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APPLICATRAM FAR CONSTRUCT iON PERMIT everett <br />Ila EwrprP•n TO BE COMPLETED IN INK —PLEASE PRINT <br />city of <br />everett f HEATING SYSTEM: U GAS U ELECTRIC ❑ <br />BUILDING DEPARTMENT -- <br />259-8810 <br />DEMOLITION I I COMBINATION t BUILDING I I MECHANICAL I I PLUMBING I I SIGN <br />OEIT MAIL ADDRESS CITY 21P PIgNE <br />VM <br />�?r, Cox .,'� ,_;� n�,� or ;c S� ,n • h�� . 9 ! Y <br />I(RANT Mna An ness cnY zm PIgNE <br />51 <br />AncRaEst OR pEGIGNPn MAa ADoness CITY ZIP PHONE <br />Ct7 ' f tvl t NL;IAtGfr:P. I� ^I S' +1E du�aEn%R.`V I D ( rAP23— 0% j % <br />21P PHONE LICENSE <br />GENEn�/r�I'/y1I In C On MAIL ADDRESS <br />/ CITY <br />A� - --- PHONE LICENSE / <br />MCGIIAIIN;AL CONIRACiGR AAUDDGESS CITY ZIP <br />PLUMOWGCOt1TBAClOn Mna nnonl¢ss CITY- ZIP PRONE <br />WORN . i - 17 nClAnl ITInM 1 1 wnnnSmVFfFRPL INSERT C1 BUILDING RELOCATION <br />1 1 NEW I I ADDHIDN X' ALIcn„ITV„ •.�.•.... <br />._. <br />- (�Qtjp <br />CONTACT PEnsaN u+D FIN>HE <br />Len'r{ tI %'Tc�M nZSkl ".'�G-3J"L3 <br />CONIFIACTPRICEOFWORK /I <br />0 <br />DESCRIBE WOnK AND SOUARE FOOAGE INVOLV <br />- <br />POSED <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />USE OF BUKDING <br />SIT/ �' <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />A J • IT SE C. W I+U� <br />-- <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPEnTY ISIIOVnI BELOW On AHACII rOU1T Cf/1 lESI <br />A PERMIT DOES NOT PRESUME TO I <br />NOT. THE VE <br />RTO <br />Tor BLOCK OF -- <br />VIOANTINGLATE OR CANCEL THE. PROVISIONS OF ANY <br />AUTHORITY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />- <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER 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 296.200 WAC. <br />SIGNATURE Or CORTnAclon on AUT14DRIZED AGENT DATE <br />�'//9 <br />i- <br />J / �t <br />rnalscrn°Dacss �Y <br />It �r <br />APPLICANTS CITY BUSIDE. LICENSE NO ANDBUSMIRi AlAME <br />.(injlN(1 <br />MECHANICAL <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />' <br />UNITS ' <br />AlC—AJHNDLWATER <br />CLOSET (TOILET) <br />—_ <br />' <br />S—B.. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />FORCED AIR S <br />BATHTUB <br />UNIT HEALERS—B.T.U. M ' <br />LAVATORY (WASH BASIN) <br />I <br />CLOTHES DRYERS <br />' <br />L— <br />---- <br />, <br />SHOWER <br />-- <br />' <br />VENTILATION FAN <br />KITCHEN SINK d DISP <br />— , <br />RANGEHOOD <br />' <br />DISHWASHER <br />_. _. <br />WATER HEATER <br />WOOD STOVE <br />' <br />_ <br />LAUNDRY TRAY -- <br />I ' <br />CLOTHES WASHER <br />, <br />- <br />METAL FIREPLACE S CHIMNEY <br />, <br />' <br />URINAL <br />FIREPLACE INSERT <br />' <br />DRINKING FOUNTAIN <br />FLOOR GRAIN <br />i <br />HEAT PUMP <br />I <br />BACKFLOW PREVENTERS <br />, <br />GAS PIPINC <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE —BAR, ETC.) <br />— , <br />EXHAUSTFAN <br />' <br />SUB TOTAL E <br />PERMIT S <br />P <br />' <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S <br />' <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />1,0,1 SE7n,,l RE" <br />RECEIPT <br />ZONE <br />LOL AREA <br />[LSE <br />VACANT SITE <br />recce <br />-•-----"'-- <br />_ <br />BUILDING <br />2hP,�Dd <br />IriT OF CONIS ALDRYAPH <br />TYN Of CONST ACRIAI <br />gRIfANL. <br />rn n PANu+RMItt <br />PLUMBING <br />MECHANICAL <br />BITE OE DLDG <br />NO. OF STORIES <br />BASEMENT <br />ADDITIONAL PLAN CHECK-16%ri" <br />OCCUPANCY LOAD <br />FIRE SPRNKtEns nE00 <br />IlEglIT IIAIITAtION <br />OTHER <br />REASON ron SPnINKLF.RS <br />S7A7E BUILDING SURCHARGE <br />' <br />' <br />Punuc wonlcs <br />n1uNC BY <br />PLANSA venm <br />CITY OFEVERETT <br />LOCAL SALES <br />TAX fnf1E IS 3105 <br />TOTAL <br />, <br />