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APPLICATIO�. FOR CONSTRUCT��N PERMIT everett <br /> mc e�a.y.P�� TO BE COMPLETED IN INK—PLEASE PRI��T � <br /> CITV OF <br /> everett HEATIIJG SYSTEM: ❑GAS ❑ELECTRIC 0 <br /> BUILQING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION JC BUILDING ❑MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER M�ILR�DRESS CITV 21P PNONE <br /> il F �nn'�pf �Iba� Vieul�r^�; °�'� CVefeth 3�l8-DS�oa <br /> TENANT��r M�ILADDPE55 LIN 21P PNONE <br /> 5ame. <br /> ARCNITECTORDESIGNER MAILADORE55 GTV ZIP PNONE <br /> 1Jerahern�e��ie CorLst s�la9 �5�� � i11ar��:�IP 9ga�� (n59-0635 <br /> GENEAALCONTR�GT�O M�ILADD 55 GITY ZIP PNONE LILENSE� <br /> 5amr �10����.� �c� c_.. NoRTN PC 1 a.��a <br /> MECHANICAl.GONTR�GTOR MAIL ADORES QTY LP PMONE LICENSE I <br /> none <br /> PWIABINGCONTRACTOR M41lAD�RESS GITV ZIP PNONE LICENSE• <br /> n�ne <br /> cuss oF woaK <br /> ❑ NEW fK ADDITION ❑ ALTLRATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ DU�LDINGRELOCATION <br /> � CONT�CT PERSON A1NlD_PNONE N0. <br /> CON'RACTPRICEOFWORK �'� /� '� �aUC Of I�� 5 SG-U(n3 <br /> DESCRIBE WORK�NO SOWFE FOOTAGE INVOlVEO <br /> e 's 'n af; 5s.f. i nelu i � 'ps <br /> raoPoseouseoFeuaowc - I HEREBY C T�FY THAT I HAVE READ AND EXAMINED THIS <br /> �a-��6 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> iecn�oescaianor+oFrnoPEeTv�sHowNee�owon.+rTacNFouncoriesl PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or_�_ BLOCN oF 5 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> _ AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE CR LOCAL LAW REGULATING CONSTRUCTION OF THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTfiACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNANREOFCONTR�CTORORAUTNORIZED�GENT DATE <br /> ��� �-a 3- 9/ <br /> PRp1ECTADDRESS � �/T/A'L/hPQ/I�/NG�{� ['�LN� <br /> � ��1 APPIIG B INESSLICENSENO.ANDBLISINESSNRME <br /> L� <br /> PLUMBIN3 MECHANICAL <br /> N0. TYPE OF FIICTURE OR ITEM FEE NO. TYPE OF EDUIPMENT FEE <br /> WATER CLOSET(TOILET) WHNDLG UNITS—H.P. <br /> BATHTUB FOP AIR SYSTEMS—B.T.U. M E.A. ' <br /> AVATORY�WASHBASW�� UNITHE ERS—B.T.U. M I <br /> S WER � f,LOTHES D ERS <br /> KITC N SINK 8 DISP i VENTILATION F <br /> DISHWA ER RANGE HOOD <br /> LAUNDRY Y � WATER HEATER <br /> CLOTHESWA R � WOODSTOVE �_ <br /> URINAL ' METAL FIREPLACE 8 CHIMNE <br /> URIhKIPJG FOUNTAIN i FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAIN�-9AINLEADERS � EXHAUST FAN <br /> � <br /> SINK(SERVICE—EAR,ETC.) <br /> � <br /> , - � <br /> � <br /> � <br /> SUB TOTAL $ SUB TOTAL $ <br /> PERMIT $ � PERMIT $ <br /> TOTALFEE $ TCTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB;CK REARSET�AL; SIDESETBiCK / PLA�G�'7MBE FEE .O �S RE��N�� �J <br /> LS ZS � fi d Y J <br /> USE20NE LOTA(iEAM vncnNrsrtE FEES VALUATION FEE <br /> R`5 I� Sw OUILDING 3676 �� �Od <br /> (YPEOfCONiS.ALLOWRBIE 1YPEUFCONS1.RGiUAI acaic�x[r xopbMuixcuxns � <br /> cnwio PLUM�ING � <br /> �� Q. � — <br /> 5¢E OF BL�('i. NO.OF STORIES OASEMENT MECHANICAL <br /> Y7 SE c'ovx I N� � <br /> OCCIJPANCY LOR� FIRE SPRNKlERS REO'D NEIGHT Llldl TION ADDITIONAL PLAN CHECK � <br /> ^/O � � OTHER � <br /> r�EnsoN onsrmNKteas <br /> --�—' <br /> STATB�UILDING SURCHARGE L� i�Z <br /> Y <br /> � INTAREOY PLANSAPPROVE�DY CITYOFEVEREIT PUBLICWORK$ ' i <br /> g� LOCAL SRLES , <br /> 1�/.( TAX CODE IS 3105 T�Tp� �a � ;-rn <br />