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APPLICATI�� FOli CONSTRUCT�N PERMIT eV� <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> tM Everyreen <br /> CtTV OF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRI� Q <br /> BUILDING DEPARTMENT <br /> 259•8610 <br /> ❑ DEMOLITION I i COMBINATION I i BUILDING �,MECHANICAL f 7 PLUMBING f 7 SIGN <br /> GiYQ ZIP PNO�NjE �` 'J ^ <br /> 01M�ER 1 MAiL�ODPE55 C C.J � F S Q� 4S/ � �`��" 1 <br /> , C 4h �.p4�tfy 1619 �a�kar crv 21r PNONE <br /> 7ENAMT M�LL A Uf1E55 <br /> �RCMITECTOBDES�GkER M�ILADDRE55 <br /> GIiY ZIP PNONE <br /> ��T� Z�p PHONE UCEHSE� <br /> t <br /> OENENAICONTN�C10� M�II.�DDRE55 <br /> CItY 21P P110NE LICENSE� <br /> r,�GW�l1LAlCOMIPACIOR (","�"+°�,as . 112 5P F,�f L�{' �v 982� 355-333/ �� <br /> ' v�� �^ �O CIIY 21P PHONE UGENSEI <br /> pLUMBM'�CONTR�CTO�i M�ILADORE55 WRV N�nq ?.�C'3 <br /> CUSg pF W�7{IN <br /> O NEW I�ADDITION 1 I ALTERATION : 1 REPAIR I I DEMO��TOc PEq�W��NEOo�FRPLINSERT ❑ BUILDINGRELOCATION <br /> �'pNipACTVRIGEOFWORN Z�O <br /> pEe(',qllE WqiK AN�SWARE FOOT�GE INVOLVED f� <br /> �.n.�ci�� qaS �o9s QboJ 3.� ��n2 <br /> � ►IqPO5EDU5EOFBUaDING I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED TH�B <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL/�LL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNINQ THIS TYPE OF <br /> �pkpQg�RIPTIONO�PROPENTYISNOWNBEIOWORATTAGNiWRLOPIES� y,/ORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEHEIN l�R <br /> w� B�aK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR TNE <br /> PERFORMANCE Of CONSTRUCTION.THAT i AM AUTFIORRED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WMICH <br /> APPLICATION IS MADE AND 1 COMPIY WITH THE STATE <br /> CONTRACTORS LAW 182?RCW AND 296.200 WAC. <br /> SIGN�TUPEOFCONTR�CTOROIIAUTHqiRED�6ENT D�7E <br /> X , ni O� �l -Z8-9b <br /> Fl10JECT ADD�E55 APRIG�NTS CITY BUS�NE55 UCENSE NO.ANO BU514E59 NA4E <br /> (�e /S/ /ec�c�ec�- <br /> ���NQ MECNANICAL � <br /> Np, TYPE OF fl%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> /UC—A/HNDLG UNITS—H.P. ' <br /> WATER CLOSET(TOILEn � <br /> FORCED AIR SYSTEMS--B.T.U. M E.A. ' <br /> ' BATHTUB � UNIT HEATERS—B.T.U. M ' <br /> LAVATORY(WASH BASIN) ' <br /> � CLOTHES DRYERS � <br /> � SHOWER ' <br /> KITCHEN SINK d DISP � VENTILATION FAN ' <br /> DISHWASHER � RANGE HOO� � <br /> � <br /> < LAUNDRVTRAY WATERHEATER <br /> � WOOD STOVE ' <br /> CLOTHES WASHEH METAL FIREPUICE 8 CHIMNEY ' <br /> URINAL FIFEPLACEINSERT ' <br /> DHINKING FOUNTAIN HEAT PUMP � <br /> FIOOR DRAIN GAS PIPING �_— � <br /> BACKFIOW PREVENTERS E;(HAUST FAN � <br /> P�JOF DRAINS—RAINLEADERS GA�s t n G-s <br /> '� $INK(SEFVICF—BAR,ETC.) � � <br /> � � � <br /> � � i <br /> 1 1 <br /> i <br /> SUBTOTAL S ' � <br /> y — SUBTOTAL $ � <br /> � � PERMIT S /J�� <br /> v PERMIT S ' TOTAIFEE S ?� '� <br /> ) TOTAL FEE S <br /> � FOR OFFICE USE ONLY: aeceirrr+o. <br /> FRONT6ETBACK REARSETBRCN S�DESETB�GK <br /> PUNCNEGKNUMBER FEE <br /> � FEE <br /> YALUATION <br /> i USE20NE LOTAPEA VpCRNi511E FEES 1 <br /> � BUILDING � <br /> i <br /> fYPEOiGON75.�LlOWPBIF 1Y1'EOiCON5LAL1UAl o0.Urexc+ xodownlixaurns i <br /> cnar p�UMBING � <br /> � <br /> OAS[MENT � <br /> SIZE OF BIDb. NO.OF STORIES MEGHANICAL — <br /> � <br /> i <br /> ADDITIONAL PLAN CHEGK '� <br /> OGGJPMlGVlOAO ���ES�RNNLE115REOD NEIGNTUMI1AilON i <br /> � orHer. _r-- <br /> � REAWNFORSPRMNL[RS STAiEOUILDINGSURCHARGE ' <br /> i <br /> jMTANE BY PUNS�PPROVED BY CITY OF EVEHE7T PUBUC WORKS � <br /> : LOCALSALES ; oa <br /> 1 <br /> TAX CODEIS 3105 ror�� <br /> � : <br />