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APPLICATII..N FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> f i DFMOLITION 1 COMBINATION � BUILDING f 1 MECHANICAL f l PLUMBING fl SIGN <br /> PRUJECT A—DDR� <br /> 3a�3 w• C,Asi,vo .�,,� �s- 3oz_ <br /> owr�en Mui�noness cnr rm r�wNE <br /> .EN.En°a�,N' � Ro.�. ���� K/a orr-r�, x�,mr, �.:�. yY,Ly sy,� = 7 J?� <br /> ��• " ♦ MRILMIORF.55 f.I1V ]IP PNONE <br /> VKyIry` <br /> Rf1C1UtF.CTOPUESIGNER MRIlR1DRE55 CITY 71A PNONE <br /> 3 b�, �A/�. <br /> OENERq.CONiRRGTOR M�IL�OOf1E55 f.I1V ]IP PI�ONE S7ATElICFNSE� <br /> MECNANILQCONTRRCTOR M�IL�D�PE55 CI1V IIP P110NE STATEUCENSEI <br /> PLUMBINQ CONiq�CTON M�IL�DDRE55 CIIV IIP p1lONE STATE IICENSE� <br /> CONTq�CT PRICE OL Y/OfiK <br /> 8� EdO HEATING SYSTEM: f 1 OAS f-1 ELECTRIC f l <br /> DESCRIBE WORR ANO SOUARE FOOTAOF.WVO�VE� CON1,1Ci PERSON�Nfl PIIONE NO <br /> NSZ✓ P•+t.7�6. �-}� �c 7L L15b A^,�-,t� 7�/Nf;oiGSk! ZG 6—�a-(� <br /> I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PR01'OSEO USE OF BUItDINO APPLICATION AND KNOW THE SAME TO BE iRUE AND CORRECT.ALL <br /> G/j,��'F� SIYEL7S� PROVISIONS OF LAWS AND ORDINANCES OOVERNINO THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OH <br /> LEO�LDESCRIPTIONOFMiOPERTY�SNOWNBELOWO{i�TTACHTWOCOPIES� NOT. THE ORANTIN6 OF A PERMIT DOES NOT PRESUME TO OIVE <br /> �or BLOCK ov AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR IOCAL LAW RE�ULATINO CONSTHUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF TH�S PROPERTV TO PERfOFM THE WORK FOH WHICH <br /> APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> r�Rce�uz i.o.r�uMeEa CONTRACTORS LAW 18.27 RCW AND 29�8J200 WAC. <br /> X� .� li'av�ti+.��'K� I/L1l l`j.T <br /> CONSfiUCTONLO�NI.ENDER.A00RES5,TElEPNONE NUMPER � <br /> 516N�I�1RE O�TE <br /> CITY BUSINE55 LICENSE NO <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TVPE OF FU(TURE OR I7EM FEE <br /> WATER CLOSET(TOILET) � AJC—ARiNDLa UNITS—H.P. i <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) i HEAT PUMP , <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK d OISP i CIOTHES DRVERS ' <br /> i <br /> DISHWASHER � VEN?ILATION FAN � <br /> LAUNDRV TRAV ; RAN6E HOOD � <br /> i <br /> CLOTHES WASHER � WATER HEATER i <br /> URINAL � WOOD STOVE � <br /> DRINKINO FOUNTAIN i METAL FIREPLACE(WOOD BURNINO) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNINO) � <br /> BACKFLOW PREVENTEFS � OASFIREPLACE � <br /> _ SINK(SERVICE—BAR,ETC.) GAS RANOE i <br /> GAS PIPINO � <br /> i EXHAUSTFAN , <br /> � � <br /> � � <br /> � <br /> _ � � <br /> SUB TOTAL E ' SUB TOTAL S �_ <br /> PERMIT S i PERMiT E � <br /> TOTAIFEE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> fRONTSETP�CH RE�fISETfl�CK SIDESETB�Ck PUNCIIECN�_ U%}f�11�FSf/1 , fEE PECEIPiNO. <br /> �� ()�l✓ <br /> use zorve �otnRe� V�C�Nf SITE fEES VALUATION FEE <br /> nvcs n r+o 8����,�Na 33 5) �/ �> >�.) <br /> 11EIOHT LIMIT�TION rro ov oweuwa size or e�oom , <br /> UNIfS � �� � <br /> PWMBINO <br /> OCCVMNCY NGO�SIptl'.S OCCUP�NTlO�D B�SEMENT MECIUNIUL <br /> CiROVP <br /> 7, � � fl'IES NO - <br /> IIRE�UM1M REOD RE�SON �DDI710N�1 PUH CHEGN �� ;� <br /> �/J - <br /> OTIIER <br /> FIPE SPFINKLEP RFO'U f1F�5pN � <br /> n/� ST�TEBUIIDINOSURCN�M3E �� .� <br /> �� <br /> TVPE OFCONSI PIAVc�ppROVEp�v CITY OF EVERETT �UPLIC WORNS <br /> � <br /> V_ � � LOCAL SALES <br /> o��e - 4, �; TAX CODE IS 3105 TOTAL / .� <br />