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�r � <br /> APPLICATION FOR CONSTRUG .'ION PERMIT <br /> everett <br /> :he E�erg,ee� G �� 1 /CDf f- � . <br /> GTV OF <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />- ! DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING ❑ SIGN <br /> OV�ME9 MAIIADDRE55 CITY IIP PHONE <br /> L✓ooc�hav��� �lo�es �o. �o.Y �d���J �rY,��—.�—wn�r/ G/q. `I�10f�G ��%G - 3 9C y <br /> TENRNT MNLADDRE55 CITY � ZIP PMONE <br /> RRCHITECTORDESIGNER MM�ADORE55 CITV ZIP PHONE <br /> GENEPALCONTRRCTOR MFILADDRESS CITV ZIP PHONB LILENSE+ <br /> G.bodhavrn �oi�ees Pd./�oX /03:1 �v��nu�ooc� L�q. °/SIOf�G SYG-39GY 1t�00�//Nl7`�d� <br /> MECHANICRLCONTRRCTOP MAILADORESS CITV ZIP PMO4E LICENSEa <br /> PWMBIIJG GONTRRCiOR MAIL RD�flESS CIiY ZIP PHONE UCENSE a <br /> GUSS OF WORN <br /> �NEW i-I ADDITION "_1 ALTERATION . �. REPAIR � DEMOLITION '. �. WOODSTOVE/FRPL INSERT '.J. BUILDING RELOCRTION <br /> TENANT IMPNOVEMENT OR INiERIOR REMO�EL ONLY QJ CC� '1IGq( CONTpCT PERSON r1ND PHONE NO <br /> r <br /> CONTRACTPRICEOFIYOPN: �S�UOO Qy�,4r �IC�/�4F^� AC,/'/Y'(� <br /> DESCRIB[WORN ANp SOUAHE FOOTAGB INVGLVED -� <br /> /I��e u� S/F /G 5 0 _ Sy6 3 9G `�_ <br /> PROPOSEOUSEOF ILDING 1 HEREBY CERTIFY THAT I HAVE ��.�EAD AND EXAMWED THIS <br /> S� ncl 1� �p!ti1/ �V APPLICATION AND KNOIV 7HE SAME TO 9E TRUE AND CORRECT.ALL <br /> LCG�LDESCP IONOFPIiOPERTY�5H0 NOELOW,nONATTRCNFOUFCOPRS� PFOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> ri a� ��"e�rn,- �'ORK WILL BE COMPLETf:D WITH WHETHER SPGCIFIED HEREIN OR <br /> ioi�_ etocK oF / qc tJriO NOT. THE GRANTING OF A PERMIT DCES P10T PRESUIdF. TO GIVE <br /> v AUTHORITV TO VIOLA"E OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LF�,V REGULA7ING GJNSTRUCTIO�OR THE <br /> PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZEO BY THE <br /> OWNER OF THIS PROPERT f TO PEFiFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE l�ND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.2:0 WAC. <br /> SIGNATUREOFCONTRACTOROP4UTHOBiZcOhGFNT OAiE <br /> X /� /// ,� l�7 <br /> PRQIECTADDRESS `� ` ���'"�� 3 <br /> � � 'S n � APPLICANiSCIiVOUSINESSLICENSENO. �USIN[SSNAME <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE ND. TYPE OF EOUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) A/C—lvHNDLG UNITS—H.P. <br /> BATHTUB ;p FOHCEDAIRSYSTEMS—B.T.U. M E.A. <br /> LAVATORY�WASHPASIN) (S;�_ UDIITHEATEHS—B.LU. M ; <br /> T <br /> SHOWER C�' CLOTHESORYERS � <br /> KITCHEN SINK 8 DISP _� � : VENTILATION FAN ' <br /> DISHWASHER RAtJGE HOOD —T <br /> LAUNORYTRAY ; WATERHEATER <br /> CLOTHES WASHER �C WOOD STOVE <br /> URINAL ' tdETAL FlFlEPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT i <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS 'C GAS PIPING ; <br /> ROOF DRAINS—RAINLEADEFiS EXFiAUST FAN <br /> SINK�SERVICE—BAR,ETC.) <br /> — ; _ <br /> n � � <br /> � <br /> � <br /> SUBTOTAL $ SUBTOTAL $ <br /> PERMIT S � PLRMIT $ -i— <br /> TOTALFEE $ O TOTALFEE 3 �` <br /> FRONTSETUACH REAq5E18ACK SIOESET� N PLANCHBC NUMBER FEE �� BECEIPTND <br /> ���' / 5� �' � <br /> usezoNe �or vnenN te FEES VALUATION FEE <br /> � �� �� �. � YES NO BUILOING � r �ly�/� <br /> t1PE0FLON5LAlLOWABLE t�Pf�(�01�$111��UAL aLUPAYLY N00'ONfIlM1iV4i15 75 30o VJ _� I �Jl�f_ <br /> GPppP � <br /> _ _ _3 1 PLUh1BING _ �S' Rn <br /> SIZEOFBLOG. NOOPSTOPoES BASEMENi MECHANICAL i <br /> ibvs sr+ Z ; ' vEs x No �nr)� <br /> S' GnR ^1 <br /> OGCUPANCVLORD FlRESPPNKLERSREO'0 HEIGNTIIM A310N OTHF.R (�, ,, 1'/ „/ a� �a <br /> �/"K-l.lL`1A11— <br /> (� . : YES X NO STATE AWLDING SURCHnRGE L-I � C/1 <br /> REASON FOR SPRINKlERS �--fC6L <br /> STATEENERGVSURCHAFGE <br /> ACPNGNtak-A(:CflM• PLANSAPPROVEDBV CITY OF EVEREIT Pl1pLIC WORNS a i �� <br /> =-�n°C�u �� LOCAL SALES <br /> W�-- q TAX COUE IS 3105 rorn� I a <br />