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the EYerOreen <br />C TY OF <br />everett <br />BUILDING, DEPAHTMEN, <br />259-HH10 <br />APPLICATION FOR CONSTR..CTION <br />PERMIT <br />� eru•II <br />TO BE COMPLETED 14 INK — PLEASE PRINT <br />OWNER MAIL ADDRESS —" WIf <br />ZIP PHONE <br />i:QOA)IAT GLLLTLI.L. I'IpLNLtS i5•f.£ur12LTi D1nLI.WtY-/i- SveleTl- "Jraoy 353-I.sOp 7ENAN1 MAILRE89 ....,. <br />ACHRECTORDE91GIIER <br />MAIL ADDRESS <br />OITY <br />21P <br />QWTAIIco -T]9 <br />GENERAL <br />Nw•_� K <br />A•4 <br />Lake SItLeL�S <br />gff158 <br />PHONE <br />334-b858 <br />CONTRRACTDR <br />•nAII ADDRESS <br />GTY <br />eV1mvL, 1 Ls 7i3_S.f. £urPeTf"ry1r.114iht—ll:. <br />sr— <br />ZIP <br />£w're?f_ <br />PHONE <br />9$105t 3s3•1,sbo�i <br />MECHAW„1L COVTMCTCV <br />MAIUODRE89 <br />GTY <br />ZIP <br />PHONE <br />LICENSE <br />PLUMBING CONTRACTOR <br />MAILADDRES9 <br />CITY <br />ZIP <br />PHONE <br />—LICENSE <br />PMEi4.r SOU UIN PLL.N!5% <br />36 aoaW W <br />.oy _ 34-1-I.AbO <br />FuGEi•Plyloz <br />IASCLASSOFWORK <br />L7 NEW ❑ ADDIT' )N ❑ <br />ALTFRATIi1N I7 Rcour. <br />I-) n�............ F'1 ...______..____ <br />_.__ <br />I <br />— -- -- — ••....�•+....vr,.�unacnl u BUILDING RELOCATION <br />TENANt IMPROYEMENTOR INTERIOR REMODEL ONLY CONTACT PEg80N ANO PIMNE NO <br />CONTRACT PRICE OF WORK Y!/%p•QOp LLL�iJ (eVS �•S3'�.S n� <br />DESCRIBE WORN AN0 80UAPE i00TA0E INVOLVED _ <br />PBOPp9E0 USE OF BUILDING <br />_ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS A'P; ICATION AND <br />KNOW'IfF SAME TO BE TRUE AND CORRECT. ALL PROVIS IONS OF LAWS AND <br />LFGALOESCRIPIIONCFPROPERTY(SHOWNBELOWOR ATTACHFdURCOPIE81 ORDII NCE 30VERNINO THIS TYPE OF WORK WILL BF COMPLETED WITH <br />WHET ER SPECIFIED HEREIN OR NOT, THE 3RAN TING OFA PERMIT DOES NOT <br />LOT4_ BI^_^N of M .,.rAl+u 017 w PRESUME TO GIVE AUTHORITY To VIOLATC OR CANCEL THE <br />ANY OTHER STA EORLOCAL LAW E3ULATIN0CONSTRUCTION ORTHE PER. <br />FORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE OWNER OF <br />p IUR].a AJ Np,� AS (At2 PL14-. P.ZEO2Df0 THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I Cf MPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND <br />296.200 WAG <br />IL1 VC--V%T. A'IS of: PLAT'Lj PA6L III T 11i_ SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />—7 <br />n 11 t� I,,d •a/aale <br />gLG iI S U F STl1DIfa.N�SM I,; .h, NIT- L.{e •, 11. ( XNry <br />LPI •�i• <br />PRWE�Cf ODOR?99-�L-r-_--_y—f_L I'� <br />_ (f W,OrF/• ;i�('jJ IH /TprMf$yRq: C/Qp,IJ /l .'TI L/d(3 <br />r Si1'.•i. v'Kt1=t.T bi. VPLICAII 8CITYBIISMESiLICENSE NO AN08U91 83NAME <br />TILE (/Y +ft12Ly 3.SLi Ftcr Tlra EnF. <br />PLUMBING .-� �� `• ` <br />MECHANICAL <br />N0. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYFE OF EQUIPMENT <br />FEE <br />WATER CLObF71'0ILET) <br />.Z <br />I A/C - A/HNOLG UNITS - HP. <br />I <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. MEA <br />LAVATORYIV.'ASH BASIN) <br />UNIT HEATEI.S-B.T.U. M <br />1 <br />SHOWER <br />I <br />CLOTHES DRYERS <br />1 <br />KITCHEN SINK&OISP. <br />VENTILATION FAN <br />I <br />-DISHWASHER <br />'- <br />RANGE HOOD <br />1 <br />LAUNDRY TRAY <br />✓ <br />— <br />I <br />WATER HEATER <br />I <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 />BACKF LOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS - RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE - BAR, ETC.) <br />SUB TOTAL & <br />SUB TOTAL & <br />PERMIT 5f <br />PERMIT & <br />TOTAL FEE S <br />TOTAL <br />FEE <br />E <br />iRONi GETBACN <br />REAR SETBACK I CK/ <br />PLAN CM CK NUMgEP�� <br />TEE _ <br />RECEIPT NO <br />USEZONE <br />LOT AREA <br />,. 3 <br />NOEOiITr <br />FEES <br />VALUATION <br />FEE <br />6 <br />CONS. <br />OCCUp NCYOROUP LLING UNITS <br />BUILDINGALLOW <br />yiwPLUMBINGi�fEJ&SLQO <br />LVACTUAL <br />V5'U <br />-3 <br />NO OF STORIES BST. <br />g*s��'xNMECHANICAL�-TAT)ON <br />OTHERFIRE <br />SPRINSLERSREOUIRED ❑YE8 NO <br />STATE BU LDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />- <br />APPLICATION ACC BY PLANS APPR BY <br />PUBLIC WORKS <br />-- <br />TOTAL <br />