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APPLICATIOrI FOR CONSTRUCT►JN PERMIT everett <br /> rne E��y,ee� TO BF(:OMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: ❑GAS O ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I DEMOUTION COMBINATION BUILDING MECHANICAL � PLUMBING SIGN <br /> WNER M�ILAD ESS GITY ZIP PMONE <br /> �Q.ae�i� 2! 4 I � <br /> TEN�NT MAILADDRESS CITY ZIP PMONE <br /> ��p y� 1 1 1 � <br /> .o <br /> \ ARqHITEC�GNE��AMILADDRE55 �� � �IP PHONE <br /> �" � 1\ � 1 <br /> GENER�LCONTRFCTOR MAI�� CIN 21P PHONE LILENSE• <br /> '�.'�olt�e.v �' C�K�� �vIQ/t�T ��.0 t T�o�c.�c.� 1 S 2 �45 <br /> MECHANICALGONiRAGTO MAILADDRE55 CITY 21P PHONE IILENSE• <br /> PLUMBINGCONTRFCTOR MAILADDRESS CITV 21P PHONE LILENSEs <br /> CLASS OF WORN <br /> ' ' NEW , ' ADDITION �ALTERATION _' REPAIR I_i DEMOLITION �.-i WppDSTOVE/FfiPL INSERT ❑ BUILDING RELOCATION <br /> - CANT�GT ERSONANDPHONENO. <br /> GONTHIICTPRICEOFV/ORK O � �e ���� <br /> DE R��NDSOWREFOOT�GEINVOLVED � O S�' <br /> P POSEDUSEOFB oiNc I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � J� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEGAI DESCRIPTION OF PROPERTV(SHOWN BELOW OR AttALH FOUR LOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE GF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�aK ov 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 U1W REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THiS PHOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 AND 29G.200 WAC. <br /> SIGN�TUREOFCONTPACTOPO RIZED.\C:NT DATE <br /> PNPIEGT�DDRE55 � ` �� •���• � <br /> �PPLIGANTSCI INESSLIC NSENO.IIN�BUSINESSNAM <br /> � <br /> PLUMlINfi MECHANICAL <br /> N0. TYPE OF flXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/�A/HNDLG UNITS--H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> UVATORY(WASH BASIN) � UNIT HEATERS--B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TiiAY ; WATER HEATER <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ' AIETAL FIREPLACE h CHIMNEY � <br /> DRINKING FOUNTAIN FIqEPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—DAR,ETC.) <br /> � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL S <br /> PERMIT $ � PERMIT $ � <br /> TOTAL FEE $ TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FROIRSETBACK REpRSETBACK SIDESETBACK PUNCHECKNUMBER FEE RECEIPTNO. <br /> �� .� s`syo 3�7 9� 3P� � <br /> U$E ZONE LOT AREA VRCANT SITE FEES VALUATION FEE <br /> "7' BUILDING 70 � i <br /> iVPEOlCONiS.ALLOW,BL�\ 'TYFEOfCONS'.A �11sr �uv� NoaDwnuHGubrts ; <br /> �5 T ° PLUMBING <br /> SIZEOFBLDG. NO.OFSTORIES BASEMENT MECHANICAL � <br /> ADDITIONAL PLAN CHECN � <br /> OCCU� �.j FIRESPRNKLERSPiO'D NEIGHTLIMIiRT10N � <br /> OTNER � <br /> y�5 ' <br /> REASON FOR SPRINKlERS � <br /> � S7ATE BUILDING SURCHARGE �U <br /> MTARE BV PUNS APPROVED BY CITY OF EVEflETT PUBUC WORK$ ' <br /> �,�rn LOCALSALES <br /> _ TAX CODE IS 3105 �T�� 5 j �� <br />