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APPLICATI - --- -- <br /> O. . FOR CONSTRUCTI JN PE e��erett <br /> RMIT <br /> rne Evargreon TO BE COMPLETED IN INK—PIEASE PRINT � <br /> CIl Y OF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-�810 <br /> i 1 DEMOLITION L] COMBINATION ¢( BUILDING ❑MECHANICAL ❑PLUMBING i7 SIGN <br /> OWN[R MRILpODfiESS CITV ZIP PHONE <br /> iE�.raF E�EaFrr f�D, F�x �3�r i /�� <,�7i- 9�r"DG r,�1 3/�¢ <br /> MAILAODRE55 CITY 21P PHONE ' <br /> SAA/1F. �S AR<',ff� <br /> ANCHITECT OR DESIGNER MAII AODRE55 CITv ZIP PNONE <br /> R,L,�i�r�lii fr[5 C�O. Gly �/,::d�li .4r, r'2c�6 '�rtir' S'9iis� f.��sL97 '1/�8'C�rs <br /> GENERALC TR�CTOR MqLAODRESS GITV ZIP PHONE <br /> � , LICENSE� <br /> ' SEfzt!!dE PI�, �k , 4,�^,-3"/ ! UM s lj <br /> MECHFNIGLCONTRACTOF MAILA DRESS CITV 21V PHONE <br /> LICENSE 1' <br /> PLUMBiNGCONTF�CtOR MAILADDRE55 CITY ZIP PNONE <br /> LICENSE I <br /> CUS$OF WORK <br /> Dfl NEW f.1 ADDITION C I AITERATION I_l REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> CONTACi PERSON AND PHONE N0. <br /> CONTRAGT PpICE OF WOpK �Q� hO^��j,� � � <br /> ' DESCRIBE WORK�NO SWARE FOOTqGE INVOLVEO �J rvc <br /> Vuo Gao � - 3i s, . 259 3/69 � Y1�e �o ,._o„ <br /> PROPOSED VSE OF BUIl01NG <br /> �pt 1 HEREBY CEFTIFV THAT 1 HAVE READ AND ExAMINE �THIS <br /> - �pr APPLICnTION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DESCRiPTION OF PROPERTV�SHOWN BELOW OP ATTACH FOUA COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �oT BLOLK oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE�N OR <br /> — NOT. THE GRANTING OF A pERMIT DOES NOT PRESUME TO GIVE <br /> �� 2 r C�{J. , OTHER STATE OR LOCAL LAW EGULATI G CONSTR C�ION OR THE <br /> ,l, PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THI� <br /> AI��I°3 �I� Ip✓S¢�axl�����E OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANO 1 COMPLY WITH T�STATE <br /> CONTRACTORS LAW 18.27 RC ANQ 2g6200 WAC. �/ r <br /> � SIGN�p]REOF�1��7qOR 1 RIZED T pI.TE <br /> // I 1/ <br /> � X `6E 1� ✓d' <br /> raaecT�oonEss /J,�� �� r`.e <br /> �.C��lL� <br /> APPLICANTS CITV BUSINESS LILLHSE NO.AND Bl151NE55 N�ME <br /> PLUMBING MECHANICAL - <br /> NO. TVPE OF FtXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C--NHNOLG 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 � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE � — <br /> UFINAL � METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOl'VTAIN FIREPLACE�NSERT — <br /> FLOOp DRAIN HEAT PUMP —�— <br /> BACKFLOW PqEVENTERS ' GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FP.N <br /> SINK�SERVICE--BAR,ETC.) � <br /> � <br /> � �T <br /> 1 � <br /> T <br /> SUB TOTAL $ SUB TJTAL a ' <br /> PERMIT $ � PERMIT $ ' <br /> TOTALFEE $ TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONiSETBRf,( qEr1R5ETBnCK SIDESETBACN PLANCNECK BE FEE RECEIPTNO <br /> USE ZONE lOT Afl— `f ���J� ��•�� I�� <br /> vncnNrssir�e FEES VALUATION FEE <br /> iYPEOiCONiSALLpWABLE v BUILDMG � <br /> lYPEOF[ONSIALIDAI aareicr xoOrDwttuxcuxrt5 <br /> GpW� � PLUMUING � <br /> i <br /> i <br /> SRE OF BIUG. N0.OF STORIES BASF.MENT ^ <br /> MECHANICAL � <br /> OCCIIPANCYLOAO FIRESPRI�KlERSfl[OD HEIGHT:�MITATION ADDITIONALPLANCHECK i <br /> � N A - � <br /> NE/SON FOP SPqiNKLERS <br /> OTHE� � <br /> $TAT:BUILDING SURCHARGE <br /> INTRKE BY PLANS �PPqOVEO BY CITY OF EVEflETT P�IBUC WORKS � — <br /> �� LOCAL SALES � <br /> � �� TAX COOE IS 3105 TOTAL <br /> � � — � `r-U c <br />