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AF►PLICATION FOR CONSTRUCT■JN PERMIT <br /> everett <br /> tne I.'veryrecn � <br /> CITV OF <br /> ��� everett <br /> BUILDING DEPARTMENT <br /> y TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> �Hx v� '7 DEMOLITION _:i COMBINATION X BUILDING MECHANICAL 'PLUMBING � SIGN <br /> y �9 .�' OWI�ER MRILADORE55 CITY 2�P PNONE <br /> � I�1L1,�r:v IN�/� {'•D• !�i( �5� ��lERt%iT �2a� Z�g�A��ri <br /> K � <br /> y� TENRNT MRILRDDRE55 Cltt ZIP FNDNE <br /> �y� �X,�;"'� �'';11.117 �IDIJ�I' (.�tT�R IDD�'i P6LI�tL. bc� L�'Y�t3�1'i" �2.01 Z�-�l�J�'i <br /> �FCHITECT OR OESIGNER A1All R�DRE55 � GTV ZIP ONE <br /> �y�o� K»'1"�GH Nbc�.�lt� I,�hI.L <}ZO(o Nb'f'I� 6��/tGi �V�1�bT9' �n2o� 2�'OS/8�y�� <br /> F] rJ GENERALGONTPA TO�� AlA�1�A.��DoRE55 Cltt 21P PNONE LICENSE� NCK'�'LAL�i'Ip'L� <br /> Q�� ��NICl�LCONiRRG!OR MRIL�DD v��� /� � �O ����i �L�����I Z5`1—�1191 <br /> 7' y� PWMBINGCONiFACTOR A:`�lA0�RE55 Cltt 21P PHONE � LIGENSE� <br /> � <br /> i-+H <br /> {y fA cussovwoaK _ � <br /> n d y i ] NEW .� ADDITION X ALTERATION :J REPAIR [.� DEMOLITION L; WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br /> TEN�NT IMPROVEMENT OR INTERIOR REMODE�ONLY CONTACT PEPSON AND PHONE N0. <br /> �/� � � <br /> � �pNTPACTPRICEOFWDNN: (/v � � <br /> y 0 y DESCR�BE WUHN RNO SOURRE FOOTAGE IN VED <br /> PR�E�USEOFPUILDING � A� I HEREBV CERTIFY 7HAT I HAVE READ AND E%AMINED THIS <br /> KIDN�^f C�N1�t'i � Y�DIt.I'[l+ 6N��L APP�ICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> L[GALDESCRIPP�NOFPROPERTV�SHOWNBELOWORATfRGNFWNGOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEflEIN OR <br /> �ar e�ocK oF NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTO LAW 1827 RCW AND 296200 WAC. <br /> _- SIGNnT�REOF �iALTORORAU ORREDRGENT DATL <br /> '_t PNQIE��DDAES� � ' ' App�� CITYBUSINESSLIC[KSENO.ANOBIISMESSNPME <br /> ' ' PLUMBING MECHANICIIL <br /> � NO. TYPE OF FIXTURE-0R ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> '�1 WATEfl CLOSET(TOILET) A1CrlUHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> IAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> '�' SHOWER CLOTHESDRVERS ' <br /> 1 KITCHEN SINK 8 OISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> ' LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOODSTOVE <br /> '� URINAL METAL FIREPLACE 8 CHIMNEY � <br /> � �RINKING FOUNTA�N FIREPLACE INSERT � <br /> f FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> � ROOF DRAINS—RAINLEADERS � E%HAUST FAN <br /> i�; SINK(SERVICE—BAR,ETC.) I <br /> i <br /> � <br /> �t� � <br /> I� SUBTOTAL $ SUBTOTAL $ ' <br /> PERMIT $ � PERMIT S <br /> TOTALFEE $ TOTALFEE 5 ' <br /> FRONTSETBAGN RER'SETBPCK SIDESETBACK PLANCH �IIMBEN FEE J 1^C REC iN�� <br /> �� s i �-�15�0 6 <br /> (y <br /> useioru, � LOTARE� vncnxrsiTe FEES VALUATION FEE <br /> �� Li YES - N� BUiLDiNG �� <br /> tYPEOiLONSi�LIOWABIE iVPEOfCONSi.ALIDFL aaveNCr x0aow[wxcurirt5 <br /> uv p�UMBING <br /> -- - ► N+-R- -2 <br /> SREOFBLOG. NO.OFp'�JRIES Bn5[MENT MECNANICAL <br /> 2 � �� (. i 1 YES rr� NO <br /> OCGUPANCYLOPD FIRESPRNKlFR,S`/REOD NEIGNTLIIdITRTIDN OTHER <br /> 'tg ! 7 YES �{ NO �� STATEBUILDINGSURCHARGE <br /> i � <br /> RERSON FON SPRINKLERS � <br /> S7ATE ENEfiGV SURCNARGE � <br /> APPLiGATIONAC BY PIANSAPP/ROVE BY CITY OF EVEflETT PUBLIC WORKS <br /> -'�+ r�:-� T1IXCODE SL3105 T�Tp� <br />