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APPLICATIO►.' FOR CONSTRUCTLON PERMIT °' <br /> the EVPFpro TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITY OF <br /> everett f HEATING SYSTEM: GAS JELECTRIC J— <br /> BUILDING DEPARTMENT <br /> 259.8810 <br /> DEMOLITION (COMBINATION XBUILDING MECHANICAL PLUMBING SIGN <br /> OWNS AUR ADDRESS CITY ZIP PHONE <br /> IT), t,,twK Tek L . '�(^n?i; /(}i(L) -s",t�rmej 1,L? Cl 126 2- <br /> TENANT MAR ADDRESS cifty ZIP PHONE <br /> ARCHITECT OR DESIGNER MAR ADDRESS CItY 2rP PHONE <br /> .r)n1 Q(r(� . i �G7(llllrTr C'(✓L �4F10 LL f:?L - l7 <br /> GENERAL CONTRACTOR MAIL ADME55 CITY ZIP PIgNE LICENSEE <br /> Ch H 7i-7i -oFC T ylus JiY 6,41nr 4- O , ) y ) <br /> C�M MECHANICAL CONTRACTOR MAR ADDRESS CITY 21P PHONE LICENSE <br /> N y <br /> F—ILIMRMG CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I, <br /> j H <br /> < n <br /> H XI cuss a woRK <br /> 0 H 0 KNEW ADDITION ALTERATION REPAIR DEMOLITION WOOOSTOVEJFRPL INSERT BUILDING RELOCATION <br /> (n IIC•-�•�I CONTACT PERSON AND PHONE NO t'rYd'07 <br /> CONTRACT PRICE OF WORK ,, - S (I •r.Z�LL(/) j 3 <br /> DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br /> 0 d <br /> Iy-1 COr1S`�Ltrf' Ik-'(✓ llCtc;� <br /> H Lni)V PROPOSED USE OF BUKDNG I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> a. 0 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> I-IAL DESCRIPTION OF PROPER")SHOWN BELOW ON ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING I HIS TYPE OF <br /> z M y LEG _ / )/ i I WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> H H LOT .i BLOCK OF I NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO ONE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> y I-R OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> 0 C7 CA PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> �' OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS yE�iJ <br /> CONTRACTORSLAWEWITH THE STATE <br /> 827R WAND296.200WAC. <br /> y 0(4 SIGNATURE OF CONTRACTOR )R AUTHORIZED AGENT DATE <br /> X <br /> PROJECT AAPPLICANTS <br /> -<C�r eLY'I APPLICANTS CITY BUSINESS LICENSE NO AND BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM qFE�ENO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) NC-AMNDLGUNITS-H.PBATHTUB FRCED AIR SYSTEMS-ST.U. M E.A.LAVATORY(WASH BASIN) UNIT HEATERS-B.T.U. M2 SHOWER CLOTHES DRYERSKITCHEN SINK A DISP VENTILATION FANDISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> If CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT i <br /> �_ �_ FLOOR DRAIN ' '� HEAT PUMP ' <br /> +.' BACKFLOW PREVENTERS GAS PIPING ' <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE-BAR.ETC.) ' 1 GJF /nI I1dLL1 C� ' <br /> _ , I <br /> SUB TOTAL S ' SUB TOTAL $ • ' <br /> PERMIT $ PERMIT f I <br /> TOTAL FEE S ' ' TOTAL FEE f qn ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK ^E REAR SETBACK SIDE SETBACK PIAN CHECK NUS FEE w R53 <br /> G" LY h/F 5 <br /> USE ZONE LOTAREA VACANT SITE FEES VALUATION FEE <br /> R-( BUILDINGS'O 9 R 00 <br /> TYPE O CDNTS ALLOWABLE TYPE Of GAST ACTUAL m NJUBMIIwlVKI6 i <br /> v. Al <br /> ;r.71 j PLUMBING <br /> SIZE OBLDG ; NO OF STORIES BASEMENT, MECHANICAL LI ' O0 <br /> OCCUPANCY HONE SPRNR9 aEOD HEgNT IIAITILiKIN ADDITIONAL PLAN CHECK i <br /> /T/ A Z _ OTHER ' <br /> REASON FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS ,fid low <br /> LOCAL SALES <br /> 7 IDA, TAX CODE IS 3105 TOTAL f j <br />