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-- - <br /> APPLICATION FOR CONSTRUCTION PERMIT��}s. <br /> CITY OF EVERETT•HUILDINCa DIVISION {�i'��� . . <br /> 3200 CEDAR STREET•EVERETT, WA 88201 •259-8810 �` �"' <br /> Cl DEMOLITION fl COMBINATION BUILDING I-1 MECHANICAL f� pLUMBING f l SIGN <br /> P'QJ TAD�R�SS �JT �J .6'C'"/ 5/RF� PQ4'�Si�`t EGST SNb <br /> / <br /> OWNER M/ul�Op1ES5 CITY 21P PHONE <br /> wri�.4». c. N%�rEs �o a �s6� EuERE71` �I T�e3 �sa- a 9y6 <br /> TEN�tiT Mi11L�0pRF.SS CITV ZIP PHONE <br /> OROESIGNE MAILI�ODRE55 Cltt ➢P PMONE <br /> �r d�'� -77y- �OOU <br /> GENE CONTMCT MAILADORE55 LiTY ZIP PHONE ��TE LICENSE� <br /> ��iGe�, �'RrEs Pos 6yz E����i'- ��.�a3 asa -a9y6 �AYEStIfOSSoT <br /> MECHANICALCONTRPCTOR MNIADDRESS CITV ZIP PHONE 5'ATELICENSE� <br /> 6�Nf� <br /> PLUMlING CONIA�CTOR MPII nDORE55 CITY LP PHONE STATE LICENSE� <br /> 0 wN� <br /> CtNlT FRIC OF WqiK <br /> � d c,/j HEATINCa SYSTEM: �GAS f-1 ELECTRIC f� <br /> OE;nE WORK H L OU RE F��T`GE�OIVE� O�� O� CONTRCT PERSONAND PHONE NO. <br /> Y< T II <br /> a . Fr. <br /> 1 HEREBV CERTIFV THAT I HAVr' q'eA.� 4ND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAMc TO BE 7RUE ANO CORRECT ALL � <br /> cIqPO5EDU5EOFBU1tqNG /j� PROVISIONS OF LAWS AND ORDI!JANCES GOVEHNING THIS TVPE OF <br /> S�K �Q��/� �"� � �� WORK WILL BE COMPLIEO WITH WHETHER �pECIFIEO HEREIN OF <br /> tEw�oesc P110NOFPROPERTV(SH� WNBELOWORATTACHTYOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tOt�_e�ocK �PaRk6,dE EGS� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> . OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPL�CATION IS MA�G AND I COMPIV WITH THE STATE <br /> Fn110El TAu 1.0.MIMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CQNSiRUCT10N LOAN LENOER.�ODRESS.TElEP110NE NUM/gER 'j �/�/ ' '.,` . _�Z%� � ����-�(� <br /> � / � (jI� SG � �I�J SICNATURE DATE <br /> CITY BUSINESS LICENSE N0. <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE QF EOUIPMENT F�€ <br /> WAT_R CLOSE7(TOILE� � A/C—AMNDLG UNITS—H.P. � <br /> BATHTUB � I FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORV(WASH BASIN) i HEAT PUMP <br /> � SHOWER ' UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK 3 DlSP i � CLOTHES DRVERS <br /> DISHWASHER � VENTILATION FAN <br /> LAUNDRYTRAV ; RANGEHOOD � <br /> j CLOTHES WASHER WATER HEATER � <br /> URINAL � -i WOOD STOVE <br /> DRINKIN3 FOUNTAIN i METAL FIREPIACE(WOOD BURNING) i <br /> PLOOR DRAIN � � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � ( GAS FIREPLACE — i <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> GAS PIPIN6 <br /> . EXHAUSTFAN � <br /> i <br /> i <br /> SUB TOTAL 5 � SUB TOTAL f <br /> PERMIT $ � PERMIT $ <br /> TOTALFEE 5 � TOTALFEE E <br /> FOR OFFICE USE ONLY: <br /> FIIONT SETBK'A( REAR SETBR�CK�} � SIDE SETBflCN CI�N CHECN NU^�R / FEE pECEIPT N0. <br /> � G!/ J�06S�J ..3.5/•�� <br /> u5E zor� LOTAHEA VRCRNi SIiE FEES VALUATION FEE <br /> � flvES fl NO <br /> �.._ em�oir�c UtQ � <br /> H£IGHT 1IM11RTION NO.OF OWEII�NG St7£OF BLDGR.1 <br /> � UNRS I �� SF. LIVnRCi` PLUMBING � _ <br /> GCCUV�NCv Iq Oi 5�(MMFS OCCUV�NT LO�O B�SEMENT MECHnNM.RI <br /> M1. „ n ��vES �u.�o - <br /> FIREAIARMRECO RE�SO}J. 0.0U�TiON�LPUNC��F.CN <br /> OTNER <br /> fIRE SPRINNLER PEO'D REASON <br /> STAiE BUIIDING SVPCNARGE � � <br /> iYiEOFf,ONSt PLANSAPPPOVEDBY CITY�FEVERETT �UBIIf,WORKS ��_� <br /> �]' �.J�} LOCAL SALES s'" <br /> �L -l.� nnre 3�(e�9�v TAX CODE IS 3105 TOTAL l <br />