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APPLICATON FOR COPISTRIJC. BION PERM) <br /> CVUTCtt <br /> Ole EOF7reTM <br /> atv of <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259.8810MECHANICAL PLUMBING SIGN <br /> DEMOLITION COMBINATION BUILDING <br /> OVYNEn MA0.ADDRESS- _ _--_CITY <br /> A z <br /> Bay /O?L -4 A,A/wee( 604 Pao,/(. S r{6 <br /> WOO(Ef)VUFN NOMdS /� m i PHONE <br /> 7 TENANT MAt AODREfiS LITY <br /> CITY <br /> MAIL <br /> IIP PHONE <br /> 10 1A ARCHITECT OR DESIGNER MAIL ADDRESS <br /> M <br /> N <br /> CITY IIP PHONE INCENSE I <br /> IH GENERAICONTRACTOR MAIIADDRE58 ��yy17yo� <br /> Q WOOc(AAVa1U NaMCS ?•0.3o1E io3z �uNDouo>< !✓a fFoyb S'�U 3569 - <br /> I�' CITY -� ! PHONE LK;ENS[F <br /> b H MECHANICALCONTRAU'UH MABMN1RE55 <br /> [' CITU 11P PHONE M-1111-1— <br /> LICENSE <br /> Q � PLWBIND CONTRACTOR MA0.ADDRESS <br /> A W CLASS OF WORK <br /> M • X NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEIFRPL INSERT '.1 BUILDING RELOCATION <br /> H CONTACT PERSON AND PHONE NO <br /> [CTG N TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br /> ly CONTMCT PRICE OF WORK: <br /> EA M DESCRRE WORK AND SQUARE FOOTAGE INVGIVED <br /> EA �,iy �..., l7 9 3 <br /> PROPOSFDUBF LR DING I HEREBY CERTIFY THAT 1 HAVE READ AN <br /> EXAMINED THIS <br /> 5 r A APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> y PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPI OF PROPERTY ISHOON BELOW On ATTACH FOUR COPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT CA `T BLOCK Of ?!d N7o@j 1 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 HE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF TOWHICH <br /> APPLICATION) IS PROPERTYISA DPI CO PLYFORMH WITHK HER STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> 6KiNATURE OF CONTRACTOR On MUTHOI AGENT DATE 7/10/9' <br /> PROIECTA 668 _ APPL ICANTS CITY BUS'NESSOCENSE NO Arfr. ^U 55 NAME <br /> I S0_ MECHANICAL <br /> PLUMBING TYPEFEE 1 <br /> N0. TYPE ET FIXTURE OR ITEM FEE ' NO. A1C—AHNDLG UNFITS UH PENT <br /> WATER CLOSET(TOILET) , <br /> \ BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> ' LAVATORY)WASH BASIN) I UNIT HEATERS—B.T.U. M ' <br /> �� SHOWER ' CLOTHES DRIERS ' <br /> �' KITCHEN SINK 6 DISP VENTILATION FAN <br /> RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER 1 <br /> WOOD STOVE <br /> CLOTHES WASHER , METAL FIREPLACE 6 CHIMNEY <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN , HEAT PUMP ' <br /> FLOOR DRAIN GAS PIPING ` <br /> BACKFLOW PREVENTERS EXHAUSTFAN ' <br /> ROOF DRAINS—RAINLEADERS , <br /> SINK(SERVICE—BAR.ETC.) ' <br /> , <br /> SUB $ roq in <br /> SUB TOTAL f PERMIITTTAL $ <br /> ' PERMIT $ TOTAL FEE S ' <br /> TOTAL FEE $ <br /> I\ P NCHEC f$ FEE <br /> RECEJp[y0 I <br /> FRONT SETBACK6 REAR;TBA� � SIDE 6Et8A� t Cc•A/'Jy�1/ �J[`UL <br /> TOT AREA VACANSSITE FEES VALUATION FEE <br /> MSE) rw _ <br /> L Q /VES NO BUILDING '7� Z <br /> IXCWEICV MIPUA'TIIHW MIl6 ' <br /> TYPE IN CONST ALLOWABLE TYPE Lg111 liNAl yqN PLUMBING 1 <br /> 611E OF BLDG NO OF STORIES BASEMENT MECHANICAL (a u:oft <br /> 111 <br /> )'156 fP I YES X NO i <br /> OCCUPAHCnOAD FIRE SPARKLERS AIHEIGHT LIMITATION 143 toy <br /> OTHER <br /> YES V NO STATE BUILDING SURCHARGE <br /> REASON FOR SPRINKLERS STATE ENERGY SURCHARGE ' <br /> , <br /> APP)ICA ITiN ACC BY F 5ATP OVED BY CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES <br /> 0/3o TAX CODE IS 3105 TOTAL <br /> �aa,� <br />