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. <br /> , ��� <br /> � APPLICATIO�rI FOR CONSTRUCTrbN PERMIT <br /> � <br /> everett <br /> rhe Everyreen „ <br /> CITY OF � <br /> everett <br /> DUILDING DEPARTMENT <br /> � 259•8810 TO BE COMPLETED IN INK—PLEASE P{jINT <br /> ; <br /> ❑ DEMOLITION IJ COMBINATION �BUILDING MECHANICAL �LUMBING ❑ SIGN <br /> � q MRIL RDDRE55 dTY . ZIP PHONE <br /> � �livc-,��� �on�sr �z,9' /��'S � ,�i.��rc 4L�,� 4B/—.�3�C <br /> N T MIIlA0�RE55 CIiV 21P PHONE <br /> ARCHITECTORDE51� NER MMLADDRE55 C:TY 21P PIIONF <br /> �s��� ��v4 Ati�� ?',D,E�x/.� /t���vc.r� 9�z7s T9s--E,s� <br /> OENEy(�L/���TOR�`— M41L ADDRESS CITY 21P FHONE ����CENS�/��� ' <br /> � E ;i <br /> M CXANIC.IL CON RAC OR MAIL pDDRE55 CITY IIP PNONE U ENSE I <br /> �R/7�O,r� -, 3L�D I 12,�5T 5',l,11 � Y.�/,l�/l,l��,p �i9D� 7q5-59��l�/ l�J-�L <br /> �PLUMBINO CONTR 70R AIL�E 5— �CITY— ZIP ONE LICENSE R <br /> � n7�nr���z�l �'l�,�° v o/�c.F1i��-T-9��z��s�7���S":;� � �4/b� <br /> ' CLA9SOFWOPK <br /> � NEW ❑ ADDITION I l ALTERATION I I REPAIfi i..l DEMOLITIGN f I WOODSTOVE/FRPL INSERT ❑ BUIIDING RELOCATION <br /> . TENNITIMPROVEMEATORINTERI^RREMO�ELONLY CONt TPEIi50NANOP ONE O. � ' ' <br /> �-7 / I'�// � <br /> CONTMCTPNICEOFWORN: F � <br /> DESCRIBE WONN�ND SOU�RE FOOTAGE INVOLVED '�� <br /> e <br /> � PROPOSEDUSEOFBUIl01 G I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �JG — � I— APPLICAT�ON AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEO�LDE�F P OPERtY(SMOWN BELOW OR�TTRCMFOURCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or niocrc oF NOT. THE GRANTING OF A PERMIT DOES NJT PRESUME TO GIVE <br /> (� /� � � � � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> / � ����`"'� 0�/"�`-�-� OTHER STATE OFl LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE 9F CONSTRUCTION.iHAT I AM AUTHORIZED BY THE <br /> . OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> � SIGNATUREOFCONTR� tORO�THORRED�GENT D�TE <br /> PROJE/G�A��RE55 /j � • ' � <br /> � {� a p� �/ SC� � �IC� SCITYB INESSI SENO.ANDBUSINESSNAME <br /> - PLJMBING MECHANICAL � <br /> � N . TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> • WATER CLOSET(TOILET) A/C—NFiNDLG UNITS—H.P. i � <br /> � BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> I.AVATORV(WASH BASIN) �— UNIT HEATERS—B.T.U. M ; <br /> SHOWER � — CLOTHESDRYEFS � <br /> . KITCHEN SINK 8 DISP ; — VENTILATION FAIJ ; <br /> , DISHWASHEF RANGE HOOD � <br /> � LAUNDRY TRAY ; WATER HEATER � <br /> � CLOTHES WASHER i — WOOD STOVE ; <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � — <br /> DRINKING FOUNTAIN � FIREPIACE INSERT ; <br /> FL� �ORAIN HEAT PIIMP i <br /> B/ )W PREVENTERS GAS PIPING ' ' <br /> � <br /> '� RG IAINS—RAWLEADERS EXHAUSTFAN � <br /> SIN� sERVICE—BAR,ETCJ � <br /> — —� , <br /> � -- <br /> ' G u � — <br /> � SUB TOTAL $ SUB TOTAL $ ��J L= <br /> PERMIT $ � PERMIT $ i <br /> TOTAL FEE $ ' � , y{ TOTAL FEE $ 9U � � <br /> FRONTSETBACR ' REARSET9FCK, SIOESETO,CN � PLANCHECNNUMBER � F RECEIPiNO. <br /> �O 2U y �O G P9 � �° �3e 9 '+- <br /> USEZONE LOTAREA VpCPNT5ITE FEES � VALUATION FEE <br /> R�Z UZ YES I I NO BUilOiNc 7�i �aj fS,S. ; � <br /> 7YPE�FCON51��llOq'ABIE iVPE01�CON51AptIlAt otcuravcr xo.dov.uUxcuNn6 <br /> / �./ / ', / nar PLUMDING s� — <br /> V /y V V <br /> SIZEOFBLDO. NO.OF5TORIES B EMENi � <br /> ,�, 4, SQ�FT� � YES NO _MECHANIC�L e,d i _. � <br /> OCCPPANCYLO�D FIqESPpNNLERSRE00 HEIOHiLIMIi tiON U���E� G�Q,�� (�/('. i - <br /> (J VES ,�i NO ��� STATEBUILDINGSURCHARGL �� � <br /> REASONFONSPRINNLERS „ � <br /> SIATEENERGVSURCHARGE � � <br /> _ ___ � <br /> APPLICATIONALC.BV P N RPPROVED�V CITYOFEVERETT PUBLICWORKS � 1 <br /> LOCAL SAIES �d '— <br /> �, TAX CO�E IS 3105 TOTAL 7( c� � ` <br /> l AJ'jC. ' /3/:� � � <br /> ;,.._ _. .... . . <br /> ��'' <br /> ;t, ,M1. .c`�;,:'rt, .i, � , ., . "JL�',I <br />