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i <br /> .. ` I I <br /> APPLICATION FOh ��e,C„ <br /> tne Evarpre�n C O N ST R U�C T I O N � <br /> GtY OF <br /> everett PERI�iIT � <br /> BUII.DI�JG DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN �NK• PLEASE PRINT <br /> � i DEMOLiTION ❑ COMBIP'ATION NXBUILDING x� MECHANICAL �43 PLUMBING G �IGN <br /> .,,i¢p MAII��ORE55 CITY ZiP �MON€06 338-0335 <br /> RC CONS'PItUCTIOtJ COMPANY 2722 100th St SE. , Everett, Washinqton 98208 <br /> <i�i:n:�r�r.iur+utsmH[.ra Me��:�oaaess cirv zia rNOHc <br /> .�•���.icon��:�croe M�iLA00RE55 - Litt ziv 206 338'LRY435 s <br /> RC CONSTRUC'�lN COMPADI'u722 100th St SE. . Everett. Washinqton 982028 <br /> :q i uA�u�lHi CONIwCIOq M��LA'�ONE55 G�iY ZIP PIIONE L�CENSE• I <br /> . �'��lln0�rv�iCON1RAC10R MAIU��NESS GTY ZIP PIIOHE tiCLNSE • i <br /> � _.SOi WORti --� <br /> . �I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITIUN ❑ WOODSTOVF./FFPLINSEFT ❑ BUILDING RELOCATION I <br /> .�.:�'��N Of YlO�n iCOSI f.F MAiEFIALS PWS LABORI <br /> � .,r x.t1iI1L WOPn � � <br /> . �i ! :1� [3L'IIUING �I <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP� , <br />� � � � � PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL ��. �'� <br />' J�:��i0[SLRiPiIOhOFPPOPE YISHOWNBELOWORATTACHFOURCOPIE51 PROVISIONSOFLAWSANDORDINAhCESGOVERMINGTHISTYPE �, �� <br /> '/ T.arcan OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE� <br />. ��L��ocK_ov IN OR NOT.THE GRANTING OFA PERMIT DOES NOT PRESUME TO f �' <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF I ' <br /> ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION ' '� <br />�. OR THE PERFORMANCE OF CONSTRUCTION. ''� <br /> _ SIGNa.!UP�oE�I) ST'1'KUI.'1'lUIVEl.UC1Y11I��(DATE I <br /> l: <br /> X / � <br /> �,. �iIr1A0DfiE55 APP�ILRNTS ITYBUSINESSI�CEN$ENO <br /> �� - ,e�, �, sr 0196 /8 <br /> aLUMBING MECHANICAL <br /> r�0. TYPE OF FIXTURE OR ITEM fEE NO. TYPE OF E�UIPMENT FEE <br /> 3 WATERCLOSETITOILET� � - AiC-NHNDLGUNITS-M.P � <br /> BATHTUB /� - REFqIGERATION UNITS�-MP.EA. _I <br /> 3 LAVATORY�WASHUASIN� "�� - BOILER$-BSL./HP. <br /> Z SHOWER 1 GASFIPEDA.C.UNITS-B.T.LL . <br /> KITCHEN SINN d DISP. � - I FOflCED AIR SVSTEMS-B.T.U. M EA. �- <br /> DISHWASHEF �j - �•�4LLHEATEflS-B.T.U. M <br /> IAUN�RVTpAV � UNITHEATERS-B.T.U. M <br /> � CLOTHES WASHER � � -� EVAPORATIVE COOLERS <br /> URINAL � CLOTHESDRYERS /�� � '�) <br /> DRINKING FOUNTAIN � VENTILATION FAN. � f� ` ��� <br /> FLOOR ORAIN � qANGE HOOD ��, "�/ ) <br /> BACKFLOW PREVENTERS WATER HEATER �� ��( �� <br /> ROOF DRAINS-RAINLEAOERS V/OCD STOVE . <br /> SINK�SEflVICE-BAR.ETC.) � METAL FIREPLACE d CHIMNEY .��� � � '( I <br /> FIPEPLACEINSERT ' <br /> HEAT PL1MP � <br /> GAS PIPING <br /> EXHAL'STFAN l, ' <br /> SUB TOTAL f �,` - 8UB TOTAL ��_1 —' <br /> .. VERMIT = - - PERYIT '--- <br /> TOTAL FEE S �,' -� - TOTAI PEE j'`�_) �- <br /> ��^mr>t�l3nCn qEeR SETBACN SIDE SETBACK P'.AN CHECN NUMBER FEE . RECEIPT NO. <br /> � � '� ' � � ' . 1 I �� � <br /> /.c �r� � � io � � � i , -, a ' :'1 <br /> i � _ �� <br /> � .' �ry[�7 LOiAHEf V�CANTSIIE ` � <br /> ^ — � � ❑rts allo . <br /> FEES VALUATION FEE <br /> �. �n f.Orv51 OCCUPANGY GPOUP NO.OF DWRLING UNRS BUILDING $�. '; ,;-%r� , - �r(-' <br /> PLUMBING � ���'.� <br /> __ �"'_) � <br /> .� �� �iIDG Np OF SiOFIE$ MAX.OLC LO�D � <br /> MECHANICAL �"�� �`�� <br /> OTHER <br /> _iRL SPRINKLERS REOUIRED O VES ❑ NO STATEBUILDINGSURCHARGE .:'� �Ji <br /> STATE ENERGY SURCHARGE �_�=���/�� <br /> �' i01�qCCllv PLA95L'HELHEDBY APPpFORIS$IIANLEBY � �t� <br /> PU�LIC WGRKS �� ; � <br /> ���C ���1, TOTAL /. � ,; _, �. <br /> r-� � � ' <br /> PflOPERN OWNEnS ARE RES?ONSIBLE FOR JETERMINING ALL <br /> PfiOPERN LINE LOCATIONS ANU REIA7ED EASEMENTS. <br />