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�`; � <br /> �►PPLICA�►':Jnl FOF; CONSTRU��i`iON PEFeMIT � <br /> ' everett ! <br /> lho Ever9reen I <br /> cever�tt _ � � � I <br /> BUILDING DEPARTMENT � <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> I 1 DEMOLITION ❑ COMBINATION I J BUR_DING �AECHANICAL ❑ PLUMBING ❑ SIGN <br /> owr�en MAILAOOPESS cirv zir PMOtlE <br /> �i-r�u� pA� �rlo�-l-�Q��� - 3��- - ya.�-,ci s�-s�, - ��.re�cL aS�S-� �-�so I <br /> TEN�N� AfAILAD�flE55 CITV ZIP PHONE I <br /> ARCHIiECTORDESIGNER MAIIADDRESS CITY ZIP PHONE <br /> GENER�L f0� tltfir1C10� �i�n'/ Cl�V 5S /J� /��nU� I T I�IJV[/l��lA✓ �` P✓ / E��L —,/ ICE=SE� � II <br /> 4 !�1%�Jt�l_A v� <br /> h1ECIlANIC�LCOI�NiRACTOq MAILADDRE55 CI Y ZIP PMONE UCENSEM <br /> Vfl�N81�3L� ', <br /> PLUTAOING WMMCTOR M�IL ADDPESS CITY ZIP PHONE LICENSE 1'� ��� /�I <br /> J.7 <br /> / I CLA55OF WORK <br /> I 1 NEW I_J ADDITION i ERATION [ I REPAIR I J DEMOLITION i ' WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION I <br /> iEN�NTIMPROVEMENTOFINTERIORREMO�EL �LY CONTA[TpEfi50NANDPNONENO. <br /> CONTRACT PqIGE OF WORN: II <br /> DESCRIBF.V ORH ANO SOU E F Tq INVOLV D N � � � <br /> S�"1 Q �w��/1 � <br /> reoroseouseoFeuao c ��./� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS , <br /> U�/ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL�ESCflIP710NOFPROPERTY�SHOWNBEL01VOfiAT(ACHFOURGOPIES) PROVISIONSOFLAWSANDOFi�INANCESGOVCRNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED W�TH WHETHER SPECIFIED HEREIN OR <br /> �or eiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PPOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTflUCTION OR THE <br /> —� PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOP,:ZEC BY THE <br /> OWNEF OF THIS PROPERTY TO PERFORM THE WORK FOR N;HICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOflS LAW 18.27 RCW AND 296.200 WAG. <br /> SIGN�TUFEOFCONTP�CTORORRUTHOflREDAGENT �ATE <br /> PRPIECTAODRE55 YJ/-� 1 I /� _ � \ � – " �'� <br /> ��\�� _(--{� ,�1 ��W APPLICANTS CITY BUSINESS L CENS O.AND BUSINE55 NAME I <br /> IJ�J• f l.Jc U�i <br /> PLUM�ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UTAMENT FEE <br /> WATER CLOS_T(TOILET) � N�A/HNDLG UNITS—N.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U'� E.A. � <br /> LAVATOflY(WASH BASIN) � UNIT HEATEAS—B.T.U. M � I <br /> SHOWER ' CLOTHES DRYERS � I <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER —� RANGE HOOD ' �I <br /> LAUNDRY TRAY ; WATER HEATER ' �, I <br /> CLOTHES WASHER � WOOD STOVE � ' <br /> URINAL ' METAL FIREPIACE 8 CHIMNEY � , � <br /> DRINKING FOUNTAIN FIREPLACE INSERT ; �, . <br /> FLOOR DRAIN � HEAT PUMP � ��� <br /> BACY.FLOW PREVENTERS � GAS PIPING ' I <br /> � <br /> ROOF DRAINS—RAMLEADERS � EXHAUST FAN � � <br /> SINK(SERVICE—BAR,ETC.) ; ' � <br /> � i I � <br /> ' ' i <br /> � � <br /> � i <br /> � ^ ' <br /> SU8 TOTAL $ ; SUB TOTAL $ ,-� I� <br /> PERMIT $ � PERMIT $ � <br /> �^ <br /> TOTALFEE ^� ' TOTALFEE $ � <br /> FRONTSETOACK REAflSETOACK SIDESET04CR PLANCHECKNUM�EB FEE BECEIPTNO. <br /> usezoNe LOTAREA vnenNrsne FEES VALUATION FEE <br /> ❑ YES ❑ NO BUILOING . i <br /> 7YPEOFLONSI.ALLOYlABLE ttPEOiCOH5LpC111AL �uPANtr 1a.0�PMElUxGUNnS i <br /> �now p�UM01NG � <br /> i <br /> SIZEOFBLOG. NO.OFSTORIES BASEMENT MECHANICAL i � ^ <br /> fJ YES fJ NO — , <br /> OCGUFANCVLO�� FIfiESPRNHLERSi1[OD ��EIGNTLIFIITATION OTHEFi � <br /> � <br /> ❑ YES ❑ NO STATE BUILOING SURCHARGE � <br /> REASON FOR SPRINKLERS <br /> STATE ENCRGY SUfiCHARGE � <br /> APPLICATIONACC.AY PLANSAPPROVED�Y CITYOFEVERETT PUBLICWOFKS � <br /> LOCAL SALES � <br /> TAX CUUE IS 3105 TOTAL ' ..� <br />