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NLKtW .,I � <br /> APPI_ICATIL A FOR CONSTRUC L ON PERMIT <br /> IAW FYPro�I <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITY OF _ <br /> everett HEATING SYSTEM: , GAS ❑ELECTRIC O <br /> BUILDING DEPARTMENT <br /> 259.8810 <br /> DEMOLITION COMBINATION )<BUILDING )JAECHANICAL )4LUMBING SIGN <br /> OWNER MAR ADDRESS CITY �ZIP PNGNE <br /> MTENANT / MAIL ADDRESS CITY 21P PHONE <br /> " ra UE <br /> ARCHITECT OR DESIGNER MAR ADDRESS CITY lIP PHONE <br /> cDsnkALC (bP_uo -y-mg-r-5 �S-Cc�-Scc.6c.�9 <br /> ACTORMA ADDRESS OrY ZIP PHONE LICENSE R <br /> yy fiTO N= <br /> 4 pie, <br /> MECHANICAL CONTRACTOR MAR AUDRFSS GRY IIP HON . NSR <br /> "^n -7q5-3930 Hora2 141.L57 IA A <br /> F3 w 20 AL <br /> CRY 21P PHONE IN:ENSEF <br /> PLUMBINGCONTRACTGR MAR ADDRESS <br /> �y 111Hrrr Pi <br /> � TSAL/D� cum lu a�a� �t51no (.t� �upretl 98�- 7�3-9s37 I�[!y�-rs yl02 <br /> F�..z T+ C 5 DF WORK <br /> [lll***�JJJ u[ NEW 1 ADDITION ALTERATION REPAIR DrWOLITION WOODSTOVEIFRPL INSERT BUILDING RELOCATION <br /> b CONTACT PERSON AND PHONE NO <br /> O H �J /�ywy.�..' ../�/).��/� yn U <br /> [SJ O CONTRACT PRICE 2t-,—ORK 5-zi D —1-1-Ls/�� O^- -/ <br /> ow 0 DESCRIBE VNNK AKDSGUARE FOOTAGE INY VED <br /> xy - Zlto m IJEID Co sr. - — <br /> PROPOSEOUSE BUILDING 1 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 /> H j LEGAL OEscnmrroNa PrAVERTY ISHO'NN BELOW oR ArrncH FOUR COPIES) WORKWILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> 0 CAI <br /> IDT_ BLocK __ OF NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> .TK7� (�� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> H3 p 14 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 1027 RCW AND 296.200 WAC. <br /> SIGNATURE O CONTMCTOROR AUTHORIZED AGENT DATE <br /> I23- (o I sL�L. 50 S. ,XC�' c 018 2 <br /> PRCUECTADDNESS (�K _eo11siRLiC;m-o—A•� <br /> I APKICAN1S CITY BIUSMESS LICENSE NO AND BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE _ NO. TYPE OF EQUIPMENT FEE <br /> i WATER CLOSET(TOILET) NC-A/HNDLG UNITS-H.P. ' <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) — UNIT HEATERS-B.T.U. M <br /> _ SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK&DISP VENTILATION FAN ) <br /> DISHWASHER RANGE HOOD ' <br /> ' LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER I WOOD STOVE <br /> URINAL ' METAL FIREPLACE&CHIMNEY <br /> ru DRINKING FOUNTAIN I FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP _ — <br /> ' BACKFLOW PREVENTERS GAS PIPING )_ <br /> HOOF DRAINS-RAINLEADERS EXHAUST FAN ' <br /> lum NTS . 1�` SINK(SERVICE-BAR.ETC.) — <br /> 1 <br /> I <br /> LI <br /> SUB TOTAL $ <br /> SUB TOTAL S ; _ <br /> PERMIT $ -r' PERMIT S ` <br /> I 'i _ TOTALFEE E TOTAL FE—E—$ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACK SIDE SETMCK PLANCHE UM FE/ <br /> E7 RECEIn <br /> wl ZC1 �7c� 1 FEE <br /> USE ZON(��/ LOT AREA VACANT SITE l FEES VALUATION FEE <br /> \\�7- iJ BUILDING <br /> TYPE O CON IS AIIpy�ARE TYPE OF CONST ACTUAL TNCInNCY Ir "w,i Wn <br /> V 'N V- r PLUMBING i0 <br /> OF Tq W STOVES GEMENT MECHANICAL 110 :oD <br /> OCCUPANCYLOAD I FIRE SPARKLERS REO'O HEIGHT LIVMITATgH ADDITIONAL PLAN CHECK <br /> OTHER <br /> REASON FOR SPRINKLERS —STATEBUILDINGBUILDING SURCHARGE <br /> INTAKE BY PIANS APPROVED BY CIOF EYERETT PUBLIC WORKS ) <br /> LOCAL SALES / <br /> �'j �p�� TATYX CODE IS 3105 TOTAL (Y <br />