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APPLICATIG.d FOR CONSTRUCT�ON PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET •EVERETT, WA 98201 •259-8810 <br /> f I DENlOL�TION f I COMBINATION I i BUILDING �70 MECHANICAL � PLUMBING I ! SIGN <br /> PROJECT ADDiiESS <br /> OWNER I MRiI�DONE55 C,yrtyY. d�P PiiONE C� <br /> TRIN„IG S�� MAI ADORESSp E�eV GC(1 1���3 2oSZ— /S �Z <br /> '� �j"Icv� �JYc\ 3�1 /��alt� ��1: �ere� IQ:ZD3 — <br /> ARCNrtECTOR0E51GNER MAiIRDDRE55 Ciiv Im �'HONF <br /> GENEP�ILCONTMCTOR M.unooness ;y-t5 y9�bY� �,G� �I1V IIP PHONL $tATEIICFN$E� <br /> /�f�"ovaable C�as t�e -f'�n9 TN E u refil �182oS 3`17�297 /�fF4RGHOs3 D8_ <br /> MECHANICRL CONTR4CTOR MRII ADD 5 CITY ZIP PIIONE STAtE UCENSE <br /> l 1 �� 1 i �� i l �1 <br /> MUMBING CONTRRCTOR MAIL�DDiiE55 CILY ZIP PHONE STqTE UCENSE� <br /> �1 1� �� 1• �' 11 <br /> ��90p`�E°F 1NORK HEATING SYSTEM: �1 GAS I"I ELECTRIC f l <br /> OESCRIBE WORN RND S�UARE FOOT�GE INVOWE� CONTACT PERSON AND PNONE NO. <br /> w t.11 �o,r d A.r s �� s s cr, Cl�a. ef o�do., 39�-o2q <br /> I v� 000 � O�C� om c . <br /> 1 HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> GIqPO5E0 USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HFREIN OR <br /> �EGI��pESpqipTlprypFpROPERTY15110WNBELOWOfiRTTRCHTWOWPIES) NO7. THE GFANTING OF A PERMIT DOES NO7 PRESUME TO GIVE <br /> ipr BIOCN oF AUTHORITV 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 AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY�TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANO 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RJW AND 296200 WAC. <br /> VARCEIDU(I.D.MiMncP ///���n <br /> CONSTRUCTION IO�N LENpER.ADORESS.TELEPNONE NUMBER X w�0. �� � �n��' � ��ZS /S <br /> SIGNAIURE DATE <br /> CITY BUSMESS IIGENSC N0. <br /> �V�� MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. 7YPE OF EOUIPMENT F€E <br /> WATER CLOSET(TOILET) � !VC—A/HNDLG UNITS—H.P. <br /> BATHTUB ' FORCED AIR SYSTEMS— M E.A. <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK&DISP CLOTHES DRVERS <br /> DISHWASHER VENTILATION FAN _ <br /> � LAUNDRY TRAY RANGE HOOD �_ <br /> CLOTHES WASHER WATER HEATER <br /> URINAL WOOD STOVE . <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BUHNING) ' <br /> � <br /> BACKFLOW PREVENTERS GASFIREPIACE __..�— <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> � GAS PIPING <br /> EXHAUST FA1V _�— <br /> SUB TOTAL $ SUB TOTAL $ i <br /> PERMIT $ PERMIT S <br /> TOTALFEE $ TOTALFEE $ _ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETPACK RE/.R$ETBRCN SIDE SETBACK PIAN CHECN NUMBER <br /> FEF RFCEiPT NO. <br /> USE ZONE LOi RREA VAGRNt SITE <br /> FEES VAIUATION FEE <br /> i i YES f 1 NO BUILDING � <br /> HEIGMT LIMIT�(ION NO OF OWELUNG 52E OF BLIX'iRl � <br /> IINIiS PLIIMPING <br /> --T <br /> OCGUV�NG� �'��S�ORIES OCCUPRNiLOAD BASEMFN! MECHANICAL _��._y_-_,_ <br /> GRW� -- <br /> IiYFS II NO <br /> — ADUIIION�I.PI AN CNFCK � <br /> FIREAURMREO'D RFFSON —T <br /> OiHER _ <br /> FIRE SORINNI ER ilEO'D RfASDN STATE 9UIlOMG SURC,H4RGF <br /> TVPEOFCONST Pl4N5PAPROVFDflV qTVOFEVERETT �IIpIIf,WORKS __ __ <br /> � IOCALSALES 1 <br /> nare TAX i.ODE IS 3105 T0Tl1l __ _ ___ ______L__. <br />