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. . . � . � . . . .., • �. '.'. a.. . .i.. ii.,J2 :Hi ' <br /> , . . .. <br /> „ <br /> , . . . ... . .. . .._.... .1._ .... . . . . �., . .. _. _ _ . _ . _ . <br /> . �.� <br /> APPLlCATION FOR CONSTRUCTI...�1 PERMIT everett <br /> meE�rero.ee� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: ❑GAS U ELECTRIC G <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> �DEMOLITION I 7 COMBINATION I I BUILDING I I MECHANICAL LI PLUMBING I 1 SIGN <br /> OWNEH MAILAUOPESS dTV 21P PMONC �'�J'J�.7J� .� -/ <br /> .�.Y�.F� IJI�/✓� %'��.Fj'C� ����� �L�Crr� / �J��� ��Cl��`i.J—`� 7-Y�— <br /> TENANT MAILADURESS CITY 21P PIIONE <br /> RRCNITECTOROESIGNEfl MRILR�DRESS CITY ZIP PHONE ���_�33� � �1-��I/J� <br /> lY�,F F R��N� P� f�Fx ��r�� Fv��fT7' ) f'��� �•��'-� �� s- r3Pii�G <br /> GENERALCONTRACTOR MAILAODRESS CITV ZIP PIIDNE LICENSEI <br /> MECHANICAL WNTRAGTOP MAIL ADDflF.55 LITY ZIP PHONE LILENSE I . <br /> PLUMBINGCONTF�CTOR MAILADDRE55 CITY ZIP PHONE LICENSE� <br /> CUSS OF WORK . <br /> ❑ NEW I-I ADDITION I I ALTERATION I I REPAIR xDEMOLITION I 1 WOODSTOVE/FRPL INSERT L i BUILDING RELOCATION � <br /> GONT��C/T P`ERSON RNO PHONE NO. -/ <br /> CONTRACT PRICE OF WORK �/�`' � �/��i�'' ` `�"S/����'" � <br /> /U�ESCRIBE WORK ANO SOUr1NE FOOTAGE INVOLVED / � <br /> //fi910 n� .�' /C c J 'T�i D L!S/Cr�� -� C`'Q ���-y/J�J`� <br /> PROPOSEDUSEO,FtBI{ILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> F/J�'��//CrU Or �' /� C-�f APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG�LDESCRIPTIONOFPROPERN�SIIOWNBEIOWORATTnC11FOURGOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF . <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior�_ BLOCN �_ oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �� . AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � �� > -�. ,� � ,5 «/ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE � <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> �5 �r P4?�!- /S!�CFROF/) //J �I�LV ['.' O OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH � <br /> APPLICATION IS MADE AND I COMPLY W�TH THE STATE <br /> . CONTRACTORS LAW 1827 RCW AND 296.200 WA0. � <br /> � SIGNATUPEO�GONTRACT:.RORAUTIIORIZEDAGENT DQE � <br /> (9 � � �^ , � FI�C�? !V-'" •C� �%l .�1 � <br /> Gr:...��r //�s/�iitl n'�' X c�'���� ,�,� � ' ' <br /> NAaecT�oon ss r ,l/�� ,�/c.' �l�i� �(� Bf����l� <br /> 7 /� �/'//�,v J� P �KTSCITV6USMESSIICEN5EN0 AHDBUSINESSNAME <br /> lU ,r ,� ii <br /> PLUMBINO ECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.R �_ <br /> BFTHTUB FORCED AIR SYSTEA7S—B.T.U. M E.A. _ ; <br /> LAVATORY(WASH BASW) � UNIT HEATERS-BS.U. td � <br /> — —T <br /> SHOWER CLOTHESURYERS ' _ , <br /> KITCHEN SINK 8 DISP V�NTILATION FAN � <br /> DISHWASHER � RANGE HOOL. � � <br /> LAUNDRY TRAY ; WATER HEATER , <br /> CLOTHES WASHER � WOOD STOVE , <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ; � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT �_ . <br /> � <br /> � HEAT PUMP ' <br /> FLOOR CRAIN � <br /> BACKFLOW PREVENTERS ; GAS PIPING �_ . <br /> ROOF DRAINS—RAINLEADERS � EXHAUST F.4N � � <br /> SINK(SERVICE—BAR,ETC.) �_ � � <br /> � <br /> —� <br /> � � . <br /> — ----�— --- — � <br /> _ _ —i�— <br /> ----�—— i <br /> i <br /> SUB TOTAL $ ' SUB Tl`?AL $ ' <br /> PERMIT $ �--�— PERMI7 $ � � <br /> � <br /> TOTAL FEE 5 TOTAL FEE $ ' . <br /> FOR OFFlCE USE ON�Y: <br /> PRONT SETOACN AERR SETORCN SI�E SETBACK PLAN Q1ECN NUMOER FEE RECEIPT NO ' <br /> usezorve LOTAPEA WCRNTSRE FEES VALUATION FEE � <br /> � <br /> BUILDING <br /> TYPEOfCONiSALLOWABIE fYPEOfCON57ACTlIRI oc[u��NCr NOqowuuNGuw�S � � I <br /> �Rd''P PLUMBING i , i <br /> -�—•-- i <br /> 52EOFBLDG. NO.OFSTORIES BASEMENT � , <br /> MECHANICAL ' <br /> i <br /> OCCUPANCYLORD FIRESPfiNKLER5FE0'0 IIEIGMTLIMITATION ADDITIONFLPLANCHECN � _ � <br /> � � <br /> OTHER i <br /> REASON FOR SPRINNlERS �— � <br /> SiATE BUILDING SURGHARGE i � <br /> i <br /> INTRNE BY PLANS APPROVEDUY CITY OF EVERETT PUDLIC WORKS i . <br /> LOCALSALES , ; <br /> TAX COL�E IS 3105 TOTAL ; � <br />