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�— <br /> t <br /> . --�, .�, <br /> • APPLICATIG� FOR CONSTRUCT.ON PERMIT <br /> r everett <br /> fM Eve�g�cen � <br /> CITV OF <br /> ��� everett <br /> y BUILDING DEPARTMENT <br /> � �y p 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ,�,�y� DEMOLITION COM�'NATION '1� BUILDING MECHANICAL PLUMBING SIGN <br /> y�� OWNER AIML PD�RES.. pTY 2iP PHONE <br /> �H� �S�Y/7N�/�i �A,erN�s�iP i�8m-iy��vs�. ��E.�» �J,� g`��� 3j�J..�/�OD <br /> TENANT MAILAD�NE55 CITV 21P PHONE <br /> �H� %/eGSTJ2c�n �v7P�L�1� '-'��v-/4�/Jo Sr �dE�ET Gd� 4P2�' �s�- s��37 <br /> N x� �ARCNItEGipR0E5iGM1ER MARAO�NESS 1 CiTY— � � ZIP PHONE �� <br /> � T -._�1( C Cou,.c�e�� ag1 ' �{�J �- u�,t�it wA `7'820� .��Z I ll I <br /> �� <br /> �rJ GENERAL GONiPRCTOR MRtL ADDHESS C TY ZIP PHONE LICENSE r <br /> ��g ' C`�rd�•� gui�.DQ�S (�S �.t ,202 SeA• 9$ISS �I&5-5�37 Cu s-4t+b ir-2�1ao8 <br /> �� A MEGHANICRIGONiRACTOR f.IRIL�D�PE55 CIiY 21P PMOfIE LICENSEr <br /> �y� PLUMBINGCONTPPC70R AIAILA�DRESS CRY Zi? PHONE LICENSEt <br /> i � <br /> C�A y CLASSOF WORK <br /> n y . � NEW �. i ADDITION X ALTERATION . �. REPAIR �. DEMOLITION . WOODSTOVE/FRPL INSERT ��' BUILDING RELOCATION <br /> ��� TENANT IMPROVEMENTOq INTERI q REMOOELONI.Y CONTACT PEPSON ANO PHONE N0. <br /> I CONTRACTPRICEOFWOHK: � Z �UD <br /> DESCRIBE WORK AND SOURRE FOOTA�[iNVOLVE� <br /> I � -- IAI�tk10 P � ONS F�N � I US FT. _ <br /> PROPOSEDUSEOFBWIOWG I HEREBY CERTIFY THAT 1 HAVE FEAD AND EXAMINED THIS <br /> ' L L!� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br />� LEGFlDESCRIPT10NOF PFOPEPTY�SHOWNOEI.OW OP RTipCM FOURCOPIES� PFOVISIONS OF LAWS AND OR�INANCES GOVERNING THIS NPE OF <br /> WORK WILL BE COMPLETED WITH WHETHEF SPECIFIED HEREIN OR <br />� ior e�_ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />� �� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br />� � PEFFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br />' � OWNER OF THIS PROPERTY TO PEPFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br />� SIGNAit1RECFCONTR0.CTORO11RUiHORIZE�r1GENT OATE <br /> PROJEGi ADORE55 .�/ / � � ' --'^ p - <br />� X ,�T �� y�19�9v <br />�'' '�' %0��� /� 7/� '/ ` / ��.��-�y qp APP ANTSGITVOUSiNESSLICENSENO.A BUSINESSNAME <br />, � � !i a p <br />�i PWMBINCa MECHANICAL <br />' 1�I NO. TYPE OF F:XTURE OR ITEM FEE N0. TVP�OF E�UIPMENT FEE _ <br />! WATER CIOSET(TOILET) !UC—NHNDLG UNITS—H.P. <br />' ' ' BATHTUB FOFCED AIR SYSTEMS—B.T.U. M E.A. <br />� LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M <br />'I 1�' SHOWER � CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> f j DISHWASHER ' RANGE HOOD <br />'�, LAUNDRY TRAY WATER HEATER <br />�� CIOTHES WASHER � WOODSTOVE <br /> I �1 URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> i FLOOR DRAIN HEAT PUMP <br /> I ' BACKFLOW PREVENTERS GAS PIPING <br />� �� ROOF DRAINS—RAINLEADERS EXHAUST FAN <br />� � SINK(SERVICE—BAR,ETC.) <br />� �' <br />' _' <br /> I _I_ SUB TOTAL 5 SUB TOTAL 5 <br /> P[RMIT 5 PERMIT 5 <br /> � TOTALFEE 5 TOTALFEE 5 �— <br /> FFONTSETBACK REAHSLTDACN SiDESETpPCK PLaNCHECKNUMBER FEE RECEIPTNO. <br /> � � rSn,S�— — ��p 1Yc. i .�7 7s' 33� Y3 <br />�I4 USE 20NE �or naen VACANT SItE FEES VALUATION FEE <br />'I z— �. YES K NO BUILDING 3 � ; � <br /> I 1YPEOFLONSiRLIOWABLE iVPEOFf �S1�A�i�AL ocCuv�r,Lr NOOrUNuI��uUNnS <br /> _ ' LL O � Aa: ..�. PLUMBING <br /> II !i C� - <br /> SRE OF BLOG. NOAF StOR1ES BASEb1ENT ��[CHANICAL <br />� JO J� / ves o <br /> OCGUPryqCyLOA� FIRESPFIJKIERSREQD H[iGHTLIMITAiION OTHEfl � <br /> �r ' : YES XNO gTATE BUILDING SURCHARGE <br /> i REASON FOR SPRINKLEf1S �� <br />. STATE EIJF,flG�SURJHAHGE <br />'I APPLICRiION�CC.BV PIANSAPPROVbUBY CITYOFEVERETT PUBLICWORK$ <br /> ��(� LOCALSALES 1 <br /> �6.L(,/ I TAX CODE IS 3105 TOTAL /3 / �_5� <br /> i <br />