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` APPLICATIOI.FOR CONSTRUCTI''!J PERMIT everett <br /> �E�a��� TO BE COMPLETED IN INK—PLCASE PRINT � <br /> ciTv oF <br /> everett HEATING SYSTEM: GAS ❑ELECTRIC U <br /> BUILDING DEPARTMENI <br /> 259-8810 <br /> C� DEMOLITION ❑ COMBINATION ❑ BUILDING �AECHANICAL ❑ PLUMBING 1 SIGN <br /> O ER� a n �AIIAD SS ��0 CITY r T� y ^� ^�,E � ` �/]� <br /> `� �j 05 j �{ <br /> TEN RDURESS GITY ZIP PMONE <br /> ARCHITECTORDESIGNEP MAILADDPE55 CITY 21P PNONE <br /> NERIIL TRiCIO 92� 355• D t IMC. ` /�I I �(�'����� / � P I N� �I � UCENSE I <br /> �D9• 7730� <br /> 7422� \( i�i Li/ V �.' <br /> MECNANICALCONTR TbR 5 5 QTV ZIP PHONE LICEN4E1 <br /> . �1 w���� �1 _ <br /> . � PLUMBINGCONTRACTOR MAIL�DDRESS CITV 21P PXONE LICENSEI <br /> �, � ' CLASS OF WOHN <br /> � � Ci NEW G ADDi�ION�ALTERATION ❑ REFAIR Ci DEMOLITION ❑ WOODSTOVE/FRPL INSEP7 G BUILUING RELOCATION <br /> „ h I � � CANT�f.'i PERSON AND PHONE NO. <br /> '� � � CONTMCT PRICE OF WORK(��� • <br /> ! � 'r. DESCPIB 1 OflK AND UA FOOTAGE INV�D � ,/� ,, q� <br /> i v <br /> � . � � l L ( /�-l! <br /> � PROPOSEDUSEOFBUILUIN �,�n I HEREBY CERTIFV 7HAT I HAVE READ AND EXAMINED THIS <br /> , � ��� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � LEdLL DESCRIPTION OF PROPEflTY�SHOWN BELOW OR ATfACH FOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> Q �or s�ocK oF NOT. THE GRANTING OF A PEAMIT DOES NOT PRESUME TO GIVE <br /> � . � AJTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AN\' <br /> ; � i OTHER STATE OR LOCAL U1W REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> j CONTRACTORS LAW 1827 FCW AND 296200 WAC. <br /> � i SIGNATUREOFCONTRACTORORRUTHORIZEDAGENT OATE <br /> �.. . . � PRQIECTADOflE55 n J � �� I ����� <br /> � . L�D7 � �� A LIGNTSCITVBUSINES CEN ENO.ANDBUSINESSNAME � <br /> � <br /> PLUM&Nfi MECHANICAL <br /> NO. TYPE OF FIXTURE ON REM FEE N0. TYPE OF EOUIPMENT FEE _ <br /> WATER CLOSET(TOILE� � Al�AIHNDLG UNIT�H.P. � <br /> � BATHTUB ; FORCED AIF SYSTEMS--B.T.U. E.A. ' <br /> LAVATORY(WASH BASIN)� � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TAlY ; WATER HEATER ' <br /> CLOTHES�':ASHEFi y � WOOD STOVE � <br /> URINAL ' METAL FIflEPLACE 8 CHIMNEY ' <br /> DRINKING FGUNTAIN � FIREPLACE INSERT T_ <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> �. SINK(SERVICE—BAR,ETC.) � � <br /> i � <br /> � � <br /> , � <br /> � � <br /> , <br /> SUB TOTAL 3 ; SUB TOTAL $ � C7 <br /> PERMIT $ � PERMIT $ ,� <br /> TOTAL FEE $ ' TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACN REAR SETBACK SIUE SETBACK PLMI CHECK NUMBER FEE RECEIPT NO. <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> � BUILDING ' <br /> TYPE Oi CONTS.RLLOW�BIE TVPE OF CONST RCTUAL occuwxcr xo ov mnwxc uxir5 � <br /> cnour PLUMBING i <br /> SQEOFBLDG. NO.OFSTORIES BASEMENT MECHANICAL (,(�) �oU <br /> OCCUI'ANCY LOpD FIRE SPRNK�ERS REO'D HEIGHT LIMITATION ADDITIONAL PLAN CHECK �_ <br /> i <br /> OTHER i <br /> REASON FOR SPPINNLEflS i <br /> STATE BUILDING SURCHARGE � <br /> INTRKL BY PUNS APPROVED BV CITY OF EYEHETT PUBLIC WORKS � <br /> LOCAL SALES � �� <br /> TAl(CODE IS 3105 TOTAL <br />