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APPLICATI(�A FOR CONSTt�UC? �ON PERMI'T <br /> � „t'���'� everett <br /> (ho Evergreen 2 � <br /> CITY OF <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> x DEMOLITION I i COMBINATION i BUILDING MECHANICAL i PLUMBING I I SIGN <br /> OWNER MAtI.ADpRE55 G7Y ZiP PNONE <br /> � (.(. U /�-��'�1Q7��/C,�c 9f��o�:_ �3yJ- �/�3SS <br /> TENANT innn.nonness cnv :m ruoui. <br /> NoN-� ---- <br /> �RCIIRGCTOROESIGNGR yAI-MIAD�qE55 � CIIY � 1iP PIIOII[ �J <br /> GENEROCONTfl�TOR �L�L[�AII.A[l��S�OO�— �y /s•7 CIII(lCOAt/f—_71L.�Z-L���ION�G ry IICt/%�z� -L����—/1� <br /> MECIIANICRLCONTMf.IOR AIAIL��bf1ES5 CIIY 111' PIIONG IIf.GNS[� <br /> PWMDINGCONTRACTOR I.IAllA0f1RE55 CITY ZIP ��'ONE Ilf.[NSE� <br /> GlASS OP WOAK <br /> I I NEW I I ADDITION I I ALTERATION i i REPAIR k DEMOLI1lON '�. i WOO�STOV6F19PL INSERT I I BUILDIIJG RELOCATION I <br /> TENPNT IMPflOVEMENT OF INTERIOq REIAOU[L ONLY CONiACI PLRSOI!Al1D PIIONE NO I <br /> CONTR�GTPRICEOFWOPK: _(��f/J B � /_I.CL�f lf�-� <br /> OESCRIBE WORK AND SOIIARE FOOinG[INVOIVG� <br /> .� s�z - � s�3 <br /> PPOPOSED SEOFOlI1tDI6G I HEREBY CERTIFY THAT I HAVE READ AND E%AMINGD THIS I <br /> � APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> iEw�oSCNIPTIONOFPRO€ran�SNOWNOE�OWORATTACHFOIiqCOPR51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETH[R SPEGFIED HEREIN OR I <br /> iot ��. _ eioc!c oF YJu {ua{�—L�Gt� NOT. THE GRANTING OF A PERMIT DOFS NOT PRESUME TO GIVE I <br /> AUTHORITY TO VIOLATE OR CANCEL ��HE PROVISIONS OF ANY <br /> OTIIER STAiE OR LOCAL LAW REGULATIN(a rONSTRUCTION OR THE <br /> PERFOHMANCE OF CONSTflUCT!ON.THAT I AM AUTHORIZED BY THE <br /> OWNER OF TIi15 PROPERTY TQ PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MACE ANI) I COMPLY WITH THE STATE � <br /> CONTRACTOFS LAW 18.27 RGW 4ND 296.200 WAC. <br /> SIGNAIuIt@OFLGNiRnCiORONt11IIlOP1[UAG[NT l)AlE <br /> � /�l 1 <br /> ----- - - ---- _ / '/� F�_��Y���•t.� �- �G- Q� <br /> PROJECT�ODRE55 - <br /> /0 ,23;2 ��� ur.ara�cn �usn�c:sur.u�ser+oevnousi���ssruaMe <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE I <br /> WATEP CLOSET(TOILET� , h�C—iUIINDLG UNITS—HP. i <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. ' i <br /> LAVATORY(WASH BASIN) - -r— UNIT IIEATERS—B.TU. M �_ ', <br /> SHOWER CLOTHESDRYERS � �, <br /> KITCHEN SINK 8 DISP i 'JENTILATION FAN - <br /> —T— fiANGE HOOD ' <br /> DISHWASHER ' i <br /> LAUNDRYTRAY ' �WATER HEATER ' li <br /> CLOTHES WASHER �— WOOD STOVE '� <br /> URINAL ; McTAI.FIREPLACE 8 CHIMNEY '� <br /> DRINKING FOUNIAIN i FIREPLACE INSERT i <br /> FLOOR DRAIN —~ HEAT PUMP _ ' �� <br /> ___.—.—i— —__ — ' <br /> BACKFLOW PREVENTERS , GAS PIPING ___ � <br /> . —._—,— '_._. _ — ---i— <br /> ROOF DRAINS--RAINLEADERS � EXIIAUST FAN _ _ � _ <br /> SINK(SERVICE—BAR,ETC.) i � <br /> —--'—__�— — --_— i <br /> ' _—_--___--_—_ <br /> — —_— ' <br /> � � <br /> _ ___ ____.___—__ ______.--.�—_ _—__ _—____—.—_____ .._____—__ <br /> i _.;_ <br /> SU9 TOTAI. 5 SU�TOTAI. $ _ ; <br /> PERMIT $ �— PERMIT $ � <br /> TOTALFEE $ ' TOTALFEE $ ' <br /> FOONTSETORCN REARS[TOALN SIOESEi�Af.K PI/NQ�ELKNUAIO[R PGL RECEIPiNO. <br /> usezoNe �on.oen vacnr+isne FEES VALUATION FEE <br /> I I YES i I NO �uuAING ' <br /> 7YPCOFLONSiALLOWA�IE 7YP[OFCONSI.ALIUAL ����"��itr xnaowwmGurinS --- --- — � <br /> cxaiv p���MBING i <br /> _ _____ ---'__ —� <br /> 52EOFOLDG. NO.OFSTORIES OASCIdGNI MECIIANICAL � <br /> I i YES I I NO — � <br /> OCCUPANCVIORD FIRESPRNNI[RSREO'U MEIGHTIIMITAIION �r���� � <br /> _ 1 <br /> I'I VES I I NO STATE BUILDING SURCHARGE � <br /> RERSON PoR SPRINKLFRS -----� <br /> STATEGN[RGYSURCHAPGE <br /> APPLICr1TIONFCC.B�' PLANSAPPROVEDOY CiiY,1FEVERETT PUBLICWORKS � <br /> Li:Gt�L SALES , <br /> � TAX COC'. 'S 3105 rorn� � <br /> i <br />