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APPLICATIOI��`OR CONSTRUCTIG"�'J PERMIT everett <br /> fhe Eve�green TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OF <br /> everett HEATING SYSTEM: ❑GAS ELECTRIC ❑ <br /> BUILDING DEPARTMENT � <br /> 259-8810 <br /> -_' DEMOLITION ❑ COMBI(�ATION BUILDING I_i MECHANICAL '� PLUMBING f� SIGN <br /> OWNER MAILA�DRESS CITV ZIP PMONE <br /> Taonc� �lsei,�.31��.�'"' /�- uF Sead� l..�A 9tllv.� 7`1�-�,S7b � <br /> TENANT MAILA�DRESS` pTY ZIP PHONE <br /> ARCHITECTORDESIGNER MAILAUDRESS CITY ZIP PHONE <br /> �1"Ir�-Ro1.L,�{ecfh lqn'1 �.��,-�1n 53_ S.u9 S,.�lo F_ S�I�,r��l< ��'1h 71)- �A�.R <br /> G(E�NEPS��pNTR.(.�TGij_�_ �5 MRILAUDHESS CITV ZIP PMONE LICENSEt � <br /> 'G'7flj O�7—RPS91Rrr <br /> ��,0�, C4;11,e.11 �, N� RoThell w'A �1ROt1 �15S-9oJq !�[i- rH 17yQ,� <br /> MECHANICALCONTRRC70R MAILADDRESS CITY IP PHONE LICENSE+1 <br /> PLUMBINGCONTRACTOfl M�ILAODflE55 CITV ZIP PHONE LICENSEY <br /> C SSOFWORK <br /> NEW Cl ADDITION -1 ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> CONTACT PEfl50N AND PHONE N0. <br /> CONTPALTPRICEOFWOflK 6 � � � Q <br /> DESCRIBE WORK ANL SOUARE FOOTAGE VOLVED <br /> �� ti. 1�L' 2?'7L <br /> PROPOSED eoFem�oiN� � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TNIS <br /> e - APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> LEGALDESCRIPTIONO PROPERTY�SHOWNBELOWORAiTACHFOURCOPIES) PAOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or BLOCK 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 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 /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> S�GNATUREOFCONTRACTORORAUTHOflIZEOAGENT DATE <br /> s -�A 3� - � ���� C'��---�b����� <br /> PflQ1ECT ADDflEqSS'\ ^�� <br /> � �Z� Lv I � 1 rI �V� S C APP��CANTS CITY BUSINESS LIC NSE NO.AND BUSINESS NAME <br /> PLUM3ING MECHANICAL <br /> ' NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A/�A/HNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIR SYSTEMS--B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN)� i UNIT HEATEflS—B.T.U. M <br /> SHOWER �� � CLOTHES ORYERS � <br /> KITCHEN SINK 8 DISP / ; VENTILATION FAN ; <br /> DISHWASHER %� � RANGE HOOD � <br /> LAUNDRYTRAY / � ; WATERHEATER ' <br /> CLOTHES WASHER i � WOODSTOVE ; <br /> URINAL / ; METAL FIREPLACE&CHIMNEY <br /> DRINKINCa FOUNTAIN % i FIREPLACE INSERT ; <br /> FLOOR DRAIN / � HEAT PUMP � <br /> BACKFLOW PRE �NTEFS ; GAS PIPING ; • <br /> ROOF DRAIN$—RAINLEADERS � EXHAUST FAN j"� � <br /> SINK(SER CE—BAR,ETC.� ; / � <br /> % � / � <br /> —r <br /> � � � <br /> � � <br /> � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMIT $ � PERMIT $ � <br /> TOTAL FEE $ ; TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: �c�/, oj� <br /> FflONTSETBACK pEARSETBACK SIOESETBACH PLANCMECKNIIMBER FEE PELEIPTNO. <br /> 2� ` ZG' ' 77 'C s 3`.� 3 .53� 7�� <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEF <br /> 2- 1 � T- <br /> BUILDING �j �G� � s „', �S'? <br /> TYPE'}O7F"CONiS.A�LLOWiA9lE TY FOFLONST.AC/iU�Lj atUvaNtx xoovoWFLUHGUNrtS � <br /> -Y—— I ''/` — � !7� G#' Z � PLUMBING �— ' <br /> SREOFBLDG. NO.OFSTORIES qSEM NT MECHANICAL — � <br /> ! (a{2 ' y� , <br /> OCQIP�V IOAD FIRE$PRNKLERS REO'D HEIGHT LIMI�ION ADDI710NAL PLAN CHECK � S�Z 7 i �'U <br /> 2 Y�=---' 3 � , <br /> t—'� OTHER <br /> REASON�OR SPRIIJKlERS <br /> �'�'y��i�j �� L� �l��l� STA7EBUILDING�URCHARGE �!} i SO <br /> INTAKEBV PLANSAPPROVEDBY CITYOFEVERE7T pUBLICWOFKS � <br /> LOCAL SALES � <br /> ( <'� J TAX CODE 15 3105 TOTAL � 7 ��I �p <br />