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/ � � <br /> APPLICATi� FOR CONSTRUCTrON PERMIT <br /> everett <br /> rne Ewro.aa� � <br /> cirv oF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED !N INK—PLEASE PRINT <br /> 259-8810 <br /> ❑ DEMOLITION 1-1 COMBINATION (7 BUILDING i MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAILADOPE55 CITY ZIP PHONC G <br /> jc�d�t�,V1 �V '�S4(l - 'J��I ro� ^o��j�l� UJ ���e/l�' _ �L� O �y ��P <br /> 7ENAN� MM1ILAUORESS CITV 21P PHONE � <br /> ����� <br /> AHCHITECTORDESIGNER MAILADDRE55 CITY ZIP PHONE <br /> GENERALCONTRAGj�Q(��ry.-{-//'��'/AI►LA�ODRE55h /�/�_ ��T�^ Q n� I�� /�`�_/1 y� '1 �I\ LI�I��� <br /> �S�*'{'����� � I.A.1 L.+SI �u IX��1�7 � � �� �rn —��t V � J"`"�'=� 'f J <br /> iJL �=�r � <br /> MECH�NICAL C TRACTOR AIL ADDRE55 CIT 21P PHONE ��CENSE• �T <br /> �-' ` U <br /> PLUMBINGCONIRACTOR MAILAOORESS CITY ZIP PHC'.P. LICENSEI <br /> � CUSSOFWORN <br /> lJ NEW ❑ ADDITION . tTf 110N I.I REPA�R I�I DEMOLITION I�I WOODSTOVEIFRPL INSERT Cl BUILDING RELOCATION <br /> TENANT IMFROVEMENT OR MTER�FE L/O"N/LY C� CONTACT PE�SON ANO PHONE NO. <br /> CONTMCT�RICE OF WORR: <br /> �`-� �_ <br /> UESCRI YI}O�RK�ND OUAflEFOOTAGEINVOWEO � �y_� � <br /> �C.�Q C. <br /> , PROPOSED�SEOFB I ING �.. �.,/� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ��V_ ���I�, APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> �� LEGALDESCRIPiIONOFPROPERTY�SHOWNBELOWORATTACMFOURCOPIES) PROVISIONSOFI.AWSANDORDINANCESGOVERNINGTHISTYPFOF <br /> � � W7RK WILL BE COMPLETED WITH WHETHER S?ECIFIED HEREIN OR <br /> � �ot OLOCK aF NOT. THE GRANTING OF A PERMIT DOES NOT PflESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF COIvSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TF�E WORK FOR WHICH <br /> . APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ' CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNATU OFCONTRACTOHORAUTNOFIZED NT D/TE <br /> : _M�_i`���, I� � N 4� I (�- � �I�G <br /> - PRaECT ADDRE55 li1'� jJ V�-�f <br /> ' J� �� �/-i ��, 1 � APPLICANTSCITYBUSINESSUCENkfNO. . DBUSINE ME <br /> �� v <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � WATER CLO5ET(l'OILET) � A/C-A�'HNOLG UNITS-H.P. � <br /> � FORCED AIR SYSTEMS-B.T.U. vl E.A. ' <br /> BATNTUB � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS-B.T.U. M �_ <br /> � CLOiHES DRYERS ' <br /> SHOWER � JENTILAI�ION FAN � <br /> � KITCH6N SINK 8 DI3P � -�— <br /> DISHWASHER � RANGE HOOD ' <br /> � WATER HEATER � <br /> LAUNDRYTRAY _ ' <br /> CLOTHES WASHER + _ WOOD STOVE ' <br /> � � METAL FIREPL4CE 8 CHIMNEY ' <br /> DRINKtNG FOUNTAIN � F�REPLACE INSERT � <br /> FLOOfl DRAIN � HEAT PUMP ' <br /> � ' G4S PIPING � <br /> BACKFLOW PREVENTERS � <br /> ROOF DRAINS-RAINLEADERS � EXHAUST F".N ' — <br /> , <br /> SINK(SERVICE-BAR,ETC.) � � <br /> � � I <br /> - � <br /> � <br /> _ � <br /> � - <br /> � <br /> � <br /> SUB TOTAL $ <br /> � SUB TOTAL $ SZJ ' � <br /> PERMIT $ � PERMIT $ / �,_ <br /> TOTALFEE $ ' TOTALFEE $ L•f ' <br /> FflONT SET9ACN �EAR SETBACN SIDE SETB�CK PLAN CHECK NUMB[R FEE <br /> RECEIPT NO. <br /> � VALUATION FEE � <br /> USEZONE LOTAREA VACANTSIIE FEES __ � II <br /> I I YES I I NO BUi1.DiWG ' <br /> TYPEOFCONS7.ALLOWABLE 1YPEOFCONSLACtGAI aCUM.ep x0arohnuN6uxn5 — � <br /> GNWV pLUMBING � � , <br /> I <br /> 1 <br /> SI2EOFBLIXi. NO.OFSTOAIES BASEMENT MECI�IANICAL � <br /> I I YES I I NO ' ' <br /> i <br /> OTHER ' <br /> OCCUPANCYLOAD fIRESPRNNLERSREOU HEIGNTLIMITATION _ <br /> i <br /> I_I YES LI NO SLATEBUILDINGSURCHAPGE i <br /> —T <br /> REASONFOPSPRINKLERS ' � <br /> STATE ENERGY SUFiCHARGE � <br /> i � <br /> �PPLICATIONACC.BV PIANSAPPROVEDBV CITYOFEVERETT PUBLICWORKS i �� <br /> LOCAL SALES � i <br /> TAX COUE IS 3105 TOTAL ' <br /> I <br />