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��,� <br /> APPLICATII.N FOR CONSTRUCti .ON PERMIT <br /> C!TY OF EVERETT•BUILDINI'i DIVISION � <br /> 3200 CEDAR STREET• EVERET'�, N7�98201 •259-P810 <br /> I l DEMOLITION f l COMBINATION BUILGING � I MECHANICAL f I PLUMBIN(i I SICiN <br /> PHOJECT ADDRESS w � <br /> 3Gt33 G� • C�►s��vo R-D yS- L�-I <br /> OWNEn M�II�DDf1F.55 c11Y rIr rMONE <br /> EiNc co• i P.o. ap�c 37a7 �5 a�-�3 . ��+t�u"'� w'�s 9Pi Ly 3Yz-7339 <br /> iEw�qT u�a�noness rirv ziv rHcr+e <br /> lSoE��►G• <br /> �qCNTEC70R0E510NER M�IL���RESS Ciiv IIP PH(�IF. <br /> �[S!KG. <br /> OENER�LCON7AACTOR M�IL��Ot1E55 CIl1� 71P PI/ �NE ST�TEIICENSE� <br /> C'LISTY-h�iSA. GLCn��A.AI� <br /> MECH�NIC�ICONTRAC70R MRIL�DORF.SS CITY 71P PNJNE STRTEUCENSE� <br /> PWMBINOCONTR�CTOR M�IL�DDRE55 Cltt 21P PNONE STATELICENSE� <br /> CONTMCT PRICE OF VqRN <br /> /00 bdd HEATINd SYSTEM: f l OAS fl ELECTRIC Cl <br /> DESCRIBE WORN�ND SOiIAAE FOOU E INVOI.VEO CONT�CT PERSON�NO PIIONE NO <br /> MUD/T/on/ av-�ZG Lc.��vs� o�as�ci u�-.3.�[� <br /> I HEREBY CERTIFV iHAT I HAVE READ AND EXAMINEU THIS <br /> •-�-- APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �ROPOSED USF.OF BUILOINO PROVISIONS OF LAWS AND ORDINANCES OOVERNINCi THIS TVPE OF <br /> G/G�({N tlµ6LT��L WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br /> LEO�LDESCRIPTIONOFPf10PEP7Y15NONT:BEIOWOfi�TTACNTWOCOPIE51 NOT. THE ORANTINQ OF A PERMIT DOES NOT PRESU�AE TO OIVE <br /> �oT BLOCK _OF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE Oq LOCAL LAW R[QULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEJ BV THF. <br /> ' OWPIEH OF THIS PROPERTY TO PERFORM THE WOFlK FOR NlHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THC STATE <br /> PARCELTAI(I.0 MIMBER CONTRACTORS LAW 1827 RCW AND 298.200 WAC. <br /> CONS7RlICTON IO�N LkNUER,�DD17E55,TELEPIIONE NUMBER x � / (/!`�/�w-w � Z"�/9s <br /> SION� IIR�- O�TE <br /> CITY BVSINE55 LICENSE NO <br /> PLUMlINO MECHANICAL <br /> NO. TYPE Of FlXTURE OR ITEM FEE N0. TVPE OF FURURE OR ITEM FEE <br /> T <br /> WATER CLOSET(TOILET) � A/C—AMNDLO UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. { <br /> LAVATORV(WASH BASIN) i HEAT PUMP � <br /> SHOWEF � UNIT HEATERS—B.T.U. M ; <br /> KITCHEN SINK 8 DISP i CLOTHES DRVERS i <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRV TRAV ; RANdE HOOD ' <br /> � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL � WOOD STOVE <br /> DRINKINO FOUNTAIN i METAL FIREPLACE(WOOD BURNINQ) i <br /> FLOOR�R.CIN � FIREPLACE INSERT(WOOD BURNINO) � <br /> BACKFLOW PREVENtERS ; OAS FIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � OAS RANGE � <br /> �AS PIPINO � _ <br /> � EXHAUST FAN �— <br /> � � <br /> i ' <br /> � _ ' <br /> T <br /> � 1 <br /> SUBTOTAL S ' SUBTO�nL _i � <br /> PERMIT S � PERMI' f T— <br /> TOTAL FEE S � _ _ _ TOTAL FEE E __ _`_ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�CK RE�RSEiB�CK SIOESETB�CN PL�Nd1ECNNU OfR fEE RECEIPTNO. <br /> ��a o �_ <br /> use zoNe IOT�PE� V�C�N�SIiE FEEB VALUVTION FEE <br /> nres n r+o guiioiNa J �� �tJ <br /> NEIOHT LIMITATION NO OF DWEIIIN(3 517E OF BLOGRI <br /> ❑NI15 / p���IABINO <br /> �h <br /> OCCVP�NCY Iq DiSfpllES OCCUP�NiLO�U B�SEMENT MLCII�NIC�L <br /> OROI/P � <br /> IIYES fl NO <br /> FIRE�URM NEOII RE�SON �DD�TIONQ PLAN LNFCN ] <br /> /V J orr�en <br /> FIRESPPINNLERREO'0 REASIXJ <br /> ,I� STRtE BWLOINO SURCNMOE L. � <br /> N <br /> rrveovcw+sr PlANSRf'P veoer CITYOFEVERETT ���A��CWORNS ' <br /> V_ �, / � LOCAL SALES <br /> V o�rE � - S-5 f TAX CODE IS 3105 TOTAI <br />