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�1 � <br /> APPLICATI4.� FOR CONSTRUCT.ON PERMIT <br /> � <br /> ��.: ` � - •" '-�'�_ everett <br /> ffre Everprcen � <br /> CITV OF ' ' � <br /> everett ����/���� ,��� � <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PI.EASE PRINT <br /> DEMOLITION COMBINATION -�BUILDING 1 MECHANICAL PLUMBING I ; S1GN <br /> XOWNEi1 MAILAODRE55 CITY 21P PHONE <br /> �, c�C3o��r In�n 8�/�- 3���-�.s� �u��.� . 4e�ao� � s 3 ds a '� <br /> TENANT MAILA��RE55 CITV IIP PHONE <br /> ARCHITEGTORDESIGNEF MFILAOpRE55 CITV 21P PMONE <br /> x�„« �3our ►m.�.� S{� M� <br /> XGENERAL LONTR�CTOR 1A�IL AODRE55 CITY 21P PMONE LICENSE� <br /> Ll•'�l/�/c-�l <br /> MECHANICA� CONTRACiOR MRI�AODRE55 CITV ZIP PHONE LICENSE� <br /> PLUMBINGCONC�IACTOR M4ILAODRE55 CITV 21P PHONE LICENSEII <br /> CLASS OF WORK <br /> �NEW i_'�. ADDITION ^� ALTERATION ,-i REPAIR f7 DEMOLITION L1 WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION <br /> `y TENANTIMPROVEMEN70RMTERIONREMOOELONLY �O�J��_ j�� J��7 CONTAGTPERSONANDPHONENO. <br /> /$GONTRACT PRICE OF WORN: �' <br /> DESCRIBEWORK�NDSW�R FOOTr1G NVOLVED <br /> X � S &'h !n f ��' I So . N.� <br /> XPROPOSE useoFeu�oiNc I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � ' U I P.� APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEGALDESCRIPTIONOP PROPEFTY�SHOYMBELOW ON AiTALH FOURCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILI BE COMPLETED 1YITH WHETHER SPECIFIED HEREIN OR <br /> ��or eiocK oc NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �.��" � AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANV <br /> �,(�GllcC�n�� O7HER STATE OR LOCAL LAW REGULATING CONSTRUC710N OR 7HE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> ;� �j � (p� � OWNER OF THIS PROPERTV TO PCRFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br /> SIGNATUREOFGONTRFCTORON/.UTHORIZEDAGENT DATE <br /> � POO G�o�ss � �1 �Qire . ��i �J�,a-'�` �.,�} YJ'lo� � YJ _ ` '�/_� .' 2 � ' / <br /> � C � <br /> ✓ <br /> APPLICANTS CITY BUSMESS IICENSE NO.AN�BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNOLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER CIOTHES DRYERS <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE&CHIMNEY � <br /> ORINKING FOUNTAIN I FIREPIACE INSERT ; <br /> FLOOR DFAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—FAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; ' <br /> T <br /> I 1 <br /> I <br /> SUB TOTAL $ SUB TOTAL $ <br /> PERMIT $ PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ <br /> FRONTSETBACK BEARSETBALK SIO�ET9FCK PLANLMECKN O�R� fE�^� �`, FECEIPTJ�i�� <br /> 3«� C ,�c !YO <br /> us or+e LOTnREA vncnNtsire FEES VALUATION FEE <br /> �— � �r7 YES ❑ NO BUILDING ' ��� <br /> iYPEOfCON57.AlLOWFBIE TYPEOFCONSi.ALTIIAt otti°�NCr NOOrbmwxGUNrtS � <br /> � � �p�u� PLUMBING � <br /> i <br /> SR OF NO.OFSTOFiES BPJEMENT <br /> .3��' �'+„ . MECHANICFL ' <br /> � _ Z ;:1 YES �C NO <br /> U C l�� FIRESPRNKLERS!1E0'D NEIGHT'IMITAT10� OTHER �, lg� � <br /> /�} f] YES �NO STATE 6UILDING SURCMARGE � <br /> REASON FOR SPNNNLERS - � <br /> STAiF ENEFGV SURCHARGE i !"�1 <br /> pPPIICPTION ACC.BY PLANS RPPROVEO BV CITY OF EVERETT PUBLIC WORK$ � G);'� <br /> LOCAL SALES <br /> '�Z �'Jy TAX CODE IS 3105 TOT+� O D � <br />