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� APPLICATIt��I FOR CONSTRUCTION PERMIT - <br /> everelt <br /> !�e Evergiern � <br /> QiV OF <br /> everett <br /> BUILDING DEPARTMENT Tp gE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 MECHANICAL PLUMBING SIGN <br /> DEMOLITION COMBINATION BUILDING <br /> OYMER MnILPDDR[55 CiTV 11�' PuONE <br /> TENANT MAII AD�RE55 GtY 21P PHONE <br /> pRCHITECiOROE5IGNEN MAILApORE55 GITY ZIP PNONE <br /> GENEPALCONiPACTOR IARILA�ORE55 CiTV ZiP PMONE Li�ENSE� <br /> l'1�� <br /> GTY ZIP PMON[ LICENSE� <br /> �r] MECNRNICALC@1iPALTOH MAILAOpRE55 <br /> GH �in. Z�p PNONE LICENSE• <br /> YHN �LUMBINGGONTBALTOR MAILRODRESS <br /> � CL�SSOi WORI( <br /> � y� NEW . �� ADDITION �. . ALTERATION . REPAIR � DEMOLITION � �. WOODSTOVE/FRPL INSERT BUILDING RELOCPTi�N <br /> � H� T[NRNTIMFPOVEMENTORINiER�ORiI[A10�ELONLV CONinCTPEP50NANDPHOVENO <br /> i/1 H <br /> Hq CONiRRI PRiCEOFWOAN: <br /> � �+a DESG�iOEWOPKANO50UAPEiOpiPGEiNVOLVE� <br /> �o �t/E�i DE�GC�,��n G 7Z�GF 6975F <br /> PROPOSEOUSEOFBUILDING I 4EREBY CCRTIFY THAT I HAVE REPD AND EAAMWED 1HI5 <br /> M �g _ APPI.ICATION AND KNOW THE SAME TO DE TRUE AND CORRECT.ALL <br /> n� n — PFiOVI510N5 OF LAN'S AND ORDINANCES GOVERNING THIS TVPE OF <br /> �E�n,oesceivrronoFPRoceanisHovrt+eeiowoanTuc�:��uncories� y.�pRK WILL BE COMPLETED WITH WHETHEFi SPECIFIED HEREIN OR <br /> � y� iar g�aK or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> N H OTHER STA7E OR LOCAL LAW FiEGULATWG CONSTRUCTION OR THE <br /> l7 Cn M _ PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEO BV THE <br /> nd N OWNER OF THIS PROPERTY TO PERFORM THE WORK F(1R WHICH <br /> p APPLICATION IS MADE AND I COMPIY WITH THE STATE <br /> �i1['� CONTRACTORS IAW 1827 RCW AND 296200 WAC. <br /> H p� <br /> SIGNALUREGFCONTPACiORORPIITNOR2E0AGENi DPLE <br /> H O f/� <br /> X <br /> PROJECTA�OFE55 APpLICANiSGItV�U51N[SSLICENSENO nNp8U51NE55NAME <br /> PLUMBING MECHANICAL , <br /> NO. TVPE OF FI%TURE OH ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—NHNDLG UNITS—H.P. <br /> �' � FOFiCEO AIR SYSTEMS—B.T.U. M E.A. <br /> I � BATHTUB — . <br /> � UNIT HEATERS—B.T.U. M <br /> LAVATORY(WASH 9FSIN) — <br /> CLOTHES OFVERS � <br /> SHOWER <br /> '�' � KITCHEN SINK 8 DISP VENTII.ATION FAN �� i <br /> � i DISHWASHER � <br /> RANGEHOOD <br /> LAUNDRYTRAY WATER HEATER �� I <br /> CLOTHES WASHER �lOOD STOV[ � � <br /> � � METAL FIREPLACE 6 CHIMNEY , . <br /> I � URINAL � FIREPLACEINSERT ' <br /> �� <br /> ORINKING FOUNTAIN HEAT PUMP � <br /> FLOOR DRAIV - i <br /> � BACHFLOW R'EVEN7ERS� GAS PIPING �I <br /> � ( � ExHAUST FAN , I <br /> �� ROOF DRAINS-7AI � ADERS <br /> SINK(SERVICE-- AR,ETG.) <br /> �� � � �� <br /> � <br /> � SUBTOTAL $ SUBTOTAL 5 _ <br /> �'� PERMIT $ PERMIT 5 �_ <br /> iOTALFEE $ _ TOTALFEE $ <br /> I PUNCHECNNUnIBER �FE /,.. (,(�K. �EGEICTNO II <br /> •' FPONi5ET9nCK REARSETBRCK SIOESEiBAGtt �` ' � �� � <br /> • vncnnrsrce FEES VALUATION FEE � <br /> USE ZONE lOT RREA <br /> � � YES �. : NO BWLDWG � J 87 I �� <br /> LYPFOftON4.AllOW�BIE iY{'COlLOHStAL111AL occuo�w.r qoamvuuM;�xas �� <br /> euour p�UMBING I <br /> — i__ <br /> SREOFBIDG NOAFSTORIES BASEMENL M[CHANICAL I <br /> 7 Sf � YES X NO _ - � <br /> OCCUGANCYlOAO FIHESPNNNLEPSRCO'0 HEIG11ilIMIiA'ION <br /> OTNEF ' �I <br /> ( I ; YES �C NO � STAiB BUIIDING SUFCHARGE _ � <br /> RGSON FOR SPRINNlERS <br /> STATEENERGYSURCHARGE <br /> nrricatior+nccov rur+sevrr.oveoar CITYOFEVERETi rUaucwo�Ks i <br /> LOCAL SRLES ;5p <br /> TAX COUE IS 3105 TOT^� __ <br /> � � <br />