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i� . <br /> �. � <br /> APPLICAT�G.1 FOR CONSTRUC7 .JN PERMIT everett <br /> tnoe�e�g�een 7'O BE COMPLETED IN INK—PLEASE PRINT � <br /> GTV OF <br /> everett HEATING SYSTEM: O'GAS ❑ELEGTRIC 0 <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION i i COMBINATION BUILDING r�iAECHANICAL 7 PLUMBING SIGN <br /> OW/N�EP MAILADDRESS �ITY Zlp PHONE <br /> TENANT � ` �MML��,�� �'� �� ZIP '�H�i�/�, `� <br /> ',1 <br /> ARCHITECTORDESIGMEfl MRILAODRESS CIiY ZIP PHONE ':, i <br /> GENERALCONTRACTOR MAILAODRESS QTV 21P PHONE IICENSE� <br /> /11fs�rura l, . 3/�n h� ,9u �i`� S�i'�I 9'���s�� a d, k,3� <br /> MECHANICA�CONTRACTOR MAILADDRE$5 CITY 21P PHONE LICENSEt <br /> °LUM9ING CONTRACTOR MAIL ADOriESS CI1V 21P PHONE LICENSE• <br /> CLASS OF WORH <br /> . ' NEW �. � ADDITION '�. � ALTERATION . REPAIR �. � DEMOLITION �. � WOODSTOVE/FRPL INSERT '—� BUILDING RELOCATION <br /> CONTACT PEFSON AN�PHONE NO. <br /> CONiRACT PRICE OF WORK � <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br /> � a? ..�3 C �o <br /> PROPOSEDUSEOFB u+c 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DESCRIPTIONOF PROPERTV�SNOWN BELOW OR AITACH FOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF � <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ceK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TQ GIVE <br /> AUTHORITV TO VIOIATE OH CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGU�ATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS FfiOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. • <br /> SIGNATUREOFCONTRACTORORAUTNOR2EDAGENT DATE <br /> PF�TADDRESS ��/1�1,t' _ // <br /> A LIC�N��QTV BUS 5 UCENSE NO.AND 9USINES$NRME <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOU�PMENT PEE <br /> WATER CLOSET(TOILET) A/C—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 /> SHC•WER � � CLOTHES DRYERS <br /> KITCHEN SINK&DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ' ; WATER HEATER � <br /> CLOTHES WASHER WOOD STOVE � <br /> UflINAL ; METAL FIREPLACE 8 CHIMNEY � <br /> DflINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FIOOF ORAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � E%HAUST FAN <br /> SINN(SERVICE—BAR,ETC.) ; � <br /> � <br /> � <br /> SUB TOTAL $ ; SUB TOTAL $ <br /> PERMIT 5 PERMIT $ <br /> TOTAL FEE 5 TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SFTBACK flEAR S'?TBACK SI�E SETBACH PLAN CMECN NUMBER FEE RECEIPT NO. <br /> usezowe LOTAREA vncnNrsiTe FEES VALUATION FEE <br /> BUILOING i <br /> iYPEOfLONiSAIIOWAPIE 7VPEOFLONSi.ACIDAI acurwpv xoorppEipx:exrts <br /> �°0pP PLUMBING ' <br /> 52EOFBLDG. NO.OFSTORIES BASEMEHT MECHANICAL i <br /> OGCUPANCV LOAD FIRE SPRNKLERS REO'0 NEIGNT LIMITATION AD�ITIONAL PLAN CHECN i <br /> OiHER <br /> REA501!FO(i SPRINKIERS �— <br /> STATE BUILDING SURCHARGE <br /> INTANE DY PLANS APPROVED 6Y CITY OF EYERETT PUBLIC WORK$ ' <br /> LOCALSALES <br /> TAX CODE IS 3105 TOTAL � <br />