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NcJ��� <br /> APPLICATIO.J FOR CONSTRUC"1'.JN PERMIT everett <br /> the Eveigreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: ❑GAS ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> i� DEMOLITION �'COMBINATION !_1 BUILDING G MECHANICAL ❑ PLUMBING ;7 SIGN <br /> OWNER MRIL ADDRESS CIN ZIP PHONE <br /> Mar�,h f�ins,4�i„ /5/�/M(��/� /_=����7t U/r9 98:7� �ZS —i2�o <br /> iENANT MAIL ADORESS CITV ZIP PHONE <br /> ARCHITECTOflDE51GNER MAILA�DRESS CIiY 21P PHONE <br /> 23/ <r� t /' � :a 7 ' 9 <br /> GENE LGONTRACTOR MAILADOflE55 �I Y 21P PHONE LICENSE� <br /> /llU� <br /> MECHqNICALCONTRRCTOR Mr11LPODRESS CITV ZIP PHONE UCENSE� <br /> PLUMBINGCONTRAGTOR MNLA�URESS CIN ZIP PNONE LICENSEi <br /> CUSS OF WORK . <br /> ❑ NEW Q� ADDITION ❑ ALTERATION C.' REPAIR ,7 DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> CONT�q/C%T PERSON AND PNONE NO. <br /> LONTRACT PRICE OF WORK . �� "/ON/(� HH /'1 fZ1 <br /> DESCRIBE WORK AN�SOW RE FOO AGE INVOLVED <br /> T ' ' .� 29 � <br /> PPOPOSEDUSEOFBUILDING 1 HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESCRIPiIONOF PROPER �SMOWN BELOW OR ATTALNFOURCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �or /O-// e�ocK3�Y -pOpF �v yy ' �"]'- � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> —� NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> i� AUTHORITY TO VIOLATE Oq CANCEL THE PROVISIONS OF ANY <br /> �'[�tI'�7'� a�+ � " ��l' o� OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ��piG .�/f' ^ 00 f D _ � OWNER OF THtS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> C OOdD/ 2 � / CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNATUREOFCONiRRCTORORAUTH IZEDRGENT �4TE <br /> PR0.IECTADDRESS � ��%%����- ' <br /> � /� !� APPLICANTSG U ESSLICENSENO.ANDBUSI4ESSNAME � <br /> .7 /- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF ECUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/�P✓HNDLG UNITS-H.P. � <br /> . BATHTUB s ; FORCED AIR SYSTEMS-B.T.U. M E.A. � <br /> � LAVATORY�WASHBISIN)� ,� � UNITHEATERS-B.T.U. M ; <br /> 1 SHOWER � CLOTHES DRYERS � <br /> / KITCHEN SINK�i�MJ! �� ; VENTILATION FAN ; <br /> i DISHWASHER � RANGE HOOD � <br /> � / LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER ,5 � WOOD STOVE ; <br /> URINAL � METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAI�' � FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ' <br /> ROOP DRAINS-RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE-BAR,ETC.) ; � <br /> - � <br /> � , <br /> � , <br /> SUB TOTAL $ ; SUB TOTAL $ �od " <br /> PERMIT $ PERMIT $ � <br /> TOTAL FEE $ '' TOTA�FEE $ � — <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBAC REARSETBACK SIOESETB ly PLANC CKNUMBER FEE ��/ � RECEIPTNO <br /> � 20 ' .�` �, �ia �o�� <br /> usezo e� LOTAREp vncnNrsrte FEES VALUATION FEE <br /> BUILDING C� L�8 �i) i <br /> TYPEOfCOHiS.ALLOWABIE 7YPEOfCONSi.ACiUAL OCCUPA4CY HodmVtuR;UxrtS � i <br /> rnouo pLUMBING <br /> s � � <br /> T <br /> SIZE OF BLOG. NO.OF STORIES BASEMENT MECHANICAL � '�- <br /> i333 5P � ^ ��v � <br /> OCCUPAN YLO�D FIRESPRNKLERSREO'U HEIGNTLIMITATIQN ADDITIONALPLANCHECK � 3 �v� <br /> 1 , <br /> N� OTHER � <br /> i <br /> REASON FOR SPqINKLERS � '�� <br /> STATE BUILDING SURCHARGE <br /> INTANE BY PLANS APPROVED BY CITY OF EYEREIT PUBIIC WORKS <br /> /f� LOCAL SALES ' <br /> Y 7�i TAX CODE IS 3105 TOTAL a � O� <br />