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arm <br />9H <br />,ozx <br />C H <br />a H N <br />rx <br />yz3 <br />K c� <br />H o x0 <br />q t" <br />Nzz <br />y r <br />Om <br />HO <br />O H <br />ZOE <br />L. z <br />r z <br />H I-3 <br />r <br />A L7 (AM ITCT t. <br />Z +3 TIE <br />H O rn <br />APPLICATIGA FOR CONSTRUC?'PON PERMIT <br />The L,,,:p,,,,... <br />CITY OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK —PLEASE PRINT <br />259-8810 <br />'i DEMOLITION COMBINATION BUILDING MECHANICAL <br />OWNER MAIL ADDRESS ,.IIc al.RD"Er....�c <br />n , 30 -M E✓FAEf <br />TE NT MAILADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESgNER MAIL ADDRESS CITY ZIP PHONE <br />PLUMBING <br />PLUMBNOCONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />SIGN <br />7•,/YAI GFPAIR nrur)l ITInN wnnnsinVFIFRPL INSERT ; BUILDING RELOCATION <br />. IKCYr ;% I,MMn RnY ••�••.•.... - - <br />TENANT IMPROVEMENT ORNTERIORREMODEL ONLY <br />L�"1�.� <br />LNt /LWL tkat, <br />CONTACT PERSON ANOPIIONE NO <br />� 6 r� - �-� � <br />4 a AIL- � a � `� <br />CONTRACT PI CE OF WORK: <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />.fJ U RE, MF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED US€7 of BDILDNa <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVINANCES GOVERNING THIS TYPE OF <br />WORK SWILL BIONS E OM^LETED WIITLAWS AND IH WHETHER SECIFIIED HEREIN OR <br />LEGAL DESCRIPTION a PROPERTY lsrwwr+BClow on ATTACH arR torn: <br />OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT_ BLOCK _ --- <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />-- <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS '.FADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1627 RCW AND 286.200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X <br />PROJECT ADDRESS <br />APPI CANTS CITY BUSINESS IICENSF NO AND BUSINESS N ME <br />PLUMBING <br />MECHANICAL <br />FEE <br />NO. <br />TYPE OF FIXTURE 0191 ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />WATER CLOSET (TOILET) <br />A'C—A'HNDLG UNITS—H.P. <br />BATHTUB <br />—�— <br />_ <br />FORCED AIR SYSTEMS-8111 M E.A. <br />LAVATORY (WASH BASIN) <br />_ <br />UNIT HEATERS—B.T.U. M _ <br />SHOWER <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 6 OISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOD <br />LAUNDRY -RAY <br />WATER HEATER <br />CLOTHES WASHER <br />_ <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />O <br />-•— <br />I <br />SUB TOTAL <br />f <br />; <br />SUB TOTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />' <br />TOTAL FEE f <br />' <br />FROG 6FjRACN, <br />REAR SEIOAL� <br />BIOS SE)RACK <br />PLNICHECKNI BE" Zr <br />RECEIPT NO <br />G�%�Y_ <br />jg� <br />USE2 <br />LOT AREA �y <br />VACANANT SITE <br />�NO <br />EES <br />FEE <br />' <br />�. <br />G7f1iL_� <br />YES <br />BUILDING <br />PFEE <br />Loci <br />TYPE a EBNsI ulawABIL <br />nrI Dl wxsr ACTUAL <br />acllNr. AP M HMI.... <br />V-AI <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />YES JC NO <br />OTHER <br />, <br />I <br />' S <br />OCCUPANCY LOAD <br />FIRE SPRNKLERS RE DO <br />N[IGHNT IIMIIF <br />STATE BUILDING SURCHARGE <br />VES X NO <br />REASON CHISPRINKIERS <br />STATE [NERDY SURCHARGE <br />� <br />APPIKIATIONACC Br PLANS. 'PRovrnm <br />CITY OF EVEfl ETT <br />runuc WORKS <br />LOCAL SALES <br />A <br />7 S V <br />TAX CODE IS 3105 <br />TOTAL <br />..a <br />