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` <br /> ��-� APPLICATIOI�FOR CONSTRUCTI�'N PERMIT everett <br /> ��E� ,�„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett �EATING SYSTEM: J GAS ❑ELECTRIC O --1 <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUi.DING �CHANICAL PLUMBING SIGN <br /> OWNER MAIIADDRESS CITY 21P PHONE <br /> �r�r��%P�'EI'��[l�� J00/�u�,f'ni.4w. fi�lt�' qk20/ ZSZ- 4JS'S <br /> TL'lANT MAII RDORESS CITV ZIP PNONE <br /> pRGH�TEGTORpESrGNER MAILr1DORESS CITV ZIP PHONE <br /> G�EN�E"RA�L�CO�NTPAGTO / Mr11LRDDRESS pTY 21P PHONE UCENSE• <br /> 1.�l�fa�� l ef��t' 264� �1� ��.�' �v`eCr'{� a)�01 25�-�1�7Z V�1-11 FN��) �LI <br /> MELHRNICAL C fiNT�ACTOR MRIL�ODRESS dTV ZIa PHONE UCENSE I �� . <br /> a � <br /> . PWMBINGCCNTRACTOR MNLADDRESS C�iY 21P PHONE IIGEN5E1 <br /> GLASS OF WORN <br /> . NEW . . ADDITION � LTERATION . I REPAIR '��. DEMOLITION . WOODSTOVE/FRPL INSERT ._; BUILDING RELOCATION <br /> ' /�y�r CONTACT PEPSON�NO PIIONE NO. <br /> '� CONTRAC�PRICE OF WORK '/�� . <br /> DESCRIBC WORN AND SOU�IIE F/O'OTAGE INVOLVED <br /> c f <br /> . PROPO'iEDUSEOFBIIILDING 1 HEREBY CERTIFY THAT I HAVE fiEAD AND EXAMINED THIS <br /> _��/Z APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ' LEWI.OESCRIPTIONOF PROPERTY�SMOWNBELOW ORATTRGM FOURCOPIBS� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> ' WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> . LOT _ BLOCK oF 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 /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> ' PPPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> . SIGNATUREOFGONiNACTORORAUiHOPREDAGENT DFTE <br /> PRQIECTAO�PE55/!'') /� � � r ti•J�/��( FI�' //�//-J�ILn"."_ ""J/IJ . V/�! r�/ <br /> . /OOI / \�C j�(/t�� �P���CANT GITYBUSMESSLIGENr9E O.ANpbJ51NE55 � � � � <br /> ', PLUMBING MECHANICAL � <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> ; WATER CLOSET(TOILET) NC—A/HNDLG UNITS—H.P. � <br /> + BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � LAVATORY(\YASH BASIN) UNIT HEATERS—B.T.U. M <br /> � SHOWER CLOTHES DRYERS <br /> � KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWA�HER � RANGE HOOD <br /> ` LAUNDRV TRAY WATER HEATER <br /> '. CLOTHES WASHER WOOD STOVE i <br /> � URINAL METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PqEVENTERS GAS PIPING <br /> � ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ET0.) <br /> i <br /> . SUB TOTAL $ SUB TOTAI S 5p '— <br /> PERMIT 5 PERMIT $ ��I ' <br /> TOTAL FEE $ TOTAL FEE $ C.S-� — <br /> FOR OFFICE USE ONLY: <br /> FFONT SE79nCK REFR SET9ACN SIDE SETBaCN PLRN CHECK NoUMBER FEE RECEIPT N0. <br /> � � .J_OJ <br /> use zoNe tor anen VpCr1NT SITE FEES VALUATION FEE <br /> BUILOING <br /> LYPE Of CONiS.ALLOWPNIE iVPE Of CONSi.ALiIIAL aarA+rcr xo w oniwxsuwri <br /> LPO�' PLUMBING <br /> SIZ[OFBLDG. NO.OfSTORiES B�SEMENT MECHANICAL ���� " <br /> OCCUPANCV lOAO FIRE SPRNNLERS REOD NEIGlR LIMIiATION ADDITIONAL PLAN CNeCK <br /> OTHER <br /> FEASON�OR SPRINNlERS — <br /> STATE BUILOING SURCHARGE <br /> INTANEBV PLANSAPPNOVED�Y CITYOFEVEHETT PUBLICWORHS <br /> LOCAL SALES <br /> TAX COUE IS 3105 rorn� ��; I_ <br />