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F•.•+', "��2 everett <br /> pppLl�p'T101.. FOFt CONSTRtJCTi..N PERlVIIT � <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> fho Evergreen <br /> GTY OP <br /> everett HEATING SYSTEM: AS ❑ELECTRIC U <br /> BUILDING DEFARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING �MECHANICAL oNE �PLUMBING SIGN <br /> �WN�� ` � IMAILA��PESS _ JCITY ` ' CZ�F�- � ��, , ��j/J <br /> . , � � ' �ii .�b� `,`iF. � '-- - ` <br /> �' PHONE <br /> IENFNi 1 <br /> MAILADDRESS CITY ZIP <br /> l�jA���� CITY 21P PHONE <br /> ARGHIiECTOF0E51GNER MAILA�OPE55 <br /> GENEHALCONTRAGTOR ldFILADDRESS <br /> CITY ZIP PHONE UGENSE p <br /> QiV ZIP PHONE LICENSEN <br /> h1ECMANICA�CONTRACTOfl MAILAD�FESS �,�,y��/ /. l('r�/?C. J7 /O���. <br /> �I �1LQ 1F r� �� �CJ �� �i�rQ i ��(R" �l�}" ��t t �� r <br /> PLNA�INGCONTfiACTOR M�ILAOORESS <br /> CITY ZIP PHONC LICENSEa <br /> �I�'1'1Q , <br /> ci ssoFwoaK �...i DEMOLITION WOODSTOVE/FRPLINSERT �_; BUILDINGRELOCATION <br /> NEW � �. ADDITION I ALTERATION . �� REPAIR � <br /> CONTACi PENSON AI:J PHONE NO <br /> CONTRACT PRICE OF WO <br /> A� �t,_.lJ� i� � �uii�.C'='��" {�t'(��- � �h <br /> DLSCRIBE WORK FN�£OUARE FOOTAGE INVOLVED� q � ' Z � <br /> . � ' �- � '�1� ` -- <br /> � <br /> PROPOS@DUSEOFBUTw� . - � I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> �. � � � - , /C�1c��'� , APPLICATION AND KNUW THE SAM[TO BE TRUE AND CORRECT.AlL <br /> �Ecnioesc PTIONO ROPERTVI• WNBELOWOPATfFCHFOUFCOPI[5� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS?YPEOF <br /> WORK WILL BE COMPLETED WITH INHETH[R SPECIFIED HEREIN OR <br /> �oT B��K 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 CnNSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOHK FOR WH!CH <br /> APPLICATIOIJ IS MADE AND I COMPLY WITH THE STATE <br /> 1 CONTRACTORS LAW 78.27 RCW AND 296200 WAC. <br /> �-r' ^. _ I-� `/1,-('� _ SIGNATURE OF CONTFAGTOR OR PUTHORIZEO AGENT DATE <br /> YI " � d C. l, <br /> PRO��!??(((� _�l� (�Y � �1 �� � �"t 1/ -�b1'1 �LI u/ -(I � ,(_cv'-� �-1 31-�-- <br /> DORESS pPPLICAMS CITY BUSINESS I.IGEN$E NO AHO BUSINESS NAME <br /> MECHANICAL <br /> ALUMBING TYPE OF E�UIPh7ENT FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. , <br /> A/C—A/HNDLG UNITS—H.P. ' <br /> WATER CLOSET(TOILET) --~— <br /> PORCED AIR SYSTER4S—B.1'.U. M E.A. i_ <br /> BATHTUB ', � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—�B.T.U. M <br /> CLOTHES DRYEfiS � <br /> SHOWER VENTILATION FAV ' <br /> _ KITCHEN SINK 8 DISP RANGE HOOD <br /> DISHWASHER WATER HEATEfi � <br /> LAUNDRY TRA`f ' � <br /> GLOTHES WA$HER � WOOD STOVE <br /> URINAL METAL FIFEPLACE 8 CHIMNEY � <br /> FIREPLACE INSERT ' <br /> DFINKING FOUNTAIN HEAT PUMP � <br /> FLOOR DRAIN � ' <br /> BACKFLOW PREVENTERS ' GAS PIPING <br /> —�— EXHAUSTFAN ' <br /> ROOF DRAINS—AAINLEADERS � <br /> i_ <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � — <br /> � <br /> — � <br /> SUB TOTAL S D � � <br /> SU8 TOTAL S � <br /> FERMIT $ PERMIT 3 /T ' <br /> TOTALfEE $ TOTALFEE $ SS ' <br /> FOR OFFICE USE ONLY: qECEiP.r+o <br /> PLANCHECKNUldpER FEE <br /> FRONT SETB�CK REAR SETBAGK SIOE SETBP.CK �S� /`n _ <br /> X. <br /> USE 20NE LOT AREA VACANT SRE <br /> FtES VALUATION FEE <br /> BUILDING <br /> iYP[OfG0��15.AllOWABIE TlPEOFCOYST.ACtUAL accu,<r,-;v NoOrmVaurv�urvrts � <br /> cNcu.� pLUMBING <br /> � I _ <br /> SIZE OF BLD� <br /> NO.OFSiOFIES �ASEMENT MECHAIJICAL � <br /> ADDITIONAL PLAN CHECK ' <br /> OCCIIPANCVLOAD fIRESPflNNLEflSPEO'D HEIGHTLIMITATION � <br /> i <br /> OTHER �� <br /> — <br /> r�EnSON FOR SPPiNKLERS STATE BUILDING SURCHARGE ' <br /> IIIiA✓.[�� PLANSPPPflOVED[iV CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES ' <br /> TAX CODE IS 3105 TOTAL 5����� <br />