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;,,r� �:�. <br /> APPLICATIONI FOR CONSTRUCTI �` N PERMIT <br /> everett <br /> Me Ewrpreen e <br /> CITV Of <br />, everett <br />; BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PF�NT <br /> 259•8810 <br /> I I DEMOLITION ❑ COMBINATION I I BUILDING �AECHANICAL ❑PLUMBING ❑ SIGN <br /> MRIADDi1E55 � r S� �TMI ��, ///��� ///��� f�21P�Y /� P E Q�� 338'��0,/�{ . <br /> 1.-� -� l�1 I�G.J� Y <br /> ✓ �� � <br /> fENrN� MAILADpRESS CI�Y 2�P P�E <br /> QnM-�- <br /> � MiCMTECTdiDE51GNEH MAILADOFESS CITV 21P �I� <br /> NERILCONTR�CTIXi MAR�ODRE55 ��� '�ITL �� LI� _P_ , / ^=�/� L���� <br /> i 'i ���i n �l� O�� <br /> YALLE� NANRRI GRS INC ,..,T!_ �.� �� y <br /> n�ciur+�uc«+rRr�q�q92"'.�4°➢P565— 7a4•29?a cirv zm i PHa+e / ���� <br /> 2605 <br /> P1U1.1NM6tON7P�CTOR Ev�reri,�'WslHA{�fb� 98201 ci*v zm r� ��cE�� �. ; <br /> 0.�SS OF WaRN <br /> ���� <br /> I I NEW I. I ADDITION i TERATION lJ REPAIR I-1 DEMOLITION L1 WOODSTOVFJFRPI INSERT ❑ BUILDINQ RELOCATION � <br /> TENIJITMPROVE�.�ENTORINiER101iR LONLY r_(',1 CONT�CTPERSON�NDP110NEN0 <br /> CONiRAGT P1110E OF WORM: �.+0 <br /> CESGRIBE WdIX AE Fd'"^- IN'.'OLVED <br /> � .��t�����U`F�1�IF'1< <(�)'1Gil °' <br /> I rrrox:.�ouseoreun.o �� I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> lEGQ0E5CHiPTqMd"PNOPERiY�51qWNBELOW OR�TIACN FWBCOPICS� PROVISIONS OP LAWS AND OPDINANCES GOVERNIN(3 THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH NMETHER SPECIFIED HEREIN OR <br /> tor e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO 61VE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY i <br /> OTNER STATE OR IOCAL LAW REGUUTING CONSTfiUCTION OR THE � ' <br /> PEHFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WURK FOR 'NHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW ANf�298.200 WAC. <br /> i — 51(iN�NRE OF CONTMCTOR OR AUTFi0RRE0 AOEHf O�TE <br /> X d ,o��,�� <br /> ! ��„�� � _ � � � n �x. <br /> AP ILANTSCITYBU SSLICENSE .I�MUBUSME6SNMIE <br /> I PLUMISINfi MECY.ANICAL <br /> Np, TYPE OF FlXTURE OR ITEM FEE � NO. TYPE OF EOUIPMENT FEE <br /> I WATER CLOSET(TOILEn � NC—AMNDLG 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 /> SFIOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP ' VENTIUTION FAN i <br /> � <br /> DISHWASHER � FANGE HOOD ' <br /> WATER HEATER ' <br /> LAUNDRVTRAV � � <br />' CLOTHES WASHER � WOOD STOVE ' <br /> i � METAL FIREPL CE 6 CHIMNEY ' <br /> URINAL <br /> ORINKINO FOUNTAIN � FIFEPLACE INSERT � <br /> FLOOR DRAIN ' HEAT PUMP _ ' <br /> BACKFLOW PREVENTERS � GAS PIPING <br /> � <br /> ROOF DAAINS—HAINLEADERS � EXHAUST FAN ' <br /> , � <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � _—� <br /> � ' <br /> i � <br /> i <br /> � i <br /> � <br /> � SUBTOTAL f ' ' ' <br /> SU8T07AL S � � <br /> � PERMIT S � <br /> �� TOTAL'FEE S ' TOTALFEE S ' � <br /> Ff10NT SETB�CK REAR SETBACN S�DE SEiO�CN PLNI CHEGK NUMBEH FEE <br /> RECEIPT ND. <br /> USF.20NE LOTAREA V�C�Ni511E FEES VALUATION FEE <br /> _ ❑ YES ❑ NO BUILOMr . ' <br /> tm[acoN5�.0.LoweBi[ TrrtnrtaNsi.�cma °Bp^""�" ��������rs i <br /> fPO� PLUMBING <br /> i <br /> SIZE OF BIIXi. tq.OF S70FlIE5 AASEMENI MECNANICAI � � <br /> I 1 YES Il NO ; <br /> OTHER ' _ <br /> occurnrvcv�ono FIRESPONNLERSREOD HEIONTLIMIiATION -. . i <br /> f 1 YES f I NU STATE BUILDING SURCHAHGE � <br /> ncnsor+FonsrRMK�ens ' <br /> S1ATE ENERGV SUfiCHARGE � <br /> nrriwn�ror+eccev PUNstirrnoveoer CITYOFEVEflETT pueucwonKs � <br /> LOCAL SALES <br /> TAl(CODE IS 3105 *oT�� ' � <br />� _ <br />