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1 <br /> � � <br /> APPLICATION FOR CONSTRUCTION PERMIT everett <br /> tne Evergreen TO BE COMPLETED IN INK—PLEA.SE PRINT � <br /> CITv OF <br /> everett HEATING SYSTEM: ❑GAS O ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> �EMOUTION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> O / M�ILADORE55 CIiY 2.1P PHONE <br /> a/� L4B� .(,� �r��9v� z���il� �����j4/ .?f'.2 'o?/.�7 <br /> TENANT � MAIL D�RE55 CITY iP M� <br /> AqCNITECTOFDE51GNEp MAl1.4DDRE55 � CITV ZiP PHONE <br /> GENE9Q,r—C�ONT�RACT,yO�R � /MA)ILADDRE55 dTV IIP pNONE UCENSE� <br /> L'`Lp iMlf/O�q�(GYLh�!-�`� _ <br /> MECNiNICAl CONTR�LTON MAII ADOFESS L17Y ZIP PHONE UGENSE� <br /> PLUMBMGCCNTRnCTOR MAILADDRE55 CITY 2iP PHONE UGENSE• <br /> GLASS OF WORK <br /> ; ' NEW '. � ADUITIUN - ALTERATION . . REPAIR . DEMOLITION �.-- WOODSTOVFJFRPLINSERT ,,� BUILDINGRELOCATION <br /> CONTALTPERSONANDPHONENO. <br /> � LONTRRCiPRICE/�FWpqH � <br /> DE IBE WORN AND 5 E FppT E INVOLVED <br /> PROP eouseoF DING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> L G�l0E5CHIPTIONOFPROP. �SHOWN BELOW OP RTTACM FOUY,GJPIES� PROVISIONS OP LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> � F� WORK WILL BE COMPLETED WI��H WHETHER SPECIFIED HEREIN OR <br /> �or� PLOCK p p / oF. NOT. THE GRANTING OF A PER�11T DOES NOT PRESUME TO GIVE <br /> T <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 PROPERTY TO PERFOfiM THE WORK FCR WHICH <br /> APPLICATION IS MADE ANO I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296. 0 WAC. <br /> SIGNA7lIHEOFC TRRCTOROR�UTHORIZEDAGE ORTE <br /> Z-`1 / S d' Z X � <br /> PRJJECTAD R'.SS <br /> _ RPPL RNTSCITY SINESSUC O.ANDBUSINESSNAME <br /> PL MBIIIG MECMANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EUUIPMENT FEE <br /> WATER CLOSET(TOILET) !VC—lVHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T,U. M E.A. <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER CIOTHES DRYERS <br /> KITCHE�SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> —r— <br /> SUB TOTAL � SUB TOTAL $ <br /> PERMIT $ PERAIIT $ i <br /> TOTALFEE S TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETOACK RERRSEtpAC( SIDESETBACN P�ANCHECNNU�BER , F[E RECEIPTNO. <br /> usezorve tornnea vncnNTsre FEES VALUATION FEE <br /> BUILDING <br /> 1YPFOfCONiS.ALLOWABLE lYPEOiCONSi.ALTOAI ULtuvex[r xo0�o'sfumLurvrtS <br /> aeoun p�UM01NG <br /> SRLOF9LpG. NOAFSiOPIES DASEMENi MECHANICAL <br /> OCCUPFNLYLUFD FIRESPRNKLERSREO'D NEIGNTIIMITAiION ADDITIONALPLANCHECK <br /> OTHER <br /> REASON FOfi SPfiINKLERS <br /> STATE BUILOING SURCHARGE <br /> INtAK[�Y PUNS APPROV[q�1',�, .,� CITY OF EVERE7T PUBLIC WORK$ __ <br /> ����"�� LOCAL SALES <br /> �� �I-a� TAXCODEIS31J5 TOTAL <br /> �: <br />