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APPLICATI�.N FOR CO�ISTRUC'� iON PERMIT everett <br /> me e�e.y�eer. TO BE COMPLETED IN IRK—PLEASE PRINT � <br /> citr oF <br /> everett HEATING SYSTEM: ❑GAS �ELECTRIC � ' C _ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATIJN JC BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MRILApDRESS CiTY 2i' PHONE <br /> ��i?� ��br�G.� 3�oi ul.9i�� iv�-.���r «,� -��7 �Sa_ �3s�s- <br /> TENANT Mrlll RDDRE55 GI ZIP PHONE <br /> Sl3ri;E <br /> �RCHIiECTORDE5IGNER MAtLR��RE55 CITY 21P PHONE <br /> � 3�l3 9 <br /> ✓irl9 �/JeLi9ziiJ �yr��r_y �vaysosr�Ei� -Ts�ao�r/J sdc . 5���/- <br /> GENERALGONTRACiOR MNLADOPE55 CITV 21P PNONE UCENSE� <br /> s'fif.'GCOfZC�ES CTD e5�/b' G-'• 9(o�5'i� TJ�'m�9 y /UC. q,���/� STiYC(CG-�?D(of�i <br /> MECHRNIC/•LCONTqRCTOR MAIL .DDFE55 CITY ZIP PNONE LIGENSE• <br /> � <br /> PWM91 GCONTRACTOF M�IL. )PESS CRV ZIP PHONE UGENSE� — <br /> N/� <br /> LUSS OF WORK <br /> '� �� NEW �'\DDITION �. � ALTERATION � �. REPAIR � DEMOLITION WOODSTOVE/FRPL INSERT �. . BUILDING RELOCATION <br /> � LONtACT PERIS�ON AND PNO E N0. /� <br /> CONTRRCTPRICEOFWORK ��/L��� � �"' /�5 �'r�'� ����" � <br /> ,p[SLRiBEWORKANO50UAR[FOOTAGEINVOLVEO 30� j <br /> l�15YX�/C7 Sl JM�A''':lSh'1 �LxV 1�PC��t� <br /> PROI'OS[DUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> ) �V�V��� (I APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALCESCRIPTIpNOFPFOPRTYISNOWNBELOWOfi ACHfOURCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPIETED WITH WHETIIER SPECIFIED i1EREIN OR <br /> �ot�_ BLOCH pnoaaZ oF �, I P NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OP THE <br /> — PERFORtiIANCE OF CONSTRUCTION.THAT I AM AUThIORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFCIRM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 78.27 RCW AND 296.200 WAC. <br /> SIGNATUREOFCONTRACTORORAUTHOR2EDAGENT DRTE <br /> PR0.IECTFUGTNt55 / �����1L-2m4,1�h 7�i2�9 � <br /> 3b�� //i ���%� `v�ne� /L� , �P IICAN CITVOUSiNE55LICENSENO AN SM[SSNFME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N . TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—lvFINDLG UNITS—H.P. _ <br /> BATHTUB FORCEU AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATEFS—B.T.U. M /- __ <br /> SHOWER � CLOTHES DRVERS __ <br /> KITCHEN SINK&DISP VENTILATION FAN _ <br /> DISHWASHER RANGE HOOD <br /> LAUNDFY TRAY WATER HEATER <br /> CIOTHES WASHER WOOD 6TOVE <br /> URINAL METAL FI CE 8 CHIMNEY <br /> DRINKING FOUNTFIN FIREP CF INSERT � <br /> _�— <br /> FLOOR DRAIN T PUMP <br /> BACKfLOW PR NTERS GAS PIPING <br /> ROOF DRAI —RAINLEADERS � EXHAUST FA�� <br /> S�,IK(SE ICE—BAR,ETC.) <br /> T <br /> I <br /> 1 <br /> SUBTOTAL $ SUBTOTAL 5 <br /> PERMIT S PERMIT 5 <br /> TOTALFEE S TOTALFEE £ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK FERRSETBACK SIDESEiBACH PIANCHEGNNUMB[R F[[ RECFIPTNO <br /> Zo' ZU' S � 9/ �� 7.� �97. G�, yfyz <br /> useicrue iotanea vacnNrsite FEES VALUATION FEE <br /> . <br /> /6 9sz� 3� � BUILDING �'f� � <br /> tvrEn�coN15 dLLowiBtE rrfE of coxsr FCIUAt aN�.�r,r eo o�d�'u�wcubns <br /> fj°'° � PLUMBING <br /> '� 'AL �Lp'� <br /> 52A6oFBL No.oFSTORI_5 BRSEMENT MECHANICAL <br /> J�G � <br /> OCCUPAN VLOAD FlRESPRNNLEFSREOD YEIGMTI� ITATION ADDITIONALPLANCHECK � <br /> A �� �g i � <br /> OTHER <br /> fiEA50N ORSPRINNLERS <br /> STATE BUILDING SURCHARGE iS <br /> INTqKE BV � PLANS RPPRCV[D BY CITY OF EYERETT PUBLIC WORKS <br /> �� LOCAL SALES � <br /> � `f S�ly TAX CODE IS 3105 TOTAL �j�$;SC� <br />