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....,� .. . .. . , � . . . _ — .. . - _ . ... . ..�.....s_ _... <br /> APPLIt..�T10�N FOR CONSTRJCTION lo`� <br /> PERMIT <br /> \ <br /> fhe Evero�een everetl <br /> CITY OF <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MAILA RESS QTY ZIP PMONE i <br /> ��{ � ��� �I i'1 -�3Q-" .�e t,� -��P ���3 �-�'1- �S-Co( �'S� �; <br /> TEN�NT MMLApORE55 LITY 21P PHONE . <br /> t. <br /> 6 <br /> �pCHITECTOflDE51ANEP M�ILADDRESS CITY ZIP PHONE <br /> i. <br /> OENERALCONTqACTOR MAIIA�OFE55 QTY 21P PNONE LIGENSEs <br /> (. <br /> MEF H�NIC�LCONTRACT R ! M�ILADDRESS CITY �TIP�..� PNONE LICENSE• . <br /> �1�� Q�,l ��� Cl��'i c��L(� ��',�.�2.�.a ���r.le,�'=���'1��-1��1�`�J/'� i: <br /> PLUMBINOCONT � TOA MN1���RESS � 21P PMONE �ICENSEN • <br /> u <br /> l <br /> CLAS.90FNqRK �` <br /> ❑ NEW ❑ AOOITION RATION ❑ REPAIR G DEMOLI710N ❑ WOCI�STOVE/FRPL INSERT ❑ BUILDING RELOCATIO•J <br /> TEN�NT�MPROVEMENTOflINTERI P�.QD�NLY CONTRCTPENSON�NDPNON'iN0 4. <br /> //� <br /> CONTRACTAFICEOFWORk �J <br /> 0F�/I.9IBEWORK�NDSOU�RE T�OEINVOWED i' <br /> (,�' S c1��'� / i. <br /> �1oweED USE oF BU!�DIN I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br /> �� HNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> LEO�LUESCpIPf10NOFPROPERtt�SHOWNBELOWOR�TfACHFOURCOPIES� ORDINANCESGOVERNIN�THISTYPEOFWORKWILLBECOMPLETEDWITH <br /> W HETHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMITDOES NOT <br /> PRESUMETOGIVEAUTHOFI7YTOVIOLATEORCANCELTHEPROVISION90F �. <br /> �oi _ e�ocK oc — ANVOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTtONORTHEPER• <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHOR¢ED BV THE OWNER OF j; <br /> TH�S PROPERTY TO PERFORM THE WORK FOF WHICH APPLICATION IS MADE <br /> AND 1 COMPLV WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296200 WAG t} <br /> � 516NRUflEOFLONTRACTORORFUTHORIZEU�GENT OFTE f <br /> X \/�"f�-�,'��/� ��� � /0,3 a <br /> PflO���RESS ' �� ^,� n I � ` ppp��CAN LITY BUSINE'S5 IC�E�N��NESS N�ME � � <br /> � / I I l� <br /> �'711Z.. <br /> F� <br /> PLUMBINO MECHANICAL ��� <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE ��� <br /> WATEH CLOSET(TOILEn A/C—A/HNOLCa UNITS—H.P. <br /> BATHTUB FORCEOAIRSYSTEMS—B.LU. E0. " � <br /> LAVATORY(WASH BA°IN) UNIT HEATERS—B.T.U. M �' <br /> SHOWER CLOTHESDRYERS � <br /> KITCHEN SINKB DISP. VENTILATION FAN t,� <br /> DISHWASHER RANGE HOOD , <br /> LAUNDRY TFAY WATER HEATER <br /> CLOTHE$WASHER WOOD STOVE G� <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSEPT I� <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING '- <br /> 1 <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAF,ETC) � <br /> 4 <br /> SUBTOTAL $ SUBTOTAL S � � <br /> PERMIT S PERMIT S <br /> TOTALFEE S TOTALFEE S '� <br /> FRONTSEfB�CN REAflSEfBRCK SIDESETBRCN PIANLMECKNOMBEP iEE NECEIFfNO. G <br /> r. <br /> � <br /> � <br /> USEZONE LO�ANEp VACRNTSITE FEES VALUATION FEE ' <br /> ❑VES ❑NO �. <br /> TYPEOFCONST. OCLUPANCYQROUP NO.OF�WELLINOUNITS BUII.DING f' <br /> ALLOWABIE/ACTU�L pLUM81NG �' <br /> SREOFB�DO. NOOFSTORIES &SMT. OCGLOAO � <br /> ❑v MECHANICAL ^ � <br /> ❑N <br /> HEIGHTLIMITA710N O7HER �• <br /> FIFESPGI�KLER5flE0UIRED ❑YES ❑NO STATE BUILDING SURCHARCaE <br /> STATE ENERGY SURCHARGE ` <br /> APPLIG�TIONACQBY P��NSAPPp.BY <br /> PUBLIC WORKS <br /> TOTAL � t, <br /> 4 <br /> � <br />