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APPLICATIGN FOR CONSTRUC7 .dN PERMIT <br /> '^"E`�'9'^"^ everett <br /> ��T�oF e <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED I�I INK—PLEASE PRINT <br /> DEMOLITION COMBINATION BUI BING SIGN <br /> � OWNEP M�IL qDDRE55 IY IP 1410NE <br /> �dG�l1 �.t/iltG.t2� MNss���r NensA�w ,ELE.CI'1'l�✓�3� 1771=AG7'i� 3S3=•tL3a <br /> TENANT M�R RDDRES F'I " '��d c��r zip 7��y rHONe , <br /> �RCHITEC�ORDESIONEH IAAll�O�RES5 f.itV ZIP PNONE <br /> GENER�LLONTR�CTOR M�ILADORE55 CITv 21P PNONE LICENSE� <br /> x_ ?�'i GiB?s raoSr.Qd�y.�� T3i� �t�rat 9va .t�r t 3�o',8,s�91' <br /> MECN�NIC�I CONiPI1CTOH M�IL AOORFSS ���,t��r„ 9F�o p� e�OO ���ENSE� <br /> M <br /> � � <br /> PIUMBINOCONTR�CTOR M�IL�O�RESS CItY IIP PnONE LILENSEI <br /> CU55 OF V/ORK <br /> NEW ADDITION ALTERATION REPAIF DEMOLITION WOODSTOVE/FRPL INSERT BUILOINO RELOCATION <br /> J1� TEN�NTIMPROVEMENTORINTERIORREMODEIONIV CONT�LTPEPSONANDPHONE NO <br /> , \GONTq�CTPRICE OF WpqN: � , _/ � �7 I\_� ^ <br /> XDE5CRIBE WORK�ND SOU��OO7I�GE INVOLVE�` �M rr r r e� �����_ <br /> �� <br /> Y� v a <br /> PROPOSEDUSEOF ILOINO <br /> '�.y I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �F��WI'1 Jr ESrA/fJ A1bD/ti APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECt ALL <br /> �'L DESCRIPTIONpF PqOPERTV�SHOWN BELOW OR�T1�CHfOUq COPIE51 PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> '/< <o'T'�L 81aK oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV iHE <br /> OWNER Of THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY 1�JITH THE STATE <br /> CONTRACTORS LAW 1B.27 RCW AND 296200 WAC. <br /> SIGN�TUREOF�pNiq�C10RORAUiNOPIZEO�OENT O�iE <br /> `� �PAQIECT�DORE55 1 � ���/ ��/��� �/l��— <br /> � O � • �� �i`I���.',l' �jJ/� �PPL�C�NiSCITYBUSINESSIICENSENORNOBUSINE55N�ME 4` <br /> PLUMBINQ MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—luNNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASHBASIN) UNITHEATERS—B.TU. M <br /> SHOWER � CLOTHESDRVERS , <br /> HITCVIEN SINK 6 OISP VENTILATION FAN <br /> DISHWASHER qANGE HOOD � <br /> _ IAUNDRY TRAV WATER HEATER <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL METAL FIREPLACE 8 GHIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PFEVENTEFS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � � <br /> SUB TOTAL S SUB 1"OTAL f <br /> PERMIT E PERMIT s <br /> TOTAL FEE S TOTAL FEE E <br /> FRON75EiB�CN REIIRSETB�CN SI�E5ETB�CN PL�NCNECNNIIMBEN FEE RECEIPTNO <br /> r D �`ii y�'� 33i l <br /> USE IONE l0T�REA V�C�NT SiiE FEES VALUATION FEE <br /> VES NO BUILDING ` <br /> MFOlGONSiAIIOW�Bt[ IYPfOiCOH5i�C7WL afuwvcr rNldoxlwNGMiR 7SD O '�O <br /> ¢nour <br /> - I PLUIdBINO i <br /> SIZE Oi B�DG NO pF STORIES B�SEMENi i <br /> GIIB SF Df+�'� � MECHANICAL � <br /> f VES oC NO �p •lo � <br /> OCCUP�NGVlOAD FIRESPRNNLERSREO'D HEIUHTLIMITA710N OTHER �,SI �,/�. • 3 ; yo <br /> I /J VES X NO STATE BUIIDING SURCHAFGE ;sa <br /> RE�Sp1 FOR SPRINkLEFS <br /> ' ' STATEENERGYSURCHANGE <br /> APPIIC�TION�CC flV PL�NS�PPROVEDBV CITY OF EVEREIT PIIBLIC WORNS � <br /> 9'U LOCAL SALES ' <br /> TAX COOE IS 3105 ror�� � ; o <br />� <br />