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i.':.•1... . �... . . ..........:........... . .. . ... . ... . . ..... .-. ... �. 4....�........_..-....._,. .... ... . . ....�.. .. . _ ...�..._.....�w.�.�.ti.r, r <br /> ��..' ' M1 � <br /> APPLICATION FOR CONSTHUCTI�N PERMIT i <br /> everett I <br /> fM Ewryroen <br /> CITY OF <br /> everett ; <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT ! <br /> 259-8810 <br /> ❑ DEMOLITION I I COMBINATION I i BUILDING I�{MECHANICAL �(PLUMBINO ❑ 810N i <br /> pyMQp MAIL�ODREfi9 ��TY Z�P P��E � <br /> /.��,�/,�/� •��j�'`j/ sLS/ Jo Zu.���"" ���d 3 _ i4�0-L� RL�6 I <br /> � MAII ADORE65 CITV =�P P��E ' <br /> ARCNITECi0R0EbI0NER M�IIADDHE53 ��Tr =�P P�E <br /> t <br /> �Ery[pALLpNfRACTOP AURAODHE65 GTY ZIP YMONE LICENSE� � <br /> MECN/WK,AI.CONTMCTOfl M�0.�OORE55 CITY 21P PNONE LILENSE� <br /> cr�- • � S• ? ' 9 'I <br /> PIUYBWOCONT MALAUOPE53 �ITY 21P PNONE LICENSE� , <br /> I <br /> CLA880FwOnK � <br /> �NEW ❑ ADDITION ❑ ALTERATION I I REPAIR f.l DEMOLITION I I WOODSTOVEIFRPLINSERT O BUIL�INORELOCATION � <br /> iENANT pAi1qVEMENi OR WTEPqR REMOOEL ONLV CONUCT PERSON�NU PHONE NO. <br /> ��.����: i s - oo � <br /> pcee�be wow�u�o eowr�roouae nrvaven � <br /> � <br /> rqopoeeoue�aeuwora I HEREBV CERTIFV THAT I HAVC READ AND EXAMINED THIB � <br /> APPLICATION AND KNOW TIiE SAME TO BE TRUE AND CORRECT.ALL <br /> �(yLL p[9pq�p{qNpF pROPEptY�61qVR/BELOW OR ATTACH FOUfl LOPIE91 PROVISIONS OF LAWS AND ORDINANCEB 60VERNIN4 THI$TVPE OF ( <br /> WORK WILL 9E COMPLETED WITM WHETHER BPECIFIED HEREIN OR � <br /> �oi e�ax oF NOT. THE ORANTINO OF A PEPMIT DOES NOT PRE9UME TO OIVE � <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVI810N8 OF ANV <br /> OTHER 3TATE OR LOCAL UW HEODUTINd CONSTRUCTION OR THE <br /> - PERFORMANCE OF CON9TRUCTION.TNAT I AM AUTHORI2ED 8V THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICN <br /> APPLICATION IS MADE AND I COMPLY WITN THE BTATE � <br /> — CONTRACTORS LAW 1827 RCW AND 298.200 WAC. � <br /> 6qN�T11 CONTR TORORAUTNd11ZEDA0FNT OATE � <br /> X/�1��✓�-�✓%'� �� <br /> ; �i.r/id�=�tsi • <br /> '�c�pe� 1� � D. d O �Q ' °A P��µTBCITY BU5ME5S IICENSE NO iWD SME88NMAE <br /> � <br /> ��� MECMANICAL � <br /> 11p, TrPf OF fl%TUHE OR REM FEE N0. TYPE OF EOUIPMENT FEE ` <br /> WATER CLOSET(TOILET) U ' NC—AIHNDL6 UNITS—H P. � i <br /> BATHTUB ' FOPCED AIR SVSTEMS—B.T.U. M E.A. ' <br /> UVATORY(WASH BASIN) [� i UNIT HEATERS—B.T.U. M i � <br /> SHOWEfl � CLOTHES DRYERS ' � <br /> KITCHEN SINK 8 DISP ' VENTILATION FAN � ( <br /> � � <br /> DI9HWASHER � RANGE HOOD ' <br /> LAUNDRVTRAV ; WATER HEATER ' � <br /> h <br /> CLOTHES WASHER � WOOD STOVE � � <br /> �R��� •�� _ METAL FIREPLACE h CHIMNEV ' <br /> — , FIREPLACE INSERT � <br /> DRINKIN6 FOUNTAIN � <br /> FLOOR DRAIN J � HEAT PUMP ' <br /> BACKFLOW PREVENTERS i <br /> �AS PIPIN6 � � <br /> ROOF DRAINS—RAWLEADERS � E%HAUST FAN � I� <br /> 81NK(&ERVICE—BAR,ETC.) �� � � <br /> � � <br /> kw � � <br /> � ' <br /> � ' 1 <br /> � ' <br /> , ' � <br /> SUB TOTAL S I SUB TOTAL S ' � <br /> PERMIT S � PEHMIT S � ��� ` <br /> TOTALFEE S TOTALFEE S ' ! <br /> F110NTBETBACK REANBETBAGK 61DE6ETB PIANCHECKNUMBEN FEE RECEIPTNO. �/ I <br /> � <br /> 1 <br /> U8E20NE LOTAREA VAGu1TSiTE FEES VALUATION FEE I <br /> I J YES I I NO BUILDINO ' ( <br /> ryP[OfCONSf/iILOWAAIE fYPf01COH5f./�CTWI �Mwcr rqabMwYauMits i � <br /> �� PLUMBINQ � <br /> � <br /> 5�ppg�pp. NO.MSTOIIIE6 BASEMENT MECMANICAL � � � <br /> Il YES I I NO ' ( <br /> OCCUPMlCVICAD fIRESPRNNLER5RE0'0 NEIONiIIMIT�110N �THER � ` <br /> I�I YES l I NO Si�TE BUILDIN6 SURCH�RGE ' _ � <br /> --T <br /> RE�60N FOR SPRINNlERS � <br /> STATEENER6VSURCHAROE � <br /> �VpIICATaNAGG.Br PUN5Aa7POVEDBY CITYOFEVEREIT PUBLICWORKS i I <br /> LOCALSALES � <br /> TA)I CODE IS 3105 rors� <br /> 3/ �'d <br />