> �259•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOLITION I 1 CO��BINATION f I BUILDING I_I MECHANICAL I I PLUMBING [_l uIGN <br /> Q�'!ER MAIL��OflE55 CIiY ZIP PHONE <br /> I/1UL SR.�.CE/� „ � � <br /> BuGvsT M�Re�'ticN --I35 �oc�t���cc�Z c:✓C�c�'r y8:�/ 3�3- /3z3 <br /> TE�N��qT MAIL ADDRE55 LITY 21P PHONE <br /> Nnn/E <br /> ARCHITEGTORDESIGNEH MAILADOflESS CITY :ip PHONE <br /> /V v�E <br /> i <br /> GENERAL GONTR�CTOR MAIL R��qE55 CIN ZIP PHONE LILENSE I <br /> MECH�NICAICONTRACTOR M�ILAUDRESS CITV ZIP PHONE ULENSE� � <br /> /�./n✓� <br /> PLUMB/INGCONTNACTOR A161LADDRESS CITY ZIP PHONE LICENSEI ' <br /> /VO�YE. f <br /> CLASS OF WORK � <br /> [.] NEW C7 ADDITION ❑ ALTERATION ❑ REPAIR �DEMOLITION f_1 WOODSTOVEJFRPL INSEFT ❑ BUILDING RELOCATION �� <br /> TENANT IMPROVL '_,�i un INTERIOR REMODEL ONLY CONT6Ci PERSON RND PHONE NO. ' <br /> LONTNACT PRICE OF WOflK; <br /> DESCPIBE WORK AND SOIIANE FOOTAGE INVOLVEO <br /> I <br /> PROPOSEDUSEOFBUILDING I HEREBY CERTIFV THAT I fIAVE READ AND EXAMINED THIS f� <br /> l�C A'�OL i T/O�/ SF/�.- APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> IEGAL0E5CRIPTqNOF PROPERTV�SM �OW OR A 011 ri PROVISIONS OF LAW'AND ORDINANCES GOVERNING THIS TYPE OF � <br /> � � �7- WILL BE COMF��_TED WITH WHETHER SPECIFIED NEREIN OP i <br /> �oi L� eiacK op • ' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE 1 <br /> AUTHORITV TO VIOIATE OR CANCEL THE PROVISIONS OF ANY ' <br /> Z `I Z Z pAKS �y39' - 68�5'�- z.o -o�a OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE i. <br /> PFRFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE � <br /> UWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE � <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGN�TURE OF GONiFACTOH OR AUTHORIZED FGENT O�TE <br /> ': <br /> X �•, <br /> PROJF.CTADDFE55 <br /> a 9 aa� APPLICANTS dTY BUSINESS LICENSE NO AND BUSINE55 N�ME � <br /> PLUMBINO MECHANICAL '' <br /> NO. TYPE OF FIXTURE OR RF.M FEE N0. TYPE OF EOUIPhiENT FEE <br /> WATER CLOSET(TOILET� � A/C—AlHNDLG UNITS—H.P. , j, <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A. � <br /> t <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; i <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ' � <br /> � <br /> DISHWASHER � RANGE HOOD i i <br /> LAUNDRY TRAY ; WATER HEATER � � <br /> CLOTHES WASHER � WOOD STOVE ; ; <br /> URINAL � MEl"AL FIREPLACE 8 GHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRA�N � HEAT PUMP �— � <br /> BACKFLOW PREVENTERS ; GAS PIPING ' , <br /> � ROOF DRAINS—RAINLEADERS � EXHAUST FAN � � <br /> SINK(SERVICE—BAR,ETC.) ; �— � <br /> � � <br /> ., <br /> � � I <br /> i - i <br /> i ' <br /> SUB TOTAL $ ; SUB TOTAL $ ' , <br /> PERMIT $ � PERMIT $ � � <br /> TOTAL FEE $ � TOTAL FEE $ � `+ <br /> FRONTSETB�f.N pEARSETBACN SIOESETBAGH PLANCHECKNUMBEfl FEE PECEIPTNO. . <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> I_] YES ❑ NO euaDING � �� <br /> ttffOfCONST.�LLOW�BIE ttPEOFLpN4.�CNnt occw,mcr naaownuxGuxits . <br /> GPWP 1 <br /> PIUMBING ' <br /> � <br /> SIZEOFBLIX'i. NO-0FSTORIES B�SEI.IENT —T— ' <br /> MECHANICAL i • <br /> i7 YES ❑ NO <br /> OGCUPANCYLOAD FIRESPRNKLEflSREO'D IIEIGNTLIMI7ATION OTHER � , <br /> f l YES I I NO STATE BUILDING Sl1FCHARGE � <br /> REASON FOR SPRINNLERS <br /> STATEENERGYSURCHARGE � <br /> i <br /> APPLICATION�CC.BY PLANSAPPROVEDBY CITYOFEYEHEIT PUBLICWORKS � � <br /> LOCALSALES � i <br /> TAX COOEIS 3105 Tor�� � , <br /> � <br />