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APPLICATIO[�` FOR CONSTRUCTL- N PERMIT everett <br /> TAe Ewrgwn TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITY OF <br /> everett HEATING SYSTEM: U GAS U ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259.8810 <br /> 1 1 DEMOLITION I COMBINATION M BUILDING I i MECHANICAL I I PLUMBING SIGN <br /> OYVNEER MAIL ADDRESS CITY ZIP PHONE <br /> L nIle, PyL S�. AP /1' S'L 5 (A/ Cl-EIt P`Ef WL26 <br /> TENANT AN DORESS CITY ZIP PHONE <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> OENERAI TACTOR �MAAOHFS6 CITY ZIP PHONE LICENSER <br /> R <br /> Z_g�2svLl'jn1- Only me o�t11f_ nLn(oa� �',rn(L oekeLuI, lYLdioi� <br /> MECHANICAL TRACTOR MAIL ADDRESS CITY ZIP PHONE IK:ENSER <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br /> CUSS OF WORK <br /> 11 NEW - DITION )4 ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVEIFRPL INSERT I i BUILDING RELOCATION <br /> CONTACT PERSON A(NDI PHONE NO <br /> CONTRACT PRICE OF WORK OD <br /> DESCRIBE VYORK AND SOUARE FOOTAGE INVO EO <br /> ami'teAt e'4._-PROPOSED USE OF BUILDING I HEREBY CERTIFY THAI I HAVE READ AND EXAMINED THIS <br /> S T <br /> IG <br /> I R ti—• _`l4 ,Q APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEDALDE RIPTM]N OF PROPERTY ISIIONBI DEL W OR ATTACH FOUR COME PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT_ BLOCK OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION,THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> PROJECT ADDRESS APPLICANTS CITY BUSINESS LICENSE NO AND BUSINESS NAME <br /> 16 - 7K. 4 W <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) I AIC—A(HNDLG UNITS—H.P. ' <br /> BATHTUB <br /> ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) I UNIT HEATERS—B.T.U. M ' <br /> CLOTHES DRYENS <br /> SHOWER ' <br /> KITCHEN SINK 8 DISP ' VENTILATION FAN <br /> I <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ' WATER HEATER <br /> I <br /> CLOTHES WASHER I WOOD STOVE ' <br /> URINAL <br /> ' METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN I FIREPLACE INSERT ' <br /> FLOOR DRAIN ' HEAT PUMP <br /> ' GAS PIPING — <br /> BACKFLOW PREVENTERS ' �— <br /> ROOF DRAINS—RAINLEADERS ' EXHAUSTFAN ' <br /> I ' <br /> SINK(SERVICE—BAR.ETC.) T i <br /> I <br /> I ' <br /> I <br /> 1 ' <br /> SUB TOTAL $ i SUS TOTAL $ ' <br /> PERMIT S I PERMIT S ' <br /> TOTAL FEE $ ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: RICE PT NO <br /> FRONT bETBACK REAR SETBACK SIDE BE N PI AN CHECK,NUMBER FEE 70 20 <br /> Zo Zo / L $ <br /> USE ZONE LOTAREA VACANT SITE FEES VALUATION FEE <br /> (Z 1 BUILDING <br /> TY%Of CONTSMLOWABLE TYPE OF CONST ACIUAI GAMY "N tlbM"I"I UNrtS <br /> PLUMBING <br /> -PJ !Z• __----r— <br /> SIZE O NO OF STORIES BASEMENT MECHANIDAL ' <br /> i <br /> D <br /> ADDITIONAL PLAN CHECK ' <br /> OCCUPANCY LOAD FIRE 6PRNKLERS PEOD NEIOHi LIMIIATI N J .. <br /> A�/t7 4 OTHER /' } <br /> REA FORSPRINKLERS U ' <br /> STATE BUILDING SURCHARGE <br /> _ I <br /> INTAKE BY %ANSAPPROVEDBY CITY OFEVERETT PUBLIC WORKS ) / <br /> 9✓L LOCAL SALES v <br /> p TAX CODE IS 3105 TOTAL 1 S <br />