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APPLICATI�.+1 FOf� CONSTRl1CT�JN PERMIT <br /> �����« <br /> .,,:,�,�..�,�.�.,, � <br /> ciTv or <br /> everett <br /> BUILDING DEPARTMENT TO BE COMP ETE�J IN INK—PLEASE PRINT <br /> 259-8810 MECHANICAL PLUMBING SIGN <br /> DEMOLITION COMBINATION BUILDING <br /> 01VNCR ldAI�P�DP[SS CIIY ZiP ��+ONE <br /> � �' � �ULE�l�r F.:rlN�2 20 3 N '�h-�'t' $EQTTis 9� � — <br /> b'� m ,�H�N� M�LLA�C�R�55 ��.� Z�� F���N� S�t7�-1 Y7; <br /> Y H V1 . GTY ZiP P�iON[ <br /> N � � ARCniIEGTOPDESiGNER AIAILp�DPE55 <br /> CITY ZIP PHONE UC[NSE• <br /> M <br /> O R' O GENENAICONTPPLT/OR MAiLADDAE55 <br /> b N H � e I LICENSE� <br /> ��T� Z�p PHONE <br /> H� � � At[LIIANICRLCONTRRCTOR MRILAD�FE55 <br /> N Q <br /> re CITY 21P PMONE LICENSE� <br /> O� n � PLUbIpMGGONTRACTOB MAILP�DRE55 <br /> M � CL �SOFWORK <br /> 7 H z . NEW �. ADDITION . . ALTERATIOt � REPAIR _ DEMOLITION WOODSTOVEIFRPLINSERT . ' BUILDINGRELOCATION <br /> t" CONTACT PEFSON RND PNONE NO. <br /> yy TENANTIlAPPOVEMENTOflINiERiORP[�10DELONLY E C C� �l�y` Fy"1�R 5�.1�1Q�1 <br /> M C 7 <br /> � b y CONTPPCiPRICE0FIVORN: <br /> C DESCFi�BE WORK AND SOUARE FOOTAGE INVOIV[ <br /> � "y � z xz r�r <br /> O tNi� PROPOSEDUSEOFBUiLDING I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> G�q�`� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESGRIPTONOFPROPERTVISN0IYNBEL0IVORAT�CNFOURCOPIES� PROVISIONSOFLAWSANDORDINANCcSGOVERNINGTHISTYPEOF <br /> WORK WIIL BE C•�MPLETED WITH WHETHEF SPECIFIED HEREIN OR <br /> �oT� o�a� �.p °F 1O I. T � NOT. THE GRANTING OF A PERMIT DOES NOT PRESU1dE TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> / TI:R�i1 OI � �a Y . I OTHER STATE OR LOCAL LAW REGULATING CONSTRUGTION OF THE <br /> PERFORMANCE OF GONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SiGNAtUREOfCON1RACTOROFFUiMOR�ZE�AGENi �AiE <br /> E M A 2► a X � '�- �� 3/�z I �'9 � <br /> �. , <br /> PRQIECT ADORE55 qPpLiCANTS.ITY BUSiNE55 LICENSE N0.AN�BUSiNE55 NRME <br /> /_� <br /> I � PLUMBING MECHANICAL <br /> � FEE <br /> Np, 1 TYPE OF FIXTURE OR ITEM FEE N�' ti�C-A�H DLG UNITS-H.p ENT <br /> 1 WATER CLOSET(TOILET) <br /> FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> f�r� BATHTUB UNIT HEAiERS-B.T.U. M <br /> ��� LAV�TORY(WASH BASIN) CLOTHES ORYERS <br /> i . SHOWER � VENTILATION FAN <br /> KITCHEN SINK&DISP ' — <br /> DISHWASHER � RANGE HOOD <br /> � WATER HEATER <br /> i I I . LAUNDRVTRAY — <br /> � WOOD STOVE <br /> CLOTHES WASHER <br /> METAL FIREPLACE 8 CHIMNEY <br /> URINAI FIREPLAGE INSERT f <br /> DRINKING FOUNTAIN HEAT PUMP <br /> �_1 FLOOR DRAIN GAS PIPING <br /> �� BACKFLOW PREVENTERS — EXHAUSTFAN <br /> . ROOF DRAINS-RAINLEADEfiS <br /> � SINK(SERVICE-BAR,ETC.) � <br /> 1� �_ <br /> �� <br /> '�� SU8 TOTAL 5 PERMOTAL 5� �— <br /> �' �� PERMIT $ - TOTAL FEE 5 <br /> TOTALFEE $ <br /> PUINCMECNNUMO[R �EE���^, R«EiPT,NO� <br /> . FRONT 5 TBA �� REAR SETBACN / � Si�[5[TB�K � 5 3 <br /> � s FEES VALUATION FEE <br /> USEZO�' � ��R�A VACANTSItE .� � iQU <br /> y � �J '. '. YES � N� pWLDING <br /> accwumr xaarowuvvevM�+s — <br /> iYPEOLCON51.AllOWABIE TVPEOiL01151!ACIDFt ppq�v PLUM�ING <br /> {�' � <br /> SREOfBLDG. NO.OFSTORIES UASEMENT MECHANICAL <br /> L`l K LN I YES �o �� <br /> � OGLUPANCYLOAD FIRESPRNKlER5RE0'D HEIGMT�ijpH <br /> � OTHER _�— <br /> N�NG i ��. YES �N� '� STATEBUILDINGSUflCHARGE y iS� <br /> R[ASON FOR SPRiNNlERS S7ATE ENERGV SURCHAflGE <br /> �PPLICATIONACC.BY PLANSPPPROVEDBY CITYOFEVERETT PUOLICWORKS <br /> LOCAI SALES rora� � ' S� <br /> TA7(COUE IS 3105 <br />