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� <br /> APPLICATIOr� FOR CONS`i'RUCTr_Ol�1 PERMIT everett <br /> meE�er9reen TO BE COMPLETED IN INK—PLEASE PRINT . � <br /> CITV OF <br /> �verett HEATING SYSTEM: ❑GAS �j)ELECTRIC ❑ � -� � <br /> BUILDING DEPARTMENT � � <br /> 259-8810 <br /> [`� DEMOLITION I I COM8INATION i I BUILDING I I MECHANICAL !-I PLUMBING fJ SIGN <br /> OWNEfl MAIIADDHE55 � CITY ZIP PHONE �vQI�Z � WO�, $SZOB • D7I <br /> ���ueGeR I�aR�r+�e2s � f eNN�bRoo� D U !ooa Se �Ze�eTr (J�aU- t�.�y , Surrc �zo i <br /> TENANT MRIL�f10flE55 � CITV 21f PMONE <br /> F3nci�uG Cammc2cra� C1r2PcaNe.. Cv , i000 sE �Ze�� IylAcc way i <br /> ARGHITECTORDESIGNER MRILAODRESS CITY ZIY PHONE <br /> (�i0�11�7G (0/Y�` I (� r2PcaNc_ �+ �z r�� �r r' <br /> GENERALCONTRr1CTOR MFILADDRE55 CITY 21P PHONE LICENSEY <br /> fY1MS 14907 ruE Yo�H �EDmouO WA 9fro5� /0/8T <br /> MECMANICALCONTRpGTOR MFILACDRESS GIiV 21P ryIONE LICENSEI <br /> �-'i 2o4 -8k � -3d3�/ <br /> PLUMBINGGONTRAGTOR M�ILAOORESS GTY ZIP PHONE LICENSEY <br /> N I� <br /> CIASS OF WORN �. <br /> ❑ NEW 17 ADDITION f�(' ALTERATION I I REPAIR XI DEMOL�TION I. I WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION �, <br /> r <br /> CONTACT PERSON AND PIIONE NO. <br /> Ob <br /> CONTRACTPPICEOFWORN Q <br /> !)ESCRIBEWORKANDSOUAREFOOTAGEINVOLVED hpO �'q�(.Z��CAR�T�P rNr <br /> 180o r� CJem� 2oFwces � i3u � o� ic <br /> PROPOSEDUSEOFBl11L01NG I HEREBY CERTIFY THAT I HAVE REAU AND EXAMINED THIS <br /> O FF'ICZ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> LEGALOESCRIPTIONOFPROPERTYISNOWNBELOWORATTACHFOUflCOPIES) PROVISIONSOFLAWSANDORDINA�ICESGOVERNINGTHIS7YPEOF . <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIF.D HEREIN OR ' <br /> �or BIOCK cF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE ` <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY � <br /> ��C� p OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE � <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FCR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE STATE � <br /> � CONTRACTORS LAW 18.27 RCW AND 286.200 WAC. <br /> SIGNATUREOGCONTflP.CTOROHAIITHORRECAGENT DRTE � <br /> PRQIEGTADDRESS NO FIOO� X 5�yI4/ <br /> QQD s �UQ(� � pC.L WA 6�LereTr' ANP��CAN I 5 C .� SN AM . <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF PIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE � <br /> WATER CLJSET(TUILET) � A/C—A/HNDLG UNITS—H.P. � .� <br /> —,— <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � , <br /> LAVATORY(WASH BASIN)� i UNIT NEATERS—B.T.U. M I � <br /> SHOW�R ' CLOTHES DfiYERS � ' <br /> KITCHEN SINK&DISP i VENTILATION FAN �_ i�� <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER � I <br /> CLOTHES WASHER � WOOD STOVE i _ ., <br /> UFi1NAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING POUNTAIN I FIREPLACE INSERT I �, <br /> FLOOR DRAIN � HEAT PUMP . <br /> BACKFLOW PREVENTERS ; GAS PIPING ; ' <br /> ROOF DRAiNS—RAINLEADERS � EXHAUST FAN �_ � <br /> SINK(SERVICE+-B R,ETC.) ; � � <br /> � <br /> � � <br /> .� � ' ' <br /> � � � <br /> , � <br /> — � <br /> SUB TOTAL 5 ' SU�TOTAL $ ' , <br /> PERMIT $ � PERMIT $ � _ ' <br /> TOTAL FEE $ ' TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: ; <br /> lRONTSETBACR FEAPSETORCK SI�ESET�PCN Pl�L�1EC�M�R FEE � � ,j5 RECEIPTNO. , <br /> i <br /> USE20NE �/ LOTAREA ^ VACANTSITE � FEES VALUATION F E . <br /> C '(1� �U BUILOIN �pQ[,)4� y�� � �a <br /> iVPEOFLONiSAIIOWABIE TYPEOFCONSTALP1At o[CuveMtY Hoo�mvuuNGuxnS i <br /> � ' �� cnaZ � PLUM6ING _�_ i <br /> SIZEOFBL'uU. NO.OFSTORIES �PSEMENT MECHANICAL � � <br /> i i. <br /> !72 sFT� 1 —' � ` <br /> OCCUPANCYLOAO FIPESPRNNLERSREO'0 HEIGNTLIMITRTION ADDITIONALPLANCHECK i i <br /> 3O ��j OTHER ' <br /> i <br /> REASON FOR SPRINNLERS � <br /> �� STATE BUIL�ING SURCHARGE 1�D i� � <br /> INiTREBV PLANSAPPROVEDBV CI�OF�EVEREIT pUBLICWORN$ � � � <br /> n � ) LOCAL SALES `i <br /> �` /,�+. 'fAX CODE IS 3105 TOTAL �3 �� ' f <br />