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APPLICAT14�1 FOR CONSTRUC�":bN PERMIT everett <br /> ,�E,�,y,,,,, TO BE COMPLETED IN INK—pLEASE PRINT � <br /> arv oF } <br /> eVere�l HEATINGSYSTEM'. ❑OAS. pELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I I DEMOLITION I_I COMBINATION O BUILDINO ❑MECHANICAL )3(PLUMBING I 1 SIGN <br /> f)WNER MAR AO�RESS �qy Z�p p�pNE <br /> f�i,iaYa��aK� �3�4 5,�.;e.l(¢� s;. .���Z `�$144— '3�,4(o�i(n <br /> TENANT MAIL ADOPESS ��Ty I�p pHp�E <br /> \, <br /> 11HCHITECTOqOESqNER M�ILADORE55 CITY ZIP PkiONE <br /> CENENALCpNTR�CTOH MAIL�UDRESS CITV ZIP PIIONE LICENSEI <br /> MECNMlIC�LCONIRACTOR MARADDRESS pTY ZIP PHpNE IICEN5E1 <br /> PLUMBiNOCONTR�CTOq MT0.ADONE55 CITY 21P PMONE LICENSE� <br /> �.1�w,Qa� e (�. ��,c�iz�rr t`�`�U �rP.�H 9YOiz �4zc�, e�av+noQBS�- <br /> CUSS OF WIXiK . <br /> NEW ❑ ADDITION ❑ ALTERATION C I REPAIR ❑ DEMOLITION U WOODSTOVE/FRPL INSEHT ❑ BUIIDING RELOCATION <br /> S PJ1D�. 'TjY(1'�� �{ �7� � CONTAC'TAPERSONANOP/IqNENO, <br /> CONTR�CTPNICEOFWqiK `���•✓' ,�/1���,1���.1.s „�C��` <br /> DESCN9E WOi1K AND SOU�RE FOOTAOE INVOLVEO ^ � "T'�-��- <br /> PIqPp5EDU5EOF`B1U,RDMI(i I HEHEBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> N`V�- APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LE6�L DESCpIPiqNUF P{qPERTY� BELOW OR�TT�CH FWR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior BIOCK ov NOT. THE ORANTINO OF A PERMIT DOES NOT PRESIIME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW RE6ULATIN(3 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CnMPLY WITH THE STATE <br /> CONTRAC70RS lAW 1827 RCW AND 296200 WAC. <br /> SIONANREOFCONfRACTONORAUTFqRIZEU�OEt�f OATE 4`7l <br /> Oz'�74K/' � /////7 <br /> PRO.IECT ADORES$ � I � � N�4..�`PAtI�'y���...rM.� <br /> APPL �TY SINESSLICENSENO.ANOBUSMESSNAME � <br /> �I/tsT <br /> PLUMBINO MECHANICAL <br /> NO. TYPE Of fl%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � AI�AlHNDIa UNIT�H.P. , <br /> BATHTUB � FORCED AIR SYSTEMS-B.T.U. M E.A. � <br /> 12 UVATORY(WASH BASIN) � UNIT HEATERS-B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD T— <br /> LAUNDRYTRAV ; WATEFiHEATER � <br /> CLOTHES WASHER i WOOD STOVE ; <br /> URINAL ' METAL FIREP_ACE 3 CHIMNEY � <br /> DRINKIN6 FOUNTAIN � FIREPLACE INSERT ' <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PRF.VENTERS ; QAS PIPINa ; <br /> ROOF DRAINS-RAINLEADERS � E%HAUST FAN � <br /> SINK(SERVICE-BAR,ETC.) ; � <br /> � ; <br /> � � <br /> � i <br /> � , <br /> � i <br /> SUB TOTAL S i SUB TOTAL S ' <br /> PERMIT S � PERMIT S � <br /> TOTAL FEE S ,�. C> ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�CK PEAPSETBACK SIDESETBACK PLANCH CKNUMBER FEE RECEIPTNO. <br /> 7�`� <br /> USE 20NE LOT�RE� VACANT SITE FEES VALUATION FEE <br /> BUILDIN6 i <br /> rvPf Oi COMIS.�IlOWABtE TYPE Of CONST.ACN�L aGpu¢r x0 a Owtunw UnR � <br /> 0R0UP PLUMBINO � <br /> SIZEOFBLDO. NO.OFSTORIES BASEMENi MECHANICAL • i <br /> � <br /> OCCUPANCY l�AD FIRE SPRNI(LERS REOD HEICiIT L�MIT�TION ADDITIONAL PUN CHECK j <br /> OtNER i <br /> REASON FOR SPRINKIERS <br /> � <br /> STATE BU�LD�NG SURCHARGE i <br /> � <br /> INIAKEBY PLANS�PPNOVEOBV CITYOFEYEREIT PUBLICWOflKS � <br /> LOCAL SALES � <br /> TAl(CDUE IS 3105 TOTAL � <br />