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i <br /> APPLICATIO�f FOR CONSTRIlCT�bN PERMIY <br /> everett <br /> ' IhB EvertJr@Bn <br /> CITY OF � i <br /> everett <br /> EUILDING DEPARTMENT � <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT i <br /> f J DEMOLITION i COMBINATION I I BUI..DING xMECHANICAL ' I pLUMBING f 1 SIGN <br /> � OW/NER IdaIL�0�RE55 CItV ZIP PHONE <br /> . U -1r'� Tr�t:.��MG..,—.� - Slo �7arws,"4.¢.. /�-/�'-�. Jo Sa.�."fi,izcs-n.��. '�Sici�a' ..�LSS343 <br /> � <br /> TENANT h1AllAppRE55 GIiV ZIP PHONE I <br /> I <br /> � ARCHITECTOq�ESIGNER lAAILADDRESS CRV ZIP PIIONE � <br /> Lr�az.-�., i�i.�iu��.J -a ASfa� �"�So1 (S�u.i�t��f (-n-�z rW�idG:T c.n���. 53•'01 3i3 �ZSJJ' <br /> i — <br /> � GENERALCONiRACTOR MAILAD�RE55 CITV 21P PHONE UCENSE� <br /> � li-•.-� Z..ukYl.-��_rS S�c /1nr.�rr.e. •�/.s:. J� .SF�:Ii!_- !.-.^s.l. s;f�`�/ 321-SJf3 , GMSuvLZ�C( <br /> ' MECNANICALf^NiRACTOR M�IL�CpqESS CITY ZIP PIIONE LICENSEII I <br /> � �2=- .sri+� /J41v -�'-./�' `1 Q��••�•••�� L-�»!. Sdo�o,- !o'r'3�7J'J o �¢�- S�S.�K.Z�iS+✓� <br /> I <br /> � PIUMBINGCON7f1ACTOR �A�IL�OOiiE55 CIIY 21P PIIONE LICENSE� � <br /> I <br /> - CLASS OF WOfIH � <br /> � �}�I,NEW I I ADDITION I I ALTERATION I I REPAIR i I DEMOLITION I I WOODSTOVE/PRPL INSERT I I BUILDING RELOCATION <br /> TENANT IMPROVEMENT OR INtER10P REMO�EL ONLY CONiACi PERSON AND PHONE NO <br /> CONTRACT PRICE JF WORH: � <br /> � OESCRI�E WORK AND SOUARE FOOT�GE INVOLVED I <br /> �//.:'ti-%-ia•C- . <br /> �� PROPO'S"�EOUSEOFBUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> /�✓�TS . APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> � IEGALDESCRIPTIONOFPpOPERTY�5110WNBELOWORATTALHfOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or_ e�ocK oF NOT. THE GRANTWG OF A PERMIT DOES NOT PRESUME TO GIVE I <br /> , ` � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY � <br /> i (� C.o 1 2 �:� OTHFR STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE i <br /> � PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE �� <br /> �-I �T K�OK '� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH I <br /> � — APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ' CONTRACTORS LAW 18.27 RCW AND 296200 WAC. I <br /> SIGNANRE ��ROR�ZEDnGENT OATE ��� _(^.,{D <br /> � { <br /> , PflOJECTADDRESS y17,. . <br /> I ��`'�7 u ST F'=il:UCii- �� Va1��. '(' 2 ��NLICAN�SCITVDUSINESSLICENSENO.AIIDBUSINESSNAME <br /> + PLUMBING MECHANICAL - <br /> ' N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> • WATER CLOSET(TOILET) � NC—NHNDLG UNITS—H.R � � <br /> � BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> � LAVATORY(WASH BASIN) T—_ 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 /> � URINAL ' METAL FIREPLACE 8 CHIMNEY � � <br /> DRINKING FOUNTAIN I FIREPLACE INSERT ; � <br /> _ �— � <br /> . FLOOR DRAIN � HEAT PUMP � <br /> � BACKFLOW PREVENTERS ; GAS PIPING ; <br /> � ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> --�— <br /> � SINK(SERVICE—BAR,ETC.) ; ; <br /> � I <br /> , , <br /> — _ �— <br /> i <br /> � <br /> , <br /> T <br /> I <br /> SUB TOTAL $ ; SUB TOTAL 5 �_ <br /> PERMIT $ PERMIT S � <br /> � TOTAL FEE $ TOTAL FEE $ ' . <br /> FRONTSETBACN PEARSETBACK SIDESET��CH PLnNCHEGN NUMBEq FEE REGGFTNO. <br /> � USEZONE LOTAflEA \MCANiSITE FEES VALUATION FEE ' <br /> , I I YES I I NO BUILDING i <br /> tYPEOfCONST.ALlOWABLE 7YPEOFCONSIACIUAL aarn!rtr uoorn•n[wncuxus — <br /> cnouv ' <br /> . PLUMBING � <br /> � SIZEOFBIDG. NO.OFSTOAIES BASEMENT MECHANICAL � <br /> I I YES I I NO ; <br /> ' OCCUPANCVLOAD FIRESPRNKLEASREO'0 NEIGHTLIMITATION OTHEfl � <br /> I J YES I I NO STATE BUILDING SUfiCHARGE � <br /> REASON FOR SPRINNLERS �— <br /> STATEENERGYSUPCHARGE i <br /> �� APPUCATIONACC.BV PLANSAPPFOVEOBY f.liYOFEVERETT PUBLICWOPHS � <br /> LOCAL SALES �— <br /> TAX COUE IS 3105 ro-AL � <br />