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a�PP�oc,�r�oN FOR cor�s�����rio� <br /> p�Rnn�� <br /> fhn Everg�eon evereU <br /> CITY OF <br /> everett � <br /> BUILDING DEPARTMENT <br /> 259-efl10 TO BE COMPLETED IN INK— PLEASE PRINT <br /> �WNEP AUILAO�RE55 GIiY =��' P��ONE _' <br /> ��y�.�ar�r�.��P1���� '7 I I c-� �?� G S�iLY:—r�Cf— I�t.�Vl �J�'<<�( � <br /> TENANI 1 n MAILP�ORESS CIiV — Z� PHON[ <br /> x �, .` ���- – ��_�'��__�Cl��'(?v� �--�—�-i ` <br /> n ic• 1' .•P � ,�" n,c ��1�+ �,7 �..• t �IA.L(- ��Z�'f ZS`1-655"l <br /> ARCHIiEG RD�SIGNE MAILRDDHE55 CIIY ZIP PIIONE I <br /> �_ I <br /> �GENERALCONi(iACTOR �. 1 J'� MAILFDORESS — CrtY ZIP PMONE LIGENSE• I <br /> (/V � <br /> � u�� '/ _ _C. ���...�. <br /> ME� LCONTpA OI AI��Lr1DD1iES$ ` "-�" CITY ZIP PIIONE LIGENSEs I <br /> PLUMOINGCONiRACTOR MAILFDORE55 CItY ZIP PMON[ UCENSE� <br /> LLASS OF WORK <br /> ❑ NEW ❑ ADDITION ❑ ALT[FATIOi� ❑ REPAIR ❑ �EMOLITION ❑ WOODSTOVE/FRPLINSERi ❑ BIJILDINGRELOCATION <br /> �TENANT IMPROVEMENT OR INTEliID��RyEidDOEL ONLY CONIAGi PERSOH/Np PIIONE NO <br /> CONTRAGTPPICEOFVJOFK -'il Iy `.)(��•_I � e;�'J'`�`f`�1�� I C1�S3�?Sy9 <br /> pESGNIBEWORN JDSOUA EFOO G I V LVED Q � <br /> n �cvt� ,cr���r`�°e ��p��.�n�n� <br /> � 1'ar�tu�s.��ta�r�F__�r- �,ti��Sec.l� 7,�tca �ceor�' -- � <br /> PFOPOSEDUSE FBUILDMG IHEREBVCERTIFYTHATIHAVEfi@ADANDEICAMINEDTHISAPPLICATIONANO <br /> ,f- SI.���,� KNOWTHESAMETOBEIRUEANDCORRECT.ALLPF:OVISIONSOFLAWSANO I <br /> t OR�INANGES GOVERNING 7HIS T`/PE OF WOfiK WILL DE COMPLE7ED WITH <br /> IEGALDESLRIPtIONOFPRO lY�SMOWNBELOWORRTIPCI1FUUfiCOP1ES1 WHETHEflSPECIFIEDFIEREINORNOT.THEGRANTIWGOFAPERMITD0ESN0T <br /> �oi eioCK oF PRESUME TO GIVE AU7hI0RITY TO VIOLATE OP GANCEL 7VIE PROVISIONS OF I <br /> - ANYOTHERSTATEOR_OCALLAWREGULATINGCONSTRUC710NORTHEPER� � <br /> PORMANCE OF CONSTRUCTION.TFIAT I AM AUTHOR¢ED 6Y THE OWNER OF , <br /> THIS PROPERTY 70 PERFORM THE WORK FOR WHICH APPLICATION IS Mi�DE <br /> AND I COMPLY WITH THE S1ATE CONTRACTORS LAW 1827 RCW AND - <br /> 296 200 WAC. <br /> S�G��AtUPEOFCO G101101inULiOqIZEDAGENf UATE � <br /> ,—��������Mp��e,HP,� ��� =Yuti� — X � <br /> f),nan l� ci a �1 [�cGr�r,1�� . I _ � <br /> PROJECfA�OR[SS rr � ' <br /> pPPLICAM5G1 FIUSIN[SSUf. lSENOANODU$�ISSNAIAE <br /> � Z( (O �-?�"L` �� r�=e-1 f�v�e-f� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE I <br /> WATER CLOSET(TOILEn A/C—NHNDLG UNITS—H.P. <br /> ___ __— � <br /> BATHTUB FORGED AIR SVSTEMS�-B.T.0 M EA �� <br /> LAVATOPY(WASHBASW) UNITHEATERS—�.T.U. M �� <br /> SHOWER CLOTHESDRYERS I <br /> KITCHEN SINKB DISP. VENTILATION FAN _ ' <br /> DISHWASHER RANGE HOOD I <br /> LAUNDRY TRAI' WATER H[ATER � <br /> CLOTHES WASHEfi WOOD STOVE � <br /> URINAL METAL FI(7EPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAW FIREPLACFINSERT . <br /> FLOUR ORAIN HE�T PUMP __ � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK(SERVICE—BAR,ETQ) <br /> SUBTOTAL 5 SUBTOTAL 5 <br /> � PERMIT 5 PLRMIT 5 <br /> TOTAL FEE 5 70TAL F[E S <br /> FflONTSETBACK FEARSEtOAGK SIOESEiDAGY, P�ANCMECKN MBER FEE flECEIPTN�. <br /> � – — �� z c� a `� ;� <br /> u:EZone �QrAR� ❑ vesT51c�FNU FEES VALUATION FEE <br /> ��2 ,j 1, <br /> TYPEOFCONST. OCCUPANCYGBOUP r+o.oFoweuiNcuNirs— BUILDING __ /l�oo � iJ � Ltt�l <br /> ALLOWA�LE CTpAL <br /> .� ' _ � 'a- Z �_ PLUMBING _ _ <br /> 512EOFOLOG. NO.OiSiOPIES 95h1i. OGGLOAD <br /> 90�o / nv �3O �� MECHANICAL <br /> NEIGHI LIMITRIION OTHER <br /> FIRESPRINNLEq5PE0UIRE� ❑ YES o STATE�UILD�NGSUf7CHARGE <br /> ` `��) <br /> � STATE ENERGY SURCHARGE <br /> �AFPLICPTIONACCBY �LANSAPPR.BV <br /> p� N PUBLIC WORHS <br /> �,;'�� '� 1�V� 1� c_?}._ \• TOTAL � : �J<� <br /> p —Z'�C��� <br />