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�— <br /> APPLICATIOI�^FOR CONSTRUCTI( Y PERMIT� ��«Pt� <br /> fheEvergreon TO BE COMPLETED IN INK—PLEASE PRINT � <br /> everett HEATING SYSTEM: ❑GA TRIC �/ ) . y�i� <br /> BUILDING DEPARTMENT — — <br /> 259-8810 � <br /> DEMOLITION COMBINATION ✓BUILDING : MECHANICAL PLUMBING SIGN <br /> WNER ^ 2 M ADDR/E�5/5� T ' I GITY ZIP ''') PHONE <br /> TENANI�mIT 1 `t_elAYYlM�oOh� I�O 1 uI�X �1'CIT� J-'~rC Z'l V LO� PNO����� <br /> ARCNITECTORDESIGNER MAILpDDRESS CITY ZIP PHONE <br /> GENERr1L CONTRACTOR M�AIL AOORESS CITV ZIP PNONE ��CENSE i <br /> Sa.� (ow��� <br /> MECHANICr1LCONTRACTOR MAILADDPESS dTV 21P PHONE LICENSE• <br /> PLUMB�NGGONTRACTOR IA�ILADDRESS LITV ZIP PHCNE UCENSEs <br /> CLA55OF WORK <br /> �.�W '�.- � ADDITION . � ALTERATION . I REPAIR . ! DEMOUTION �. ! WOODSTOVEIFRPL INSERT L� BUILDING RELOCATION <br /> �y_�p,�.� ��F�.�. LON�TACTPERSON,lNOPNqNENO c (� <br /> CONTRACTPPICEOFWORN !/`^�11�.���1 I��(� �yS C7UQ�� <br /> �ESGRIBEWORKANDSOUPREFOOT�EI�OWEU SWO �� � <br /> r <br /> �F- <br /> PROPOSEDUSE c oiN 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> e ^� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> LEGAL DESCRIPTION OF PROPER �SMOWN BELOW OR ATTACH FOUR COPIES) � h� PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> S� CfS l QOR � WORK WILL BE COMPLETED WITH WHETHER SPEGIFIED HEREIN OR <br /> �or �I �Z e�ocK q'�� oF ' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OP 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 COMPLV WITH THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> SIG! \TUPE OF CONTRACTOR OR RUTHORIZED AGENT DATE <br /> 1�'�, �/y� ^(\�\ <br /> -+-F� �trrYk.—V�T,+-� X \ �� KU�"�" 1 "�"ia'I�K� 1 Z� "l'� <br /> ' PROJECTADDRE55 � <br /> J � � ��i ��`� 'nv RPPLICANTS CITY BUSINE55 LICENSE NO.ANO BIISINE55 NAME <br /> K+� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXiURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) AIC—A/HNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> , DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY ' ; WATER HEATEA ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLA 8 CHIMNEY ' <br /> DRINKING FOUNTAI i FIREPLACE E i <br /> FLOOR DRAIN � HEAT P P ' <br /> BACKFLO EVENTERS ; GA IPING � <br /> ROOF AINS—RAINLEADERS HAUST FAN � <br /> SI (SERVICE—BAR,ETC.) � � <br /> � � <br /> � � <br /> , � <br /> � � <br /> SUB TOTAL S ' SUB TOTAL $ ' <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: is'�-9t � <br /> FRONT SETBACN REFR SETBACK SIUE SETBACK PLAN CMECK NUMBER FEE RECEIPT NC. <br /> � /O � /O � 9' a� so � 4/, 1 - Ft" y'r�ir' <br /> use zoNe lOT AREA VACANi 51TcE�(� FEES VALUATION FEE <br /> G � "V BUILDING � VuJ ;7� 1.T ' � <br /> iYPEOiCON75.dLLOWA6lf fVFEOFCONST.ACIUAL OauPwr xOMRtiEu�.AtuYrs � <br /> 1�_ .� / V _ �✓ faa"� PLUMBING ; <br /> y 'V .v <br /> SIZE OF BLDG. NO.OF STORIES BASEMENT MECHANICAL � <br /> �-`—' ADDITIONAL PLAN CHECK �j i <br /> OCCUPANCY LOAD FIRE SPRNKLERS REO'D HEIGN��ION !� J SS ��� <br /> / <br /> N(� OTHER � <br /> REASON FOR SPRINI:LENS <br /> STATE BUILDING SURCHARGE i.� <br /> INTAKE BY PLANS APPROVED BY CITY OF EYERE7T PUBLIC WORKS �.�� d O <br /> � LOCAL SALES , <br /> „� ��I �h TN(COOF.IS 3105 rora� ��,7 �� <br />