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APPLICATIO'►.� FOR CONSTRUCTI.�N PERMIT everett <br /> Ihe Evergreen TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OF <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILOING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ECHANICAL ❑PLUMBING ❑ SIGN <br /> 0 MAILADDflE ��ry ZiP PHONE <br /> � ^ 20- � �- - 7�G��y <br /> T AN MAILADD SS p� Z �I E ,�/�_� �(�_� '" <br /> Q <br /> �RCHITECTORDESIGNEfl MAILADORESS CITV ZIP p <br /> GENERALCONTRACTOR lMILAUDRESS � CITY IP PHONE LIGENSEI — . <br /> 2 �,� <br /> MECM IG1LC TMCTOR MAILADDR SS CITV ZIP PHONE LICENSE/ �� ' O <br /> a y �.�r� . J , <br /> PLUMBINGCONTMCTOR MAILAD�RESS CITV 21P PHONE LICENSE• <br /> � ���L�, 7_ s `1-��S�O B EA IM�T1�P 2�'3L.T <br /> � cuss oF wonK N11C: �—�—� <br /> � ❑ NEW ❑ ADDITION ❑ ALTERATION� �� REPAIR L7 DEMpLITION ❑ WppDSTOVE!'RPL INSERT ❑ BUILDING REIOCATION � i <br /> � - _ "�. CONT�CTPERSONANOPHONENO. <br /> - �, CONfiUCT PRICE OF WdiK <br /> . � � DESCflIBE WORI(AND SIXIAPE FOOT OE INVOLVEO . <br /> I� � I�� <br /> a -� v�ouseoFaw�onic �, T � $ I HEREBV CERTIF!' THAT I HAVE READ AND EXAMINED THIS <br /> �',.. � . r N�� � <br /> ' � � �T � � �. DO � APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br />� . j .�. � � LEGK DESCRIPTION pF PRppER7V(SHOWry BELOW OR A1 ACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES CaOVERNING THIS TYPE OF <br /> � � �or 9LOCK oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTINCa OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �� � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF qNY <br /> I ; . <br /> � OTHER STATE OR LOCAL U1W REGUUTING CONSTRUCTION OR THE <br /> PERFO E OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> f `��' '•`� OW OF T IS PROPERTY TO PERFORM THE WORK FOR WHICH <br />� ' , AP LICATI IS MADE AND I COMPLY WITH THE TATE <br />� � � C N RACT S IAW . 7 pCW AND 296200 WAC. /I <br /> y � _ ' S flE flAC AOENT DATE �I I2 r ( <br />� ����� � ' <br /> 3 i <br /> �4.' <br /> 'P �iCij DRE55 � <br /> Q �.y PL TSCITVBU ESSLICENSENO.µDBUSINE AME <br /> PLUMBINO MECHAtqCAL <br />� � � NO• TYPE OF flXTURE OR REM FEE N0. TYPE OF ECUIPMENT FEE <br />� �� � WATERCLOSET(TOILEn � A/G—AIFiNDLGUNIT�H.P. , <br /> � � � BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN)� � UNIT HEATERS—B.T.U. M ; <br /> � � `'�WER ' CLOTHES DRYERS <br /> - KITCHEN SINK 6 DISP � VENTILATION FAN � <br /> �ISHWASHER � � RqNGE HO00 , <br /> LAUNDRY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> � ^ URINAL METAL FIREPLACE&CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE iNSERT ; <br /> FLOOR ORAIN HEAT PUMP , <br /> BACKFLOW pREVENTERS ; GAS PIPING � <br /> _ ROOF DRAIN�RAINLEADERS � EXHAUST FAP7 , <br /> SINK(SERVICE—BAR,ETC.) ; �'— <br /> � � <br /> � � <br /> ' i <br /> i � <br /> ' i <br /> _ SUBTOTAL $ ; SUBTOTAL $ o � <br /> PERMIT $ � PERMIT S � � <br /> TOTAL FEE $ ' TOTAL FEE S {�s ' <br /> FOR OFFlCE USE ONLY: <br /> FqONTSETBACK REARSETBACN SIDESETBACK PLANCMECKNUMBER FEE RECEIPTNO. <br /> USEZCNJE LOTAREA v�cu�rsrce FEES VALUATION FEE <br /> BUILDING ' <br /> TYPEOFCONIS.�LLOW,I6LE 1YPEOFCONStACN�L o[turnxn' x0.ormnlliMGuxitS � <br /> GRWP PLUMBING � <br /> I <br /> SIZEOFBLJG. NO.OFSTORIES BASEMENT MECHANICAL �i � <br /> OCCUPANCY LOAD FIRE SGRNKLERS REO'D HEIGHT LIMITATION ADDITIONAI.PLAn CHECK � <br /> OTHER i <br /> REASON FOfl SPPINKLERS <br /> STATE BUILDING SURCHARGE � <br /> INTAKE BV PLANS APPROVED BY CIYY OF EYEREiT PUBLIC WORKS � <br /> LOCAL SALES ' <br /> TAX CODE IS 9105 T�T�� y f; oa <br />