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"1� �, <br /> APPLICATIO�FOR CONSTRUCT�'.;:�N PERMIT everett <br /> �„E,�,o,�,,, TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF }} ' <br /> eVerell ' HEATINGSYSTEM: �GAS ❑ELECTHIC 0 � <br /> BUILDi'VG DEPARTMENT � <br /> 259•8810 I <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑MECHANICAL C'PLUMBING ❑ SIGN <br /> �R MAILADDRESS C�TY 21P PIqNE E <br /> v�-� � .lPa�,f� �1v2� //SA�c NE k,y/c%.�f , Pp3y 8'�D OY/2 '� � <br /> TEIWIT M�ILAOOPESS CITV ZIP PHONE i <br /> 1 <br /> ARGMITECTOflDESqNER MAILADDRESS /I CITY ZIP PHpNE � <br /> S}pn.r�-v,r �if;4� �SJUC. RD• iJJ✓ 3/ /�a�c�..���P 58073 8G 9-71 S�/ ' <br /> OENERALCANTRACTON MAILADDflESS CITY ZIP PMONE IICENSE� � <br /> So..� sf a6o�a [EAvzGGcJ /l8n'8 ; <br /> MECHANIGILCONTMCTOR MML�DDPE55 CITY ZIP PNONE UCENSEt i� <br /> �o i ro� /-l�c�%..� T� 36 0 i —/2/ S. c✓. Ly,.�,...o„✓ 98 03� 7Si5 3�3� i <br /> PLUMBRKiCONTMCTOR MAIIADDRE55 CITY ZIP PHONE LICENSE� <br /> C'r< ��1 P/u»�1;.,� /71�s 1G A..c S•C. Oo�/� /✓� i�iz 3ss6o/S _�z� 07 �,cRFri-iGydv� <br /> CLASBOFWdIK ' '• <br /> L�NEW ❑ ADDITION CI ALTERATION C7 REPAIR I I DEMOLITION f I WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION j; <br /> r <br /> CANUGi PERSON AND PHONE NO. p �{ <br /> CONTMCT PRICE Of WORK + r. � O �O D Y/L y� <br /> G_✓i � <br /> DEBCRIlE Wq11:AND30UAflE FOOTA6E INVOLVEO �� <br /> /3?4' S f r <br /> � <br /> PROP06EDU5!iOFBUILDI O I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> Rer;����/u � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL { <br /> LEOAlDESCF' '7N0.� OPERTV�SHOWNBELOWORATTACHFWRCOPIES� PROVISIONSOFLqWSANDORDINANCESGOVERNINaTHISTYPEOP I� <br /> u+?i_ � ' / �.ocu I S8 pF t�• D F E��I� WORK WILL OE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ��-� NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO �IVE <br /> �C 1 7 � �aCLt 30 Qi t p.c(/ D 7' OTHER STATE OR LOCAL LAW REGULATING CO STRUC�T ON OR THE <br /> PERFORMANCE OF CONSTHUCTION.THAT I AM AUTHORIZED BY THE ' <br /> .1/r :��� O.o+ i J� �J 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 296200 WAC. �: <br /> SIGNANPEOFCONTRACTOROPAUTHORIZEDAOENf DATE <br /> NIQIECT � �7s�LY v' �-GCh�L� ' <br /> � � /'I�JS�� ST APPIIGWTSCI BUSINESSIICENSENO.ANDBU5INESSNMIE <br /> � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF flXTURE ON REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � — N�AlHNDLG UNITS—H.P. , <br /> $ BATHTUB ; — / FORCED AIR SYSTEMS—B.T.U. M E.A. � <br />� 3 LAVATORY(WASH BASIN)� '� — UNIT HEATEHS—B.LU. M ; <br /> SHOWER � / CLOTHES DRYERS <br /> KITCHEN SINK 6 DISP , - VENTILATION FAN � <br /> / DISHWASHER �- / RANOEHOOD , 1 <br /> LAUNDRYTHAY ; / WATER HEATER � <br /> / CLOTHES WASHER '� — WOOD STOVE ; � <br /> URINAL ' / METAL FIREPLACE&CHIMNEY � �! <br /> DRINKINO FOUNTAIN � FIREPLACE INSERT ; i <br /> FLOOR DRAIN � HEAT PUMP � '� <br /> BACKFLOW PREVENTERS ; X GAS P�PING � �I? <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN , t�. <br /> , r;a <br /> SINK(SERVICE—BAR,ETC.) , , }; <br /> � � <br /> � � <br /> � � <br /> ' � I: <br /> � � , <br /> � � 1 <br /> , <br /> SUB TOTAL $ �i� SUB TOTAL S !;; <br /> PERMIT 3 � PERMIT S ; j <br /> TOTAL FEF. S ''— TOTAL FEE S �- <br /> L, <br /> FOR OFFICE USE ONLY: � <br /> FHONT6ETBACN, REARSET&1CK SIDESETBAC� PLANCNE KNIIMBER FEE � HEGEIPTNO. k�� <br /> 2U 't0 ' S � - ---- <br /> ueeMr�E LOT�PEA VACANTSITE FEES VALUATION FEE <br /> -L 2A9 � !� 724 �i <br /> BUILDING � t` <br /> TYPEOfCONTS.AIIOW/�BIE MEOFCONSf.I�tNAL occuruA xoamttiuxcuNns � <br /> ���P PLUTABING ' � �' <br /> I <br /> SREOFBLD6. NO.OFSTONIES B�SEMENT MECHANICAL � 1. <br /> Z . I. <br /> � <br /> OCCUPANCYLO�D FIPESPRNKLERSREO'D HEIOMTLIMITbTI� A�DITIONALPLANCHECK � �1• <br /> Z� � �' <br /> flEA50NFOR5PflINKLEPS OTHER ; �, <br /> STqTE BUILDING SURCHARGE ;ij n <br /> _� k; <br /> INTAKEBV PIANSAPPROVEDBV CITYOFEYERETT PUBUCWORNS i �.n � <br /> �� LOCALSALES _ � <br /> I��� TAX CODE IS 3105 ror�� <br /> � .. <br /> _ <br /> , � <br /> . <br /> . <br /> � <br /> L _ __ _.__.____........__..._............ ....._ <br /> _ . ., . ..._,�__-,- <br /> . . ..._,.—�.-y-.�,-,,..-.,�._.�.".,.-..� <br />