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, APPLICAT14�1 FOR CONSTRUC'fti�N PERMIT <br /> � ��E�ro�� everett � <br /> cin oF � <br /> everett <br /> � BUILDING DEPARTMENT <br /> '� 259-8810 TO HE COMPLETED IN INK—PLEASE PRINT <br /> � ❑ DEMOLITION ❑ COMBINATION �BUILDING �MECHANICAL P_�LUMBING ❑ SIGN <br /> i OWNER MAILADOREOS CITV ZIP PMONE <br /> � .1�i,¢� Q¢aT.D�v cvR.? /6ziz-adrr,�cu_r�.olvs•�.aFiv� �c,ic.c c� 96oiz.. 33gl4R� <br /> � TENANT IA�ILAOORE55 GT ZIP ^NONE <br /> 5 <br /> ,j �RGH�TECTOROESIGNEP MAILADDRE55 CI1Y 21P PHONE <br /> 1 <br /> � 6EN�E`n�TR���MFILAD�RESS ��� ZIP �HONE �/D/E/�r'-Q.Jl�dlr <br /> /r�IrC � �-01Q./' /Y <br /> �j MECWWICK..ONTR�CiOP M�IL�ODRE55 CITY 21F PNONE LICENSE� <br /> ; �ZiZdn��a� <br /> PLUM0INOCONTHAGTOR MMLADORESS GTY 21P PHONE LICENSEI <br /> i •�G$7-1�711.11� f�Gtt�+.Q/h��— <br /> j �Cf SSOF WORK ' — <br /> % .6LNEW ❑ ADDITION I.I ALTERATION I I REPNR I I DEMOLITION I ! WOODSTOVEiFRPI INSERT L I BUILDIN6 RELOCATIUN <br /> � <br /> �3 COlIRACTPRICEOFWORI(INTEN/IOj�LREAI-OD�ELON-Lv pa) 737 � CONT�CT��SONANOPMONENpMN^ ����/�� <br /> /�fl�^-c Os.-/ O K��.y - � <br /> � ,..� <br /> DESCflIBEWORK�NDSWAREFOOT�GEINVOLVED T '` <br /> % � / �/ / 7' —��7 <br /> �� PflOVQSEDVSEOFBUILDINO�y/ I HERE3Y CERTIFY THAT I HAVE READ AND EKAMINED THIS <br /> � _�S7 J/! APPLICATION AN�KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> -� LEOAL DESCflIPTqN OF PROP TV�SHOWN BELOW OR RTTRCH FOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNINQ THIS TYPE OF <br /> WORK WILL BE COMPLCTED WITH WHETHER SPECIFIEO HEREIN OR <br /> � �or�_ e�ocn oc NOT. THE ORAIJTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> ` AUTHOPITV TO VIOLATF OR CANCEL THE PRO�ISIONS OF ANY <br /> ,i /L�S•C' ��[{y /✓, ,L OTHEFl STATE OR LOCAL LAW REGULATING CONSTRUCTION pR THE <br /> _�j PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> '' OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> - APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> * CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> ,y SIGNATUREOFCONIflACTOflORr1UiHORIZEDAGENT OATE <br /> � 6ZoZ— 2N� • E X /�`c,�n..�..� � _ G�a�,90 <br /> ,r� PRQIECTADDRESS �•� <br /> 1 <br /> �PPUCANiS CITV BUSINE55 LICENSE N0.I1Np BUSINE55 NAME <br /> � <br /> � PLUM91N0 MECHANICAL � <br /> :7 ND. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �`' WATER CLOSET(TOILET) � IVC—/vHNDLG UNITS—H.P. , � <br /> BATHTUB ' FORCED AIR SYSTEMS--B.T.U. M E.A. ; <br /> ,� � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.LU. M ' <br /> � <br /> SHOWER � CLOTHESORYERS i <br /> ' KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> �� DISHWASHER � � RANGE HOOD , <br /> � LAUNDRVTRAY ; WATER HEATER � <br /> �� CLOTHES WASHER � WOOD STOVE ' <br /> URINAL � � <br /> � METAL FIREPLACE 8 CHIMNEY � _ <br /> � DqINKING FOUNTAIN i FIFEPLACE INSERT ' <br /> FLOOR ORAIN ; HEAT PUMP � <br /> BACKFLOW PREVENTERS , GAS PIPING � <br /> ,I ROOF DRAINS—RAINLEADERS � EXHAUST FAN , <br /> �•� � S�NK(SERVICE—BAR,ETC.) ; �_ <br /> i � ; <br /> � � , <br /> � ' i <br /> � <br /> j � � ; - <br /> i • SUB TOTAL $ ; SUB TOTAL $ 9u ' ' <br /> -� � PEPMIT $ i PERMIT $ i <br /> �� TOTAL FEE $ <br /> ;; (p ' � TOTAL FEE $ Qe � � <br /> i FRONTSETB�CK REARSETBALK SIDESETBRCK / PUNLHECKNVMAER FEE y 'f� REGEIPTNO <br /> Jjjj ` o' ' ' l0 9d aY7�Y . �Ga. �n FSZ <br /> � 115E20NE� LO7AREA �� VACANTSITE , FEES VALUATION FEE <br /> I I YES CI NO / / ��` r <br /> BUILDING y � r.. <br /> TVP OFCONST.ALLOW�BLF lYPEOFCONSi.RCIU�L �nta>eeaq MaqhMluxGUNns <br /> � � _ N V ' IY /�p+J � PWMBWG G��� ^ <br /> '� SIZEOFBIW. -t('A NO.OPST RIES BASEMENT �— <br /> j SR �T, (� r� � f I YES � NO MECHANICAL 9e � �- <br /> ,; OCCUPANCVLO�O FIPESPRNNIERSREOD HEIGHTLIMIT ION OTHE � �� G i �p <br /> ' �l 2g� <br /> ❑ YES I NO STATEBUILDINGSURCHARGE y �-a <br /> REASON FOR SPRINNlERS _�_ <br /> STATE ENERGY SURCMA(iGE ' <br /> i <br /> �-' APPL�C�TION�GC.BV P PPROVEDBV CITYOFEVERETT PUBLICWORNS � �� <br /> y LOCAL SALES ' <br /> i . TAX CODE IS 3105 rorn� �� ;30 <br /> . <br /> . .-.... ,. . <br /> , -.�-.... ._ ., . ,. ,- _ <br /> . -„�_. _, .. . .. . <br /> . -. . .. ... . �..� � .. .� .. � :'T <br />