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� <br /> � AfPPLICAT1�eN FOR CONSTRUC�-�ON PERMIT <br /> ! everett <br /> '� the Eve�preen •i��� <br /> , CINOF ��� � <br /> � everett <br /> � BUILDING DEPARTMENT <br /> j 2Eg-eg�p TO BE COMPLETED IN INK—PLEASE PRINT <br /> i O DEMOLITION ❑ COMBINATION ❑ BUILDING ❑MECHANICAL ❑ PLCMBING ❑ SIGN <br /> �.� py@Eq IAAIL�CJRESS CITV 2IP PHONE <br /> � ��,,, �? — Yd�srfw ,�f <br /> 1 7ENAqT MAJ.�DDRESS CITY ZIP PHONE ' � <br /> �� ARCXITECTORDESIGNEfl MAIL�DDRES£ CITV 2IP PHONE <br /> 1 <br /> �� OENEflALCONTMCTOH MAILADDRESS CITV ZIP PHONE LICENSE� <br /> 'I MECHMlIC0.CONTR�CTOR MAILAD�RE55 CITV ZIP PHONE LICENSCN <br /> ; �✓•l�r �✓a�-��(sc�- �� 31�0- f{iti.. nvc ivf 5j'tol 15'S-rJ1i �1�,�wk /T7 /�� <br /> ;i PLUMBINO CONTflA.TOB MAIL ADORESS CITY 21P PHONE LICENSE M <br /> � <br /> �i ClAS50FWORK <br /> ' NEW G ADDITION ❑ ALTERATION ❑ REPAIR C7 DEMOLITION ❑ WOO�STOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> , <br /> TENMITIMPflOVEMENTORINTERIORPEMODELONLY �.Iw CONTPCTPEHSONANDPHONENO. <br /> 7 �'� <br /> CONTMCT PRICL OF WORK: <br /> DESCRIBE WORl:AND SOUARE FOOTAOE INVOLVED <br /> S�i►y� (,4'S <br /> Pf10POSEDUSEOFeUILDINO I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � `( APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEOALOESCRIP 10NOFPR ERN�SHO BELOW ORATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVFRNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocK oF NOT. THE GRANTING OP A PERMIT DOES NOT PRESUME TO GIVE <br /> ' AUTHORITY TO VIOLl.TE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW HEGULATING CON:TRUCTION OR THE <br /> , PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ' I OWNER OF THIS PROPEFiY TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNPTUREOFCONTRACTORORAUTHORIZEDAGENT DATE <br /> PRQIEC �D�RESS / � � ! L ��Gi�-/� ,. <br /> —Y1 Cf .� APPLICANTS CITY BUSINESS LICENSE NO.AN USINE55 NAME <br /> \� � � <br /> PLUMBINO^ MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/�NHNDLG UNITS—H.P. � � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNI'. HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATERHEATER <br /> -.;� CLOTHES WASHER � WOOD STOVE � <br /> � ' URINAL ' �dETAL FIREPLACE 8 CHIMNEY � <br /> �� DRINKING FOUNTAIN i FIREPL..CE INSERT i <br /> .-j FLOOR DRAIN �� � HEAT PUMP � <br /> "� BACKFLOW PHEVENTERS ; GAS PIPING ; <br /> -�' ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> � SINK(SERVICE—BAH,ETC.) ; ' <br /> � <br /> I � i <br /> �— <br /> i i i <br /> i - <br /> � i <br /> i i <br /> i T <br /> � 1 1 <br /> ! SUB TOTAL $ ; SUB TOTAL $ ' �-- <br /> � PERMIT $ � PERMIT $ � <br /> � TOTAL FEE $ ' TOTAL FEE S I 30 �� <br /> ; <br /> FRONTSETBACK REAflSETBACN SIDESETBACK P!tNCHECKNUMBER FEE RICEIPTNO. <br /> USE20NE LOTFREA VACANTSITE FEES VALUATION FEE <br /> ❑ YES ❑ NO <br /> � BUILOING i I <br /> � TYPEOiCON57.ALlOWABLE lYPEOFCOHST.ACiURL acaouv5r qo.aoxtwxcuxrts <br /> i <br /> � PLUMBING � � <br /> i <br /> �L SQEOFBlIX3. NO.OFSTORIES OASEMENT MECHANICAL � � � <br /> ❑ YES L7 NO � , <br /> OCC:IPANCYL0�0 FIRESPRNKLERSflEO'D HEIGHTLIMITATION OTHER j <br /> ;� U YES L� NO STATE BUILOING SURGHARGE � , <br /> REASON FOR SPflINNLERS . <br /> i STATEENERGVSURCHARGE i �. <br /> �I �PPLICATION ACC.BV PLANS APPROVED BV CITY OF EVEREIT PUBLIC WORNS � I <br /> � LOCAL SALES I <br /> � TAX COOE IS 3105 TOUL I-- <br /> fi <br /> �' ;.. . , .,:.— . � .;:1',��u �,.`y . _ .... :u;.. �.� ' <br /> . ,o,-., . ,t�:., . .; <br /> ,ar;�:"- :r. <br />