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.. . . .. ... .... �. : ';..<,. . . ._ .....� • .'. _.. '.�`:�'.' 1_'�'.'�i�.�_.!:_ ... . ' -.. .`:.. .. . .'.� . . . . . .._.... .._.�l'*.�!`e�>'.:'i <br /> ^ � � � <br /> APPLICA7 �ON FOR CONSTRUC�ION PERMIT � ; <br /> � � <br /> tMEHrrpreen eve �tt � <br /> CIIY OF � <br /> everett � <br /> BUILDING DEPARTMENT � <br /> 259•8810 TO BE COMPLETED IN INK—PLEASE PRINT � <br /> Ll DEMG LITION I I C06ABINATION �(BUILDING I�MECHANICAL �LUMBING ❑ SIGN <br /> ONTlER M�ILADDRESS CITY 21P PHONE <br /> �CI�O/�T(�'ONSI �D �OY /�Oe� Il%nr�s��,/� 5'�s.��U 33�i3 ='r�3 � <br /> TENANT MAILADDRESS CITV � 21P P/IONE <br /> �RLNITECTOROESIGNER M�ILAOOFESS dTV ZIP PHONE � <br /> � <br /> GENERA.CONTRALTOP MAIL ADDRESS CITY 21P PNONE LICENSE 1 { <br /> { <br /> MEChANICALCONTRRCTOR AIFILAODf355 GtY 2IP PHONE UCENSE� � ( <br /> I <br /> — i <br /> PLOMBINGCONTflACiOfl MAIL�DORE55 CITY 21P PlIONE LICENSEI � <br /> � <br /> ClA9S OF WONK t <br /> �JEW � ADDITION ❑ ALTERATION I I REPAIR ( I DEMOLITION I-I WWDSTOVE/FRPLINSERT I_I BUILDINGRELOCATION � <br /> TENNIT IMPROVEMENT OR INTERIOfl PEMODEI ONLY CONTACT PERSON ANJ PHONE N y <br /> CONTN�CT PRICE OF WORK: I'l�I �0!'�1 H ET.z�. <br /> DE6CflIBE WORK ANO SOU.IRE FOOTAGE INVOLVEO <br /> 11 YJ11 �y'1�.� _ <br /> PROPOSED SEOFBUILOINO I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEOALDESCHIPTIONOF PROPERTY�SNOWNBEIOW OPATTnCII FOIIPCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br /> WORK WILL BE COMPLETEO WITH WHETHER SPECIFIEO HEREIN OR <br /> �or�_ e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �L�It t uJOOi�. � r YC�C 2— OTHER STATE OR LOCAL LAW REGULATINCa CONSTRUCTION OR THE <br /> PERFCaMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> - CONTRACTORS LAW 78.27 RCW D 296200 WAC. <br /> SIGNATUREOFCdJT ORORRUTHO EDAGENT O�TE <br /> X � <br /> rawecr�oon�D l s� � <br /> �P IC�N CItt01151NES5LICENSENO.ANDBU51NE55N�ME <br /> 1 <br /> PLUMBING MECHANICAL ' <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE C <br /> WATER CLOSET(TOILET) �— AIC—A/HNDLG UNITS—H.P. T— <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. � I <br /> LAVATORY�WASHBASIN) ��' UNITHEATERS—B.T.U. M ; � <br /> SHOWER CLOTHES DRYERS � ��- <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; j <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATERHEATER ' i <br /> GLOTHES WASHER �r WOOD STOVE S <br /> UHINAL ' MET�L FIREPLACE 8 CHIMNEY �— � <br /> DRINKING FOUNTAIN FIREPLACE INSERT � � <br /> FIOOR DRAIN � HEAT PUMP � i <br /> BACKFLOW PREVENTERS � GAS PIPING ' �� <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> --i— i <br /> — —T � <br /> � <br /> i <br /> � <br /> � — � ^ , <br /> SUB TOTAL $ '^ SUB TOTAL $ � <br /> PERMIT $ PERMIT $ '—F� <br /> TOTAL FEE $ '� TOTAL FEE $ �—� ' <br /> FRONT SCTBACK RERR SETOACK SIOE SEiBRGK P�AN CH N NUMBER FEE � RECEIPT N0. � <br /> LG` �.p' ` � ' <br /> usEior+e LOTRRE� VACANTSITE FEES VALUATION FEE <br /> �i �Z �ZI [ 1 YES f_I NO BUILDING i <br /> 7YPE0lIONSi.AIIOWABLE TYPfOFL0115T.RtIORL o[[uveNa Modd.vluiNGUNits <br /> flaour ' � <br /> PLUM9ING ' � <br /> i <br /> SREOFBlD6. NO.OFSTOBIES OASEA1ENi MECHpNICAL q�! '� � <br /> I I VES I I NO — �� � <br /> OCCUPANCYIO�D FIRESPRNKLERSREO'D NEIGIITI.IAIIT TION OTHER � � <br /> L] 1'ES L1 NO ���� STATE DUILOING SURCHARGE � j <br /> REASON FON SPRINKLERS I <br /> STATEENERGVSURCHARGE i �� <br /> APPUC�TIONPCC.9V PUNSAPPpOVED9Y CITYOFEVERETT PU�LICWORKS � <br /> [/�/ LOCALSALES � <br /> � g�q TAX CODE IS 3105 TOTAL � 1---� � <br /> i <br /> � <br />