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APPLICAI .ON FOR CONSTRUt� f10N PERMIT <br /> everett <br /> ,��E�2,.a,�..�, e <br /> CITY OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8610 <br /> DEMOLITION CQC.781NATION BUILDING _ MECHANICAL PLUMBING SI <br /> OIYNER �Q- AIAIIADDRE55 ,(� _J� Ciiv/. ,. C, v ,lL `, ��1�\'��(��( ��J� � J>�,�,� <br /> �_ � II�,I ,�� i� 1� C � ` � ') <br /> ��,�a�,� � <br /> tEH�NI <br /> AIP.I�ODRE55 Gtt ZIP PMON[ <br /> nnCrni TOROES�GNFp ������D9RE55 C ZIP PMONE <br /> ti�! U���S ���Y�� � ,1�)r - <br /> GR1EHAlGOHiRACTOR MnILA DRE55 �J � ' /�� �v �P PNONE ��- LIGENSE� <br /> �_ I � � -i- n j �� '�� -7 J'I� <br /> ��� 'LN zia vrwr+e ucEr�se. <br /> M[CHFWULL T�ACTOR MMLApDRE55 ��N <br /> 9 y CITY 2�P PNONE UGENSE• <br /> .L�CO.`� PLU40iNGCONTP�LTOR MIaAD�R[55 <br /> C H <br /> 9 H p� <br /> r`� <br /> y L1P550F WCPK <br /> � x� NEW ADDITION ALTERATION . REPAIR DEMOLITION . WOOOSTOVE�FRPL INSERT � BUILDING RELOCATION <br /> cor+* c*rEr�sor+nr+o rrror+e r�o <br /> H� 1[NANTIMPROVC�AENTORINIERIOflRENQLp[LONSY�' �P��.� / 'I <br /> CIC �`A <br /> � H� ca,rnncrr -Eor vonK• r woAra� 02 � <br /> y V�� o�scr�me woarc nN sounne Foornce r+voiveo T — <br /> L� x� ��,,, <br /> `'• �d rr+oPps�DUSEOFpU�DiNG I HEREB� CERTIFY THAT I HAVE READ AND E%AMMEU 1HIS <br /> \ I n-��C, . � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECi.ALL <br /> J �� K" pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE OF <br /> u:cnioesc ior+o PRa eR*�'i��owNBLLOWOR��� u��cow/Esi � � yyORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �`�� ior �_�� g�aK oF �1 C C� � ��� NOi. THE GRANTING OF A PERMIT DOES NOT PRESU�AE TO GIVE <br /> Z H� AUTHORITV TO VIOLATE OF CANCEL THE PROVISIONS OF ANY <br /> ? y � �� o��� f 7 f' OTHcR STATE OR LOCNL LAW REGULATING CONSTRUCTION OR THE <br /> t" H y / /I � — PERFORM�NC[OF CONSTRUCTION.THAT I AM AUTHORIZED B�THE <br /> � OWNER OF THIS PfiOPERTV TO PERFGRM THE WORK F�R WHICH <br /> yH APPLICAiION IS MADE AND I GOMPLV WITH TNE STATE <br /> n d y CONTRACTO LAW 1827 RCW D 296200 WAC <br /> ��� SiGNn1UPF F N UCiOROPnUt��OFi'EOAGF��T Dni[ <br /> I <br /> x y v, � ' � <br /> H O C/l X � .1 ,L � ��' '�� <br /> er+aEcr nooaess � <br /> npvu/,.NiSGrtVIU5�NE5 UCENSENOANO USiNE55N4F1E <br /> //0 0; – „� 'fE� <br /> PLUMBING MECHANICAL <br /> FEE NO. YPEOFEOUIPMENT FEE <br /> N0. TYPE OF F�XTURE OR ITEM p�C—A�HNDLG UNITS—H.P. <br /> / WA7ERCLOSETITOILET� <br /> FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � BATHTUB ; <br /> � �' � IAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M �_ <br /> _ � SHOWER CLOTHES DRVERS <br /> KIT�HEN SINK 8 DISP _ VENTILATION FAN T__ <br /> � .�' DISHWASHER _ RANGEHOOD <br /> '� LAUNDRV TRAY WA7ER HEAIER <br /> " '� WOGD STOVE <br /> CLO7HE5 WASHER <br /> METAL FIREPLACE 8 CHIMNEY <br /> URINAL ; <br /> DRINKING FOUNTAIN FIREPLACE INSERT �— <br /> 1 � FLOOR DR�IN HEATPUMP <br /> BACKFLOW PREVENTEFS GAS PIP�NG <br /> .,. ROOF DRAINS—RAlI1LEADERS E%HAUST FAN <br /> �',� SINK(SERVICE—BAR.ETC.) <br /> .�.. � <br /> SUBTOTAL S _� SUBTOTAL S <br /> PERMIT 5 PERMIT 5 <br /> �I`I TOTALFEE S TOTALFEE 5 <br /> p�pry��f�M1IBER � FEE ��� � �[CEICT NO <br /> FPONTSET9ACN REANSEiOALH SIOESEIBACN ^ <br /> S `� <br /> Z J/ wcnr�t srte FEES VALUATION FEE <br /> '• " USE ONE LOL AREP <br /> _I �(� SO(� � � YES NO guaowc �r ,. . '� <br /> IYPE Of LONSI AllOV/ABIE 1YPE Of CONSt FLiU�I ocavev[v �.a o�.nRvx,urns � <br /> �9p'° PLUMBING <br /> L-3 <br /> SI2[OF OIDG NO.OF StORiES BASEMENt MECNANICAL <br /> ,_���� VES X NO � <br /> OTHER <br /> OCCUPANCYLOP� FIIiESPRNKlER5RE0� NBGMTI'Ii�110N � <br /> �` YES � NO 2 STATE�UILDING SURCHARGE �i S� <br /> �� <br /> RERSON FCR SPRINNlERS � <br /> STA�ELNERGYSURCHARGE <br /> APVLIC�110NRCC OY rv,r+;nrr•poyio nr CITY OF EVERETT PUOLIC WORKS � <br /> 4;;- LOCALSALES sT/ <br /> TAX CODE IS 3105 TOTAL � S y' I <br />