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APPLICATION FOR CONSTRUCTION PERMIT <br />everett <br />CITY <br />GP <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK —PLEASE PRINT <br />L: DEMOLITION ❑ COMBINATION BUILDING ❑ MECHANICAL .7 PLUMBING ❑ SIGN <br />OWNED NALADDPEss CRY ZIP PHONE <br />Aln/Fcc� J?anf s I% nip S=2?o Gtis -7Sz� <br />TENANT MAILADDRESS CRY ZIP PHONE <br />ARCHRECT OR DESIGNER MALADORE55 CRY LP PHONE <br />I <br />GENEML CDNTMCTOIT MALADDRES5 CRY ZIP PHONE ENSEI <br />�n5 n>r Co, /26e/ 9/sr ii�l a�E niAg/lySviL.Lc 5�'z�u LSy-'�y'a3 <br />MECHANK..LLCCfITRACTOR MAIL. ADDRESS CRY ZIP PHONE LICENSE. <br />PLUMBINGCOIITMCTOR MAIL AJAI CRY ZIP PNONE INTENSE. <br />Rtanc ?[, «AI.V(r 5AAPAlemw4 <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION Li REPAIR DEMOLITION ❑ WOODSTOVEIFRPL INSERT ❑ BUILDING RELOCATION <br />TENAIITIMPPOVEMEMORINTERKMREMOOELW6/) �PD CONTACT PERSON AND PHONE NO <br />CGMRACT PRICE OF WdY(: o j <br />DESCRIBE WORK AND SIXIARE FOOTAGE IN VED <br />AlrN be PAp W dY d <br />PRONSELkWE OF uLOINK, 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />LE6-DEWRIMOFPRWEnWiSHOWNBELOWORAITACHFWRLOPIfB1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />wT__ BLOCK of NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />FIRM»WA'/ J / - I CIE OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />Y OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />Oa 3 ci GO R(rr• If T3 .93 APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 10.27 RCW AND 206.200 WAC. <br />Ve FI— - c;Fin-imz 97IP6 SKJUIORE OF CIXRIULTOH OR AUT IZEDAGEENNT DATE <br />PROZECTAPDREss 0 +` <br />R✓ S� APPLICA! vBLL NE55lIL[NSE NO ANG Dl15:NE55 NAME <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) (Q� AIC—AIHNDLG UNITS—H.P. <br />BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) UNIT HEATERS—B.T.U. M <br />SHOWER CLOTHES DRYERS <br />KITCHEN SINK a DISP VENTILATION FAN <br />DISHWASHER RANGE HOOD <br />LAUNDRY TRAY WATER HEATER <br />CLOTHES WASHER WOOD STOVE <br />URINAL METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN FIREPLACE INSERT <br />FLOOR DRAIN HEAT PUMP <br />BACKFLOW PREVENTERS GAS PIPING <br />ROOF DRAINS—RAINLEADERS EXHAUSTFAN <br />SINK (SERVICE —BAR, ETC.) <br />1 <br />SUBTOTAL S SUBTOTAL S <br />PERMIT $ PERMIT $ <br />TOTAL FEE $ TOTAL FEE $ Woo <br />FPONt SE IK REARSEE+TRACK S SIDESETBBA�LKA PAN LN L NU �� f E �� REC5 <br />USE zaHE wTAREA GO ,.[ V" YES ❑ NO FEES 3 VALUATION FEE L.r <br />V� BUILDING elz5 `(� <br />TYPE MCONSl AllOWABIE TYPE CDNsf ALiUAI M'JPLOlRO IMR <br />_Al PLUMBING <br />SIZEOF No Of STORIES BASEMENT MECHANICAL <br />6°76 Sf ^ YES X NO <br />OCCUPANCY LOAD FIRE SPRNKLERS REOD HEMHTLIMITAT� OTHEfl :7 <br />U YES X NO STATE BUILDING SURCHARGE (D�C/'L <br />PEASON fOq SPRMKLEPS I <br />STATE ENERGY SURCHARGE <br />APPl1GTKM ACC. BY P✓,Nsenrnovgo=• CITY BF EVEBETT PUBLICWORKS <br />9/�Q/ LGCAL SALES <br />TAX CBDE 153105 TorAL �/� l y <br />