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� �,�\� APPLICAY1�1�1 FOR CONSTRUCTt�N PERIlAIT <br /> � everett <br /> 1 ciTv orefBe� � <br /> � everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ❑ DEMOLI'fION f I COMBINATION 1 I BUILDING �MECHANICAL f � PLUMBING CI SIGN , <br /> �R� �A . � �� � ITY ZIP PHONE I <br /> OOPC`S / ��-� �-v �� �-,�-- a�c�q <br /> TE T ���1 ^ �` CITY ZIP PHONE I <br /> �RCH�OR DE� MAIL ADDRESS CITY ZIP PHONE il <br /> i <br /> �E E AL O TflAGTOR AIL OORC 5 CI7Y ZIP vH NE LI NSE M i <br /> .- ����l�ll ,�Sc,l-S�o'1 � <br /> I MECHANICALCONTR ' OR h1AIL�0URE 5 CIIY ZIP ��PII �F � �LICENS� <br /> �� � � �./�l r7�J <br /> PLUMBINOCONiRACTOR MAILAOORE55 CITY 2iP � ONE LICENSEI <br /> � CUSS OF WOfiH <br /> � ❑ NEW I I ADDITION ATION I I REP�IR I I DEMOUTION I I WOODSTOVEIFRPL INSERT I I BUILDING RELOCATION <br /> • TENANTIMPROVEMENTORINTERIORREMO�ELONLV CONiACiPEfi50NAlIDPHONENO. <br /> / f <br /> COI.TRACT PPICF OF WORN:��`P� <br /> � �Cf.foG ORN �I�p�O�00TAG� e1NVOLV�� � ��� <br /> U 11 Y r� �"i <br /> � PROPOSEOUSE F o I HEREBY CERTIFY THAT I NAVE READ AND EXAMINED THIS <br /> ' APPLICATION AND KNOW THE SAME TO BE TRUE AIJD CORRECT.ALl <br /> - LEGAL�ESCRIPTIONOFPROPERTY�SHOWNBELOWORA7TACHFOURCOPIES) PROVISIONSOFLAWSANDORDW�NCESGOVERNINGTHISTYPEOF <br /> WORK WILL 7E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �! �or BLOCK oF NOT. THE G:iANTING OF A PEFiMIT DOES NOT PRESUME TO GIVE . <br /> . AUTHORITV TO VIOLATE OR CANCEI. THE PFiOVIS�ONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGULATIIJG CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAi I AM AUTHOAIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> ' APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> . CONT(iACTORS LAW 18.27 RCW AND 29G.200 WAC. <br /> � sicr�n�uneorcomnnctononnurHonizeo eut onre <br /> � _������ <br /> � PRQIECTADUf1ES5� yi�!„ ('�J^-� ./1 _ / C�i qpp��C�N'SCIiY�U51NE5 CENSENOANDBUSINESSNAME <br /> U � V �_'�V� �W <br /> ; PLUMBiNG MECHANICAL � � <br /> � NO. TYPE OF FIXTI;RC•OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—NIiNDLG UNITS—H.P. � <br /> � BATHTUB ; � FORCED AIR SYSTEMS—B.T. . E.A. ; <br /> i <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—D.T.U. M � <br /> ,' � CLOTHES DRYERS �— <br /> SHOWEfl � � <br /> ,� KITCHEN SINK&OISP � VENTILATION FAN ' <br /> j DISHWASHER —�— RANGE HOOD —�— <br /> ,� LAUNDRY TRAY ; � WATER HEATE(1 ' <br /> .� CLOTHES WASHER � W000 STOVE � <br /> � <br /> J URINAL ' METAL FIREPLACE 8 CHIMNEY ; <br /> ; DRItJKING FOUNTAIN FIREPLACE INSEfiT �_ <br /> �, FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING �_ <br /> � ROOF DRAINS—RAINLEADERS --� EXHAUST FAN � <br /> —•— <br /> ' SINK�SERVICE—BAR,ETC.) ' � <br /> ——T-- � <br /> , � <br /> — , --- � <br /> _ � <br /> i �_ i <br /> — �— <br /> . SUB TOTAL $ ' SUB TOTAL 5 yd ' �I <br /> � <br /> ' PEfiMIT $ ----���— --- __ _ PERMIT $ i�� , <br /> � � TOiAL FEE $ S '� <br /> TOTAL FFE $ �� <br /> i FPONTSEfBACK �@�RSET�ACK SI�FSE70ACN PLANCI�ECKNU1dflEf1 fEE RECEIPTNO. ' <br /> � USE ZONE LOT�f1EA vncnnT srte FEES VALUATION FEE � <br /> �T <br /> � I I YES I � NO BUILDING � <br /> i � <br /> TYPEO�CG�SI.RLLOWABIE IYCFOFC01lS7.ACIUAL OCNrANcv xnOroW[wh,UHnS i <br /> Gaour PW�dBING i <br /> 512EOFOLOG. NOAFSTORIES A�SEIAENT MECHANICAI �C� ��"' <br /> I I YES I ! NO <br /> ' OCCUPANCVLOAD FIRESPFNKlEli5�E0'0 HEIGHTLIMITAiION OTf1ER � <br /> . I 1 YES I I NO STATE 9UILOING SUfiCIIARGE � <br /> � REASON FOR SPBINNLERS --�— <br /> STAiE ENERGV SUf7CHARGE • i <br /> _ i <br /> � APPIICATIONACC.BY PLANSAPPROVEOBV CITYOFEVERETT PUBLICWORKS � <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL SS� �Oo <br />