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1 ' � � <br /> � APPLICATItiN FOR CONSTRUCI �ON PERMIT <br /> everett <br /> � Ihe Everpreen � <br /> CITY OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> (7 DEMOLITION I_I COMBINATION I I BUILDING Sn MECkANICAL I I PLUMBING fJ SIGN <br /> OWNEfl MAILAD�RE55 CI ZIP �HONE ��7 <br /> Tr•c�n)/ l',o��a �2Y46 /�14�C�i%n �'p�Wy� ��'•�nwb� 9�S! 3�"3/brt� <br /> i'�— TENANT MAILADDRESS CITy 21P PNONE <br /> `ft <br /> rh"� ' �RCNITfCTORDESIGNER MAILAODRESS CITY ZIP PNONE <br /> �'.:. <br /> �i}=' <br /> ib��: GENERALCONTflACTOR MAILADDRESS CITV ZIP PHONE LICENSE• <br /> r OL.N�' �-tGA�G'/�`�C%� <br /> �r� <br /> t'` � �' MECHMlICALCONTRACTOfl MRIlA00RES5 CITY 21P PHONE LICENSE� <br /> � <br /> �•,' <br /> >� PLUMBING CONTRACTOB MAIL AODRE55 CITY ZIP PNONE UCENSE 1 <br /> S)". <br /> .�:.. <br /> 3S- �� C OFWORK <br /> �• . Y. �� <br /> �j;:,=.� r� 17 NEW ❑ ADDITION I J ALTERATION I I REPAIR I I DEMOUTION I 1 WOODSTOVE/FFPL INSERT I I BUILDING RELOCATION <br /> {:{ TEWINT IMPROVEMENT OR INTERIOR REMOUEL ONLV CONiACi PERSON AND PI IONE NO. <br /> tiy;Ll; <br /> r�" � CONTR�C!PRICE Of WORK: <br /> jy�.�� DESCRIBE\VOFN ANO SOUAfiE FOOTAGE INVOLV[D � <br /> ����� _ /Vo,' '�`�," <br /> � PROPOSEDU:'�EOFBUILDING I HEflEBY CERTIFY THAT I HAVE READ AND EXAMINE� THIS <br /> • '� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ��i LEOOAL DES/CRIPI�ION OFB�K HTY�SHOWN BELOOF OFlAT�TA�CtN'FOUR�C2P�5) 1'.LLS PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> /( �'� iv riY WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN Ofl <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> #� AUTHORITY TO V�OLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULA'i ING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> �! OWNEFi OF THIS PROPERTY TO PERPOflM THE WORK FOR WHICH <br /> i APPLICATION IS MADE OMPLY WITH THE STATE <br /> '. CONTRACTORS LAW 18. AND 29l`200 WAC. <br /> � SIGNATUREOFCO F HORIZE GEN DATE�.I I��� <br /> l�/ <br /> X <br /> PRQIECTADDRESS _ ��r� AU^ � pp pNT ITV USINE LICEN E .AN 1151NE SN/ME <br /> �G�f �- — <br /> � PLUMBI 6 MECHAN AL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE F EOUIPMENT FEE <br /> - WATER CLOSET(TOILET) � A/C—IVHNDLG UNITS—HP. � � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> . LAVATORY(WASH BAS�N) � UP 'T HEATERS—B.T.U. M � <br /> � SHOWER ' CLOTHES DRYEFS ' <br /> � KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> . DISHWASHER � RANGE HOOD � <br /> � LAUNDRYTRAY ' WATERHEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE&CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> � FLOOR DRAW � HEAT PUMP ' <br /> DACKFLOW PflEVENTERS � GAS PIPING � <br /> . � ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> ' SINK(SERVICE—BAR,ETC.) I � <br /> � <br /> � ' <br /> , ' <br /> � ' <br /> , ' <br /> � ' <br /> . SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMIT $ � PERMIT $ i <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FRONTSETBACH RERRSETB�CK SI�ESE7BACK �'LANCIiECKNl1M�ER FEE �7ECEIPTNO. <br /> � usezoNe �otaaen VACANTSITE FEES VALUATION FEE i <br /> I.I YES I�.I NO BUi�DirvG ' I <br /> ttPEOFCONSI.RLLOWAeLE iYPEOFCONST.ACTI1nL acursxcr HOOfOWFIIINfI1H115 i � <br /> cAWP PLUMBING i I <br /> SIZE OF BLDG. NO.OF STORIES BASEMENT 3 3� � ' <br /> , MECHANICAL � � =,j <br /> 1 I YES I.I NO — � <br /> OTHER � <br /> OCCUPANCV LOAD FIFE SPRNHLERS REO'D HEIQHT LIMITATION � <br /> � <br /> LI YES CI NO STATE BUILOING SURCHARGE ' _ <br /> � <br /> � flEA50N FOR SPflINKLERS - <br /> STATEENERGYSURCHARGE � ' <br /> i <br /> � <br /> �PPLICATIONACC.BY PLANSAPPflOVEDBY CITYOFEVEflE1T PUBLICWORKS i <br /> LOCAL SALES 3 �� <br /> �� TAl(CODE IS 3105 TOTAL <br /> � _.. <br />