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1--3 3 <br />3�. HH <br />OH0 <br />ti H <br />M <br />C)• c"D <br />z C <br />yy.'H� <br />t q z <br />H H <br />gy <br />H <br />C] C7 [A <br />zOEn <br />IftaA► <br />�sow <br />S <br />PM <br />I <br />NJ fwpproYn <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />DINNER <br />APPLI..ATION FOR CONST&.JCTION <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />DPEES CITY TIP <br />ml <br />ARCHITECT OR OESKiNER MAIL ADDRESS CITY -- ZIP —PONE <br />GENERSLCON1RAElOR ^ MAR ADDRESS _ ---GTE —ZIP ^ ^ PHONE- T LICENSE <br />PLUMBING CONTRAWOP MAILADDRESS G1Y ZIP PONE LKENSL• <br />CLAW Of WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPL INSERT i BUILDING RELOCATION <br />TENANTIMPROVEMENT OR INTEPON REMODEL ONLY /.� <br />CONTRACT MICE OF RORK <br />CONTACT MR" AND PHONE NO <br />DESCRIBE WORK AND SQUARE FOO�INVOLVED <br />RFf nvAT.B.Y�I <br />PRDPOBEDuaEWeuaDlNu ,/_ <br />/�ti.✓TH-L <br />_ <br />THE CERTIFAND <br />CORK CT. ALL PR VISIONSHIS ICATIONOF <br />NNDW THE SAME TO BE TRUEAND CORRECT. ALL PROVISIONSOF LAWS AND <br />KNOW TO BE TRUE AHAVE ND <br />ORDINANCES GOVERNIN9 THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PE RMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATEORLOCAL LAW REGULATINGCONSTRUCTIONORTHE PER- <br />FORMANCE OF CONSTRLrTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296.200 WAG <br />SONATUREWCGNiRACTORORAtii" REDAGENt DATE <br />�W w -- <br />APRK:AN16 GtY BUSINESS LICFN3E AND BUSINESS NA4( <br />LEGAL DEWRIPTONOf PROPERTY ISNOWN BELOW OR ATTACH FOUR COPIES) <br />Lm.j 4OCX OF <br />sit_/ <br />7a 7 - 4rJ 3' 06-7 0 � <br />PPOJEA�D0RES6 �J/T� <br />mI1^ <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />NC - NHNOLG UNITS - H <br />FORCED AIR SYSTEMS- BT.U. M EA <br />UNITHEATERS -BT.U. M <br />_ <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK&DISP. <br />VENTILATION FAN <br />_ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFL(AN PREVENTERS <br />OAS PIPING <br />ROOF DRAINS - RAINLEADERS <br />EXHAUST FAN <br />_ <br />SINK (SERVICE - BAR, ETC) <br />SUBTOTAL 6 <br />SUBTOTAL 6 <br />_ <br />PERMIT 6 <br />PERMIT 6 <br />TOTAL FEE 6 <br />TOTAL FEE 6 <br />FRONT SETBACK <br />Zoi <br />p , <br />USE Wt_ <br />REAR SETBACK <br />F <br />7P <br />LOTAREA <br />MDESEK <br />6% <br />VACANT SITE <br />❑YES ONO <br />PUNK fCKNUMBER <br />v E- <br />FEES <br />FEE <br />VALUATION <br />AECEIPTNO. <br />�1r�r) <br />FEE <br />BUILDING <br />ryPf OF CONS) <br />ALLFBVA&FIAiN0. <br />OCCUPANCY GPOUP <br />-3 <br />MO OF OWELLINGUMTS <br />PLUMBING <br />SIZE OF ULM j,,jj ,Sf ♦ <br />�st <br />�%. Si <br />NO OF STORIES <br />/ <br />BSAT1. <br />} M <br />DEC LONG <br />MECHANICAL <br />OTHER <br />FIRE SPRINKLERS REWIRED ❑YEE EfNO <br />NEIOH.ILL nITA <br />W <br />STATE BUILDING SURCHARGE <br />J <br />APPLICATION ACC BY PL\NSAPPP BY <br />_ . / �� <br />/ !�0�LjVI�\\i <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />7 <br />