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APPLICATI010FOR CONSTRUCTION PERMIT everett <br />rNP [rr9zen TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ]ELECTRIC O <br />259 8810 <br />DEMOLITION :: COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br />OYd1/EB(� MAIL ADDRESSES CITY ZIP PHONE <br />TENANT V MA4ADDRESS DRY DP PIICNC <br />GENERAL TMCTOR MAN ADDRESS CRY ZIP PROBE LICENSE <br />MECHYIILAL LIXITRAIL�T^O-R,Z�''MANAdJRESS M� � CRY ,Q.�% ZIP PHONE LICENSE <br />'7T ot <br />7A?DAN'Ay,yIE1CyAY ZL'a3 TILwA/% aroz 25- +_4d F i,7?li/,P.t/ <br />PLUMBW6LCIITMCTd1 MANADORESS CRY ZIP PHONE LICENSE <br />CLASSOF WORN <br />NEW G ADDITION ..' ALTERATION i_I REPAIR i : DEMOLITION WOODSTOVERFRPL INSERT I--, BUILDING RELOCATION <br />CgIIMLT PENCE OF VADRY. � <br />ACi PER50/Z�AN�D PHONE NO. _/� <br />W/('E.j�i� � ' /b <br />DESCRRE WVRN ANO SOWLRE f001AGE INVCIVEO <br />PROMS =NowO <br />U <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />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 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />ST.NATURE CONTR//ACTOR OR AUTHORIZED AGENT DATE <br />X /IJ� �r,/ <br />LEDAL DESCRIPTION OF PROPERTY ISHCAMI BELOWOR ATTACH FOUR COPIESI <br />LOr BLCCN a <br />C`y ./ <br />2(�d? <br />PRWELiA00R1E55 <br />APpI SCI BUSMESSIK.ENSE NO IHO BUSINESS NAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A'C-AHND:G UNITS -H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />_ <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR. ETC.) <br />SUBTOTAL $ <br />SUBTOTAL $ <br />D <br />PERMIT $ <br />PERMIT $ <br />,$- <br />TOTAL FEE $ <br />TOTAL FEE $ <br />S ' D <br />FOR OFFICE USE ONLY: <br />M2(v441 <br />FRONT SETBACK <br />REM SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBEC <br />RE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />TYPE IX CONIS. MLMME <br />IYRdC0X5f. ALTWL <br />eLENAALY No pBALIIK Wn <br />T'A0W <br />SIZE OBLDO. <br />NOOFSTORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRINKLERS RECTO HEIGHT LIBRADOR <br />REASONFORSPRNKLEF3 <br />OTHER <br />STATE BUILDING SURCHARGE <br />WMNEBY <br />FLMSAPPRDVEDBY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUDLIC WORKS <br />TOTAL <br />! ob <br />J <br />