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;,.�., Gu s /�a �- ,�. <br /> APPILICAT10.�1 FOR CO�ISTI�UCTwJN PERMI'� <br /> the Evergreen everett <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 Ta BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOLITION COMBINATIQN BUILDING MECHANICk,I_ PLUMBING SIGN <br /> pWNER � ���;� MAILAOOFE55 CITY CIP PNOHE <br /> ���.I LI -laY��`p�� ) 1� UW CU � ���, �.r7.�'� 8�f5�, <br /> TENANT IdNLA�OFE55 r�CR�i1�"IP PHONE <br /> ARCHITECTOROESIGNER IAlJLAO�PESS GITY I:IP PHONB <br /> GENERFI.CONTRFCTOR lAAIL A�0 SS CITY 1:IP P/IONE UCENSE u <br /> U�`�ioN C� t �� ��o�; 4,r��c� _�� 9�o?w _3_�7����—u��io�u�-� u�i�� <br /> MECHANICALGONT :iOfi MAILAOOflE55 CIiV ZIP PHO�E IIGENcEa <br /> PWIABINGCONTRACTOR IdNLADDPESS CITY ZIP PNOkE LICENSEa <br /> CLASS OF WORK <br /> I� NEW i . ADDITION ��. � ALTERATION �� REPAIR � DEMOLITION WOODSTOVEIFFPL INSERT , ��. BUILDING RELOCATION <br /> TENANTIMPROVEMENiORINTERIORREh100ELONLV � aJpp (;� Q�/` CONTACiPER50N�N�PHONENO. <br /> � 7 [� <br /> CONIRACT PRICE OF WORK: ��J 7 J � �- <br /> ` , OESCRIBE WORK AND SOLIARE fOOTAGE IN OLVED <br /> ��U,�� �r 3� _ �� _ <br /> �aaoPos�ouseoFem�ou+c I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED HIS <br /> _�� lo� � �'A�r APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESC IPT�ONOFPROP ai (SMOWNBELOWORATTACMFOUFCOPIfS� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ���or o�ocH ar NUT. THE GRANTWG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ��� AUTHORITY TO VIOLATE OR CANCEI_ THE PROVISIONS OF ANY <br /> OTHER STATE O!� LOCAL LAW REGULATING CONSTRUCTION OH THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOAIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE �h'ORK FOH 6VHICH <br /> -- APPLICATION IS MADE AND I COMPLY VJITH THE STATE <br /> CONTRACTORS LAW 1827 RCW ANG 296200 WAC. <br /> SIGNATUFEOFCONTR�GTORURAUiHCfiiZL'DAGENT D4�[ <br /> �PROJECTADD 55 (��.� � � `��-- <br /> 1��� I�V 1 '� APPLICANTSCITYBlI51NE55LICENSEN� l,NU�USiNH55tlAIdE <br /> p<- l�i ` <br /> PLUMBING MECHAIdICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EDUIPMENT FEE <br /> 'NATER CLOSET(TOILET) = A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB ( — FORCED AIR SYSTEMS--B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UtJIT HEATERS--B.T.U. M <br /> SHOWER ' CLOTHESDRYERS � <br /> KITCHEN aINK& DISP '^ VENTILATION FADI ; <br /> DISHWASHER RANGE HO00 T— <br /> LAUNC+RY TRAY ; WATER HEATER <br /> CLOTHES WASHER '— WOODaTOVE i <br /> URINAL ; METAL FIREPLACE 3 CHIMNEY "— <br /> DFINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR ORAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; ; <br /> � <br /> _ � <br /> � �— <br /> SUB TUTAL $ ;— SUB TOTAL S <br /> PERMIT $ _.-- PERMIT S �-i-- <br /> _� <br /> TOTAI FEE 5 ; — TOTAL FEE S — <br /> FRONTSET�CH REAR��CK SIDESET��CK PLYCHEG'�4�E� � � FEE� p2 RECEIPTN?�� L ' <br /> 3 O <br /> us�z�ojrve�7 �orLnaEn vn�cn�NTsi.e FEES VALUATION FEE <br /> /( " L �.J �� ! YtS �. �� NO BUILDING r�� '�C' � � j� <br /> iYPE OF COtlSi.ALLOVIABLE 7YPE 0 GOqSi.ACiIIAL omucar;h rvo or Or.[wr.c uu'�is , I��� <br /> ruouo ' <br /> Y- - J -3 PLUMBING _ /� v� — <br /> t_ <br /> SIZEOFBLDG, NO.OFSTORIES �ASEIAENT MECHANICAI l`�� �- <br /> ZIZ�+ sv� vES 0 <br /> '90 SF[::IR �� i - <br /> OCCUPANCVIOAD FlFESPRNKLEPSRE�'D MEIGNSLnIMI`1TION OTHER i _ <br /> }� /� ,.�� YES ` i NO Z C.� STFTE 6UILDING SURCHA(iGE „C �� "1 <br /> REASON FOR SPRINKLERS - - - <br /> STATEENERGYSURCHARGE <br /> EC-B�- PLPNSAPPROVEDBV CITY OF EVERETT PU�LIC WORKS � ��� <br /> �1 �+ �,n � LOCALSALES <br /> �� f TAX COUE IS 3105 TOTAL �� ' � ' <br /> C���d.�t L�Z�c's��� _ ���aT `�ut ��E ��� C%�,���rv.yir�ti-i-� Gu2(� <br /> �� - <br />