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�. <br /> APPLICA4'11,.d FOR CONSTRUCti .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> � DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRES � <br /> ONTlER MAILADORE55 CITY ZIP PHO�� <br /> � �--^50 �� -STb <br /> 7ENANT MAILA�DR25S G1TV 21P PHONE <br /> �.�`_T �� 22D3 t+.d1�G�-"���So, S�7�GE ��Sl� <br /> ARCHITEC ORDES/IGN yMFILAODHE55� I I pTy Z�p PHONE <br /> '/r—�ll� T � <br /> GENERAL NTRACTOR MAILADORE55 CIiV ZIP PHONE STATEIJCENSEY <br /> I.L1�( v.�,�-- <br /> MECHAN ALCONTRACTO AILAD�RE55 T� CIiY ZIP PHONE STATEUCENSE/ <br /> �/-a''.�1 �:s ►• � � �1-h�'i'L ��7 i V S.F' 1?�bt�1 1 o�Q.nl� <br /> PLUMBING CONTRACTOfl^ MAILADO:ESS Cltt ZIP pHONE � STATE LICENSE� <br /> T <br /> CON PRILEOFWORK <br /> �j �-Z')y� " HEATING SYSTEM: AS ELECTRIC C <br /> DESCRIBE yWO�R/KAND SOUARE FOOTAGE I V VED CONTACT PERS(1N AND PHONE NO. <br /> �i� O <br /> � a rL <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOS SE OF 9UILDING APPLICATION AND KNOW THE SAME TO BE THUE AND CORRFCT.ALL <br /> ��I� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK K'!LL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESC IPTI070FPqpPEfl7V(SHOWNBEL OR TfACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or o�ocK oF AUTHORITY TO VIOLATE OR CANCEL 'fHE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTPUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFO THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I C M LY WITH THE STATE <br /> PARCEIT�x I.O.NUMBER CONT TORS LAW 78.27 RCW D 29 2 O WAC. <br /> CONSiRUCT70N LOAN LEN�ER.ADDRESS,TELEPHONE NUMflER <br /> 5 G T RE DATE <br /> C BUSINE55 LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF F�XTURE OR ITEM FEE NO. TYPE OF FIXTURE OR IiEM FEE <br /> WATER CLOSET(TOILEn � A/C—AMNDLG UNIT5—H.P. � <br /> 9ATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIT HEATERS--B.T.U. M � <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HUOD � <br /> CLOTHES WASHER � 'vVATER HEATER � <br /> URINAL � WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> Fl OQR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACI<FLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERVICE—BAq,ETC.) � GAS RANGE � <br /> ' GAS PIPING ; <br /> � EXHAUST FAN � <br /> i i <br /> i � i <br /> � T <br /> SUB TOTAL $ ; SUB TOTAI $ � ; Da , <br /> PERMIT $ i PERMIT $ /jT_ <br /> � <br /> T7TAL FEE � TOTAL FEE $ )� ; � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETrIACK SIDESETBACK PIANCHECKNUMBER, FEE AECEIPTNO. <br /> Y <br /> usezor+e LOTAREA VACANTSITE FEE� VALUATION FEE <br /> ❑VES ❑ NO BUILDING � . <br /> HEIGHT LIM�TATION NO.OF DWELIJNG SIZE OF 6LOC/T.l. � <br /> UNITS p�UMBINCs i <br /> OCCUPANCV NOAFSTONIES OCCUPRNiLOAD BASEMENT j <br /> GROUP MECIIANICA: i <br /> OVES � NO i <br /> FIREALARMREO'D f1EASON ADOIiIONRLPLANCHECK i <br /> i <br /> OTHER � <br /> i <br /> FIRE SPRINKIER REC'D REASON � <br /> STATE BUILDING SURCHFRGE � <br /> T <br /> TVPEOFCONST. PLANSAPPFOVEDBV rCITYOFEVERETT PUBLICWORKS j <br /> LOCAL SALES � <br /> onre TAX CODE IS 3105 70TAL I <br />