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APPLICATIO� FOR CONSTRUCTC3N PERMIT <br /> everett , <br /> tr�e ewr�,�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CI7V OF <br /> everett HEATING SYSTEM: GAS ❑ELECTFIC ❑ <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> ❑ DEMOLITiON C COMBINATION _ i7 BUILDING �MECHANICAL y�PLUMBING ❑ SIGN <br /> ONRlER I� MAILAUDRE/5�5� �i7y /Z��p p�"E� <br /> �R-N NT I�l Il U—d///�l)R�YIAD IEIX � �I�nk'F�Y' �r\�L� / Oy��� rVN A Y ]/ Y ) <br /> ARCHITECTOflDE51GNER M�ILAODNE55 CITY 21P PHONE <br /> �GENEIULCONTRACT/O�R MAIL�,DID,RE55Qn-�.�^' [C�ITV /Z�IPp' P/H7O,�NE] / /UyCE,/N�SE�-y• -I /� <br /> MECM�!lICALCONTR'�CTtI�)1Fwl^IIA41q�s'1�7lIC�ll i(t�i 1 / �TV f ICG� -/ p �� '�J 7Y'���L' C_ �P lY/I RJ//�f�f /R�" �� <br /> PWMBIN(3CONTq�CTOR MAILADDRESS CITY ZIP PMONE UCENSE• <br /> ClASS OF YIORri <br /> r ❑ NEW O ADDITION i ALTERATION I�.' REPAIR ;� DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILOING RELOCATION <br /> �j TACTPERSONiV1DP Np. [� / /� <br /> r CON�RACTPRICEOFWOfiN I Q �'� C"��� F �ti / `ICU.�(�C� <br /> j pDESC�R,I�BEWORKANDSW�REFOOTAOEINVOLVED <br /> ' '�-_j ( OC_l�� -�.71 P./Y] C f� <br /> PFiOPO5EDU5EOFBUILO IG I HEREBY CERTIFY THAT I HAVE FiEAD AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEOAL DESCRIPTION OF PROPERTV�SHOWN BELOW OR RTTFCH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> ! �oT BIOCK pF WORK WILL 8E COMPLETED WITH WHETHEFi SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY � <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEfiFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> �� OWNER OF THIS PqOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> � CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SIGN�TUREOFCONTRACTOROR�UTMORIZEDAGENT O�1E <br /> � PHQIECT,WDRESS � S � ���,5��[S[ IO I I� I _I I <br /> �QO� APPLICANTS CIIY BUSiNE55 LIGENSE NO.AN�BUSINESS NRME <br /> PLUM81Nfi MECHANICAL <br /> � N0. TVPE OF FlXTURE OR fTEM FEE NO. TYPE OF E�UIPMENT FEE <br /> ' WATER CLOSET(TOILET) lV�A�HNDLG UNITS—H.P. , <br /> ! BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � <br /> UVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> � SHOWER CLOTHES DRYERS � <br /> KITCHEN SINK 8 D�SP VENTILATION FAN <br /> . DISHWASHER RANGE HOOD , <br /> UUNDRY TRAY WATER HEATER <br /> � CLOTHES WASHER � WOOD STOVE ; <br /> URINAL METAL FIREPLACE&CHIMNEY � <br /> , DRINKING FOUNTAIN � FIREPLACE INSER7 ; <br /> FLOOR DRAIN HEAT PUMP � <br /> ' _ BACKFLOW PREVENTERS GAS PIPING <br /> __ ROOF DRAIPiS--RAINLEAUERS EXHAUST FAN � <br /> _ SINK(SERJICE—BAR,ETC.) � �— <br /> � <br /> � <br /> � <br /> � <br /> � SUB TOTAL $ ; SUB TOTAL $ ,[//J .. <br /> _ PERMIT $ PERMIT $ /�i - <br /> TOTAL FEE $ TOTAL FEE $ — <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�CK REARSETBRCN SIDESETORGK PIANCHECNNUMBER FEE RECEIPTNO. <br /> useZOr+e LOT�RER VqCANTSITE FEES VALUATION FEE <br /> OUILDING � <br /> i <br /> iYPEOFLONiS.pLIOWABtE 1vPE0FtONSi.ALiUAL occuwrtr xo OvowtwxGuxns <br /> 4NWP pWMBING <br /> 1- <br /> SIZEOFBL�G. NOAFSTORIES B�SEMENT MECHANICAL � <br /> m - <br /> OCCUP�NGVLO�D FIRESPPNKLvqS(iEOU HEIGNTIIMRAT10N <br /> ADDITIONAL PLAN CHECK ' <br /> OTHER <br /> REASON FOR SPFINKLEPS <br /> STATE BUILDING SURCHARGE <br /> INTRNE BV PUNS�TPROVEO BY CITY OF EVERETT PUBLIC WORKS � <br /> � LOCAL SALES ' <br /> TAX CODE IS 3105 �TAL ' <br /> �r-� - <br />