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� ^ <br /> APPLICAT14rV FOR COI�f�TRUCTION PERMIT <br /> CITY pF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAH STREET• EVERETT, WA 98201 •259-BB10 <br /> ❑ DEMOLITION (',�COMBINATION ❑ BUILDING ❑ MECHANICAL <br /> P OJECT DDRESS: ❑ PLUMBING ❑ SIGN <br /> .���� � /� -�`���f- q�� <br /> ONMER ���y R�OOItE55 ,tn CITY J _ — ��'/�U � <br /> Tm 1' OHE <br /> TENNIT M�II,A�OOC.55 — <br /> ���� � f.IIY /IC_--���� <br /> 1`nONE <br /> IIRCMITECT 011 UE516NER M��AOORE55 <br /> Clh' JIP PRONF <br /> U,<s.,,f� �s����r�s y �.� V�o,��e ��� z� zsz33»/s����v U�sscg�.rs�aa�j <br /> 6ENER�ICpNtR��Tp1 MqlA000E55 <br /> C�IY PiIONE , <br /> GGiE IICENSE� <br /> MECHANICAICONTR�CTOq yul �ppnC•.i <br /> Gtt <br /> ��ry S qUM��I� 1i� C�IONE SUiE LICENSE r <br /> rwMBINGCONTRA�fOR A1qlA00pE55 — <br /> CItV !IP PIpNE <br /> STATE LI�ENSE� <br /> CONTR T PPoCE OF YpnN ____ <br /> HEATING SYSTEM: O GAS Q ELECTRIC ❑ <br /> ND Spp�RE Fpp7 E INVOI 0 CONT�Cf PC�SON�q0 PNpNE NO <br /> � <br /> p�� ..i1�111C NXX�J I �I T <br /> L'Bd�L�9. ICt.YO .x l..i�,).,,� � ` �„ , � ( I HBREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> P�OOOSE�E OFBULprq '� '�a4����' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> � ����K��t�� i PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LE6AlDESCPIPTIWpip{qpQqry�S�pµ�BElOWpqATtA�NTWpC ¢s� WOFlK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ioi NOT. THE ORANTINO OF A PEHMIT DpES NOT PRESUME TO 61VE <br /> eL�K or AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> OTIIER STATE OR LOCAL LAW REf3ULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MA AND I COMPLY WITH THE STATE <br /> PMCEI PUf 1.0.MIMBE_ CONTRACTORS .27 RCW AND 296.200 WAC. <br /> S't� I��%� ;� , �� n/l ���7 �� <br /> CONSTpIILnON lp�N IENDER.ADDAE55.IELEAIONE NUMOEP <br /> x <br /> s� nr — <br /> �TE <br /> PLUMO�NO crtn „�,,,�„ <br /> NO. TVPE OF FlIfTURE OR ITEM MECIIANICAL V <br /> � WATER CIOSET(TOILET) FEE I O. TYPE OF EOUIPMENT FEE <br /> BATHiUB aC—M1NDL4 UNITS , <br /> UVATORY(WASH BASIN) � FOHCED AIR SYSTEMS � <br /> � AT PUMP <br /> SNOWER � , <br /> KIiCHEN S�NK d OISP � � HEATERS � <br /> DISHWASHER ' CLO ES DFlYERS � <br /> ' RANGE OOD � <br /> UUNDRY TRAY ; WATER H ER � <br /> CLOTHES WASHER WOODSTOV � <br /> � <br /> URINAL � � <br /> ORINKINO FOUNTAIN MEfAI FIREPLA (WOOD�URNINf3) � <br /> � FIREPLACE INSER OOD BUANINO) � <br /> FLOOR DHAIN � GAS FIREPLACE <br /> BACKFLOW PREVENTERS ' <br /> SINK(SERVICE—BAR,ETC.) ' GAS RANGE , <br /> GAS PIPIN6 � � <br /> ' EXHAUSTFAN <br /> i <br /> i <br /> � <br /> � — <br /> i <br /> i � <br /> i ' <br /> SUB TOTAL S ' SUB TOTAL S � <br /> PERMIT f � PERMIT f <br /> TOTAL FEE f � TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: � <br /> FqONTSETBACK REARSF.tp�CN SIDESFTB�CI( P�ANf.11F.CkN11MOf1 <br /> �--�— fEF REf.FIPf NO <br /> USEdp/E LOteaEA " ' C ���.. <br /> V�CANI SIiE FEES VALUATION FEE <br /> ❑res ❑ nw J <br /> NE�ONT LIMI1�tION amin�Nn � � �� <br /> NO OF DWELUIp SIZE OF 8LD0?I � j�) <br /> UNIfS <br /> PIIqINNO � � � <br /> i <br /> a C�UP�MCY NO IXSIMBFf OCCUPANIl0�0 B�SEMEN/ <br /> ME=11.1MGL I <br /> i <br /> ❑YES ❑NO � <br /> FIRESPRINNLERREO'D BEASON �DDIIIONq.P(eNCRlCK � <br /> i <br /> FIREMAIIMREO'O nHSpN - ������� i <br /> _ ' <br /> SiME OWIDwG SUnn�u16F � <br /> IYPfOfCpNST Pl�NSAPPpOVEDOY — -- r�,� <br /> CITV OF EVERETT ��IBI iC WnlitlS <br /> �ocn� sai.es ___.. _--------- � � <br /> u.�E T1X �ODE ,�, — ---- -t--- <br /> ._. — _ �g -...tni. y� <br /> � � <br /> - I. . � j/ <br />