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���� APPLICATI�.A FOR CONSTRUC7 ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-B810 <br /> fl DEMOLITION f 1 COMBINATION I"I BUILDING y's�MECHANICAL r� PLUMBING f � SIGN <br /> PROJECT ADDRESS �j " � <br /> 3 i oS" $n,o..o w ti-/ — �� � �-� /O/ �/r 1 �y � <br /> pyyp�Eq MAILnDDRf55 CIT�' � IIP PI iE y <br /> �+�rl Rc�13.��J�� i-IoY-fA✓� �vEu�.�L.�eao I ZS� -9 � o0 <br /> TEN N7 IdAIL,�DDRC.55 CITV ZIV PIIONE <br /> ���"-`-,n n <br /> h I Ci0AUE51GNER MAILADJRESS GITY 71P PHONf: <br /> �.�. ���. ��3o��R-.�s ula�/ MJ�-r� �z-4�4 <br /> GENERRLCONiRACTOR MAILADDRE55 CIIr Z�P PHONE STATEL�CENSE� <br /> �I�.iDDnD v{R.owtkrlfil��n.ita.e�f, Zol C�'�r5a1 /1ff3�ul ��0 1 93�1 -9A9S'�i�I�roF�oa�ur/ <br /> MECHANICALJOIJTRACTOR MAIIADDRFSS CITY ZIP PHONF STATF.LICENSE• <br /> �PLUMPING CONTF'PC�OR MAIL AODRE55 Cltt IIP P�'J�:F SIDTE IICENSE� <br /> o a.� <br /> or+rRncTrRiceoF onK HEATING SYSTEM: I7 GAS �ELECTRIC ❑ <br /> � <br /> UESCFIBE WOFK ANI150UAFE FOOTAGE INVOLVE� � WNiAGT PERSON AN�i'HONE NO. <br /> I HERE6Y CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSED USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> CUy.I � CE 1� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIP710NOFPiiOPEHNISNOWNBELOWORA7TACHT\VOCOPIE51 NDT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ar BLOCK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION Of ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERF MANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWN OF THI ROPERTY TO PERFORM THE WORK FOR WHICH <br /> APP IC TION S MADE AND I COMPIY WITH THE STATE <br /> PAnCEITaxI.O.NUMBEn CO R CTOR L 10.Z7�296.ZOOWAC. <br /> CONSTPUf,T10N LOAN LENDER AODIiE55.TELEPMONE NUMBER x Lj � <br /> 51 a � ATE <br /> CITV BViRI SS L [NSE HO. <br /> PLUMBIN6 MECHANI _ i <br /> NO. TVPE OF FlXTURE OR ITEM FEE N0. TYPE OF FIXTURE OR ITEM FEE i <br /> WATER CLOSET(TOILET) � A!C—AMNDLG UNITS—H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M [.A. ;�— <br /> LAVATOFY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER ' UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWHSHER VENTIIATION FAN � <br />� LAUNDRYTRAY � RAN6EHOOD � <br /> CLOTHES WASHER � WATER HEATEF ' <br />' URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> � FIREPLACE INSERT(WOOD�URNING) ' <br /> FLOOR DRAIN � <br /> DACKFLOW PREVENTERS ; G�SFIREPLACE � <br /> SINK(SERVICE—DAR,EtC.) GAS R�NGE ' <br /> — GAS PIPING � <br /> i <br /> ; EXHAUSTFAN ' <br /> � � <br /> � <br /> � � <br /> � � <br /> , <br /> � <br /> SU8 TOTAL S � L SUB TOTAI S � J i <br /> PERMIT 5 PERMIT 5 _! <br /> i <br /> T07AL FFE S ' <br /> TOTAI.FEE S % ' <br /> FOR OFFICE USE ONLY: <br /> �RONTSETB0.CN �E/.RSFT[fFGN SIDESETAACK ��'y7 <br /> PlA4(HFCY.NU."�fR FEE AECEIPTNO. <br /> / �.J_'�_�- _ <br /> — PEES rVALUATI0t1 FEE�_ <br /> USEZONE LOT�REA VAGANTSITE _ — I i <br /> f7VE5 f1 NO OJILDINCa � __ <br /> I <br /> 1 <br /> HEIGHTLIMITpTION NO.OF�WLWNG SREDFBLWRI � <br /> UNITS PIUM�l4G � <br /> �— <br /> � <br /> OCGUPANCV NO.Of5T091F5 OCCUPANTLOA� �ASEMENT MECNANICAL � __— <br /> Gf10UP - ' <br /> ❑YES fl NO � <br /> ADDITIONAI PLAN CHECK � <br /> FIREALARMREO'D REASON _ --- —��— <br /> i <br /> OiNER � <br /> _ i - <br /> FIRE SPIiINNLER REO'0 REASON � <br /> STAtE OWLDIN3 SUI1GNRqGE � <br /> _..1-- � <br /> TVPEOFCONST. P�NSAPPROVEDBV CITYOFEVERETT �'UBLICWORNS � <br /> LOCAL SALES j <br /> oATE TAX CODE IS 3105 TOTAL _ <br /> �Va/+.� iY�nL���u114��- " <br />