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' ,-. <br /> APPLIC.,TION FOR CONSTRvCT10N <br /> ,haE,�ro,aa� PERMIT <br /> CITV OF <br /> everett r°°��" <br /> BUILDING DEPARTMENT e <br /> 259•eeto T BE CO PLETED IN INK- pLEASE PRINT <br /> �N��/ STURM�N I?F¢1 4'�AV�IN1� S�,-i-r� wA zs�-szza <br /> M1IRILRDCRE55 CIIY 21P PNONE <br /> TEN�NT MAIL AD�PESS ��J� <br /> 21P PMOAE <br /> "L34�Ip fY, JAn�Es i.AtaEe�u.F�u� bR.#io¢. f3�lt�arUE 9goo5 �f�62- 84b9 <br /> ARpHITECTEAEL�lpq�11 MRIIAppRE55 J �jp <br /> Z�P PHONE <br /> .SCJ /� SFGG_C_'�/� <br /> GENERRLGpNTRRCTOR MAILADORESS <br /> ��/ ��iY VHONE <br /> ,-� Z�P IILENSE• <br /> MECHANICRLCONTRA�TOR MRILADORESS <br /> CITV 21P PNONE <br /> IICENSE• <br /> PLUMBINGCONiR��TOR MAILRpDRE55 CIiY <br /> Z�P PHONE LICENSE• <br /> �CL�S FYIOqK <br /> W ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLIiION ❑ WOODSTOVE/FqP�INSERT ❑ BUILOING RELOCATION <br /> TEN�NTIMPpOVEMENTORINTERIOFREM ELON/IJY CONiACTPER50NANDPMONEND <br /> CANTfUCTVRICEOFWpqK � �(T�� , <br /> VOIVED — <br /> BLLY A — E,9'�7 SQ Fi' <br /> nflWMEN7'S - ' IHEREBYCERTIFY?HATIHAVEREADANDE%AMINED�HISAPPLICATION .VD <br /> KNOW THE SAME TO BE TRUE AND CORRECT.ALL PPfNISIONS OF LAWS AND <br /> LEG�L DESCPIPTION OF PqOPERTV�SHOW N BELOW Oq�TTpCM FOUB COPIE51 ORDINANCFS GOVERNING 7415 TVPE OF WORK WILL BE COMPLETED WITH <br /> `otl 19 ��N �/ p` WHETHERSPECIFIEDHEREIIJORNOT.THEGRANTINCaOFAPERMITDOESNOT <br /> •r �((,S D/� PRESUME TO GIVE AUTHORI'�Y TO VIOLA7E OR CANCEL THE PROVISIONS OF <br /> AN V OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER• <br /> �'� / FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296200 WAC. <br /> — SIGNATUREOFCONTR4QOqOFqUTHOPIZEDPiENt DATE ��/,a��C� <br /> ♦ Q <br /> PROJECTAODRESS � ���0 � � <br /> AP ICANT CiyBUSME$$LICEN$ N RNpBU51NE55NAME <br /> PLUMBINO <br /> MECHANICAL <br /> �• TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> WATER CLOSET(TOILE'f) FEE <br /> A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M EA <br /> LAVATORY�WASHBASIN) UNITHEATEFS—flT.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> , _ DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKINCa FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> FOOF DRAiNS—RAINLEADERS EXHAUST FAN <br /> SINK�SERVICE—BAR,ETC.) <br /> SUBTOTAL S SUBTOTAL 5 <br /> PERMIT g <br /> PERMIT g <br /> TOTAL FEE S TOTAL FEE 5 <br /> FRONi5ET84LN REARSET6ICH SIDESET&'�CK PIANCHE RNUMBEH <br /> �� �� FEE .�.�� qECEIVTNO. <br /> USE20NE LOTAREA VAC�NTSITE � <br /> SJ � <br /> ckrEs ❑ No FEES VALUATION FEE <br /> BUILDING 8�93 Y � <br /> TYPEOFCqNST. OCCUPRNCYG80UP NOOFDWELIINGUNITS ��y /u 333 7Go <br /> �LLOWA�CTUR _� <br /> / � PLUMBMG <br /> SIZEOF6LDG. npOF510RIE5 BSMt. p�G�pqp <br /> ��.�� —1 ❑N 3 v MECHANICAL <br /> HEIGMT4MIiAiION �1 ^ <br /> OTHER � �� 1( L' "/ <br /> FIRESPNINNtER5RE0UIqED ❑YES O � <br /> STATE E ILDING SURCHARGE 3 <br /> L <br /> STATE ENERGV SURCHARGE � <br /> �PPLICRt10N ALG BY PLRNS�PPR.BY <br /> �_ \ PUBLIC WORKS <br /> { `"� l� 3� l�� <br /> Tora� Z r"� <br />