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—- - � �•. <br /> APP�ICATION FOR Ct?NSTRUCTION PEF�SIAIT <br /> CITY OF EVERETT• BUILDING DIVISION �C� <br /> 3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br /> �l DEMOLITION f 1 COMBINATION rl BUILDING f"1 MECHANICAL PLUMBING f� SIGN <br /> PROJECT ADDRESS <br /> 3i 5 <br /> pWNER MAILAO�RE55 GITY IIP ��+OUE <br /> �Cc11 0l 'cal Su�iuh Z�2£� �-4-oy� AvL �u� W� 9A�2o1 2`i2•91t� <br /> 1ENANT MMUf��PE55 Cltt ZiP �HONE <br /> l',lv.�ro�l 3�oK_B��a�___��[u�kl VJF� �✓�L� — <br /> ARCHITCGTORC1E51G��ER MIRp�)pRE55 CITY Z1P PHONE <br /> fk.�.7lai5�- l2?03 G�r�s W� M�kil�r-o WA� 9�27s Zoco �9���� <br /> GEN[RI.LGONTRApOR MAIL/���FSS CIIV Z�� P110N[ J�d'ELIC[NSFt L <br /> �� �lu��c✓ £ Sr�ns 1 ?�i Gyn�s Wc,4 fV(vk+�� 1.�✓� °►e�27s �gz_Mi4 5�1991� <br /> MECHANICALCONTRACTOR MAILADDRE55 � CITV ' lIP PH N[ �y� `:inTGLICENSE� p, <br /> �ABI.YGCON��ACtOR IZ'L�EG'�j}� W4:1 IVIU�j��A WA IVZ�S ��Z'�YI !{L��I l:�l/ <br /> .L. �i�Li� 2'�03 C yy, uk-�l'{'ca In1R BZ - �l�iL�S�I`�`1Db_- <br /> CONiRRCT PNICG OF WOPN <br /> ,# QO � HEATING SYSTEM: f 7 GAS f 1 ELECTRlC CI __ <br /> OESCfi10 WOAH ANO SOUARE FODTAGE INVOLVED WNTA.1 P(fi50N PND PHONE NO <br /> �� C��al�itaau "l4Z•9�i'�4 <br /> I HERE(3V CERTIFV TI�AT I HAVE FiEAD AND EXAMINED THIS <br /> -� APPLICAT�ION AND KNOW THE SAME TO BE TRUE AND CORREGT.ALL <br /> PROPOSED 115E OF BUILOIHG PROViSIGNS OF LAtNS.4ND OR�INANCES GOVERNWG 7HIS TYPE OF <br /> SGf V�(ti S��o/1• WORK WII_L BE COMPIIED WITH WHFTFIER SPECIFIED HEREIN OR <br /> IEGRLDESCR�FTIONOFPROPENTYISMOWMO[IOWORATIACHNIGC4?IE51 NOT. THE GRANTING OF A PERMIT DCES NOT PRESUME TO GIVE <br /> �or e�ocK oF AUTHORITY TO VIOLAT? OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATIEiG CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTIUN.THAI I AM AUTIIORIZED BY THE <br /> '-' OWNER OF THIS PROPERTY TO PERFOR�v' THE WORK FOR WHICH <br /> APPLICATION IS MAf?� AND I COMP�.Y WIiH THE STATF <br /> PARCEIL`%I.O.NUM9ER CONTRACTORS�'d.27 CW A•!D 29G.2001YAC. <br /> �.�� ',,/ 3 <br /> CONSTI:LCPON LOAN LENDER,ADDRE55,TELEPNONE NUMBER X �L' � " r �� <br /> SIGNATURE � <br /> ❑TV BUSM[35 UCEN$G N0. <br /> PLUMBING MECHANICAL <br /> NU. TYPE OF flXTURE OR ITEM FEE NO. TVPE OF FI%1 UP.E OR ITEM F�EE �. <br /> WATER CIOSET(TOILET) � A/C-NHNDLG UNITS-H.P. _ ' <br /> BATHTUB � FORCEDAIRSYSTEMS-B.T.U. M E.A. __ ' <br /> --�r— <br /> LAVATORY(WASH BASIN) I IEAT PUA1P ' <br /> � �_ <br /> SHOWER � UNITHEATERS-B.T.U. M � <br /> i <br /> KITCHEN SINK 8 DISP � CLOTHES DAYEFS � <br /> DISHWASHER � VENTILATION fAN ' <br /> LAUNDRY TFAY ; R�NGE HOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> � WOOD STOVE � <br /> URINAL � <br /> DRINKING FUINTAIN � METAL FIREPIACE(WOOD BURNING) � <br /> —r— <br /> FLOOR DRAIN � FIREPIACE IMSERT(WOOD BURNING) ' <br /> i <br /> B4CKFLOW PREVENTERS � uASFIREPLACE �_ <br /> � SINK(SERVICE-BAR,ETC.) � GAS RANGE � <br /> � GAS PIPING � <br /> ppY �71 � � <br /> S�� 4 � EXHAUST FAN <br /> 0 1 <br /> � '3 7M 'F I G11 S i�1 _ ' - <br /> � � <br /> (�G IM�A � T-' <br /> - � <br /> � <br /> � SUB TOTAI 5 i <br /> _ SUB TOTAL 5 � pERMIT S -T- <br /> PERIdIT 9 � -�--,�- <br /> TOTALFEE $ ' _ TOTAL�=EE $ ' _ <br /> FOR OFFICE USE ONLY: — <br /> fRONT5Ei04CK R@ARSET64CN SIDESETBRCN �UNCNELKIJUMOGR :'EE RECEIPTNO. <br /> useior+e LOTAREA vncnNisire FEES _ VALUATION FEE ____ <br /> rnes n r+o yUIL01NG I <br /> - — — � <br /> HEIGNT LIMITATION NO OF UWELLING S�ZE OF�LDGRI. i <br /> UNI75 PIUM�ING � <br /> --T <br /> OCCUPANCV NOOFSTORIES OCWPANTLOAU 9ASEMF.NT �r����qNICAL � <br /> GRJUP i <br /> CYES fl NO i <br /> ADDITIONAI PL�N CHECN � <br /> FIREALARMREO'D REASON �—� <br /> i <br /> OTNER � <br /> � <br /> FIRE SPRINKLER RFO'D �1EASON � <br /> SiPTE OUIL�ING SURCHARGE j <br /> —�— <br /> TYPEOFCONST. PL\NSAPPROVEDBV CITYOFEVERETT PU9UGWORNS ! <br /> LOCAI SALES I <br /> oATE TAX CODE IS 31D5 7oTAL ' <br />