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APPLlCATIQ.. F'OR CONSTRUCT. JN PERMIT/ <br /> CITY OF EVERETT• BUII_DING DIVISION MC�r��� <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 � <br /> ❑ DEMOLITION Cl COMBINATION f-1 BUILDING I—I MECHANICAL � PLUMBING fl SIGN <br /> PROJECT ADDRES,S <br /> n?70�7 �GL3Y �c�E �/"��t� . <br /> OWNE� jJ1� MAILADDRE55 CIiV ZIP pNpryE i <br /> C'ol Svi�are �o���v��rs �j31 We�-mor� AvP `f4Sao� 3�' ' s`���v <br /> IEN��T G MAILADDRE55 N� �i� Cltty^� ���lIP PMONE <br /> i Y_7-� �� �t�-� I-r� Gl2�C// .:�'�� <br /> � <br /> ARCNITECT OR OESIGNER Mqlt ADURE55 Cltt 21P PHpNE <br /> GENFRALCONTAACTOR MAILAUDRE55 Cltt ZIP pHONE STAiEIICGNSE� <br /> MECHRNICRICONTPACTOR MAILADURE55 Cltt plP PHONE STRTEUCEkSE� <br /> PLUMBINGCONTRACTOR MAILAODRESS CIN� IIP VMONE STATEUCENSE� <br /> �-wws� v� 3�o w�a. ��'3 u,c�-I(I-v►�c-3y3(N <br /> corvrnncT amce oF vronK � <br /> HEATING SYSTEM: CI GAS ❑ ELECTRIC ❑ <br /> CESCRIBE Y/ORKAND SOUARE FOOTAGE INVOIVED LD4iACT PFRSON ANO PMONE N� <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> PROP05EDUSE OF Blll DINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> L� PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HI5 TYPE OF � <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LE�RLDESCRIPTIONOFPROPERTV�SHOWNBELOWORATTACMTIVOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tor e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROV�SION CF ANY <br /> OTHER STAT W REGULATING CONSTRUCTION OR THE <br /> PERFORMA CE O ONSTR TIUN.THAT 1 AM AUTHORIZED BY THE <br /> OW OF HIS PR PERTY PERFORM THE WORK FOR WHICH <br /> APPLIC 1 I MADE A I COMPLY WITH THE STATE ' <br /> PARCEITA%I.D.NUMBER CONTRA F W 18;27 AND296.200WAC. ' <br /> CONSiRVCTONLOANLENDER.ADDRE55,TELEPMONENUMBER X � �I�� I <br /> SI NATURE OATE �' <br /> CITV DUSMESS LICENSE NO. <br /> PLUMBINO MECHANICAL � <br /> NO. TVPE Or Fl%TURE OR ITEM FEE NO. TYPE OF FI%TURE OR ITEM FEE <br /> . WATERCLOSET�TOILET) � A/C—AMNDLGUNITS—H.P. � � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ; i <br /> LAVATORY(WASH BASIN) � HEAT PUMP i �, <br /> SHOWER � UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOiHES�RYERS ; I <br /> DISHWASNEq � VENTILATION FAN � <br />, LAUNDRV TRAY ; RANGE HOOD ' I <br /> � <br /> CLOTHES WASHER � � WATER HEATER � I <br />� URINAL � WOOD STOVE ' li <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i I, <br /> FLOOR DRA�N � FIREPLACE INSERT(WOOD 6URNING) � I <br /> BACKFIOW PREVENTERS ; GAS FIREpLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE � <br /> ' GAS PIPING ' <br />� i EXHAUST FAN i �' <br /> " <br /> i i i <br /> � � <br /> � � <br /> SUB TOTAL S �pO SUB TOTAL 5 ; <br /> PERMIT S �.0� PERMIT S � <br /> TOTALFEE S � TUTALFEE $ � <br /> FOR OFFICE USE ONLY: �p�0 <br /> FPONTSEIBACK RERRSETOACN SI�ESETBALN PIANCHECKNUMOER FEE RECEIPTNO. <br /> USEZON[ IOTAREA VACANi51TE FEES VALUATION FEE <br /> f1YES ❑ YO pUILDING i � <br />� HEIGNTLIMIiAT10N NOOFDWEWNO SIZEOFBLOGRI. i <br /> UNITS PLUMOING i <br /> OCCUPANCY NOAi5i0RiE5 OCCUPANTLOAD BASEMENf MECNANICAL � <br /> GROUP <br /> ❑VE$ ❑ NO j <br /> FlRERURMR@O'0 REASON PDDITIONALPLANCHECK � <br /> T <br /> OTHER � <br /> FIRE SPPINI(I.ER PEO'D R@ASON ' <br /> STATE�WL�ING SURCYARGE ' I <br />, -�.� _�� <br /> TYPEOFCONST ?V.NSAnPnOVE08Y CITYOFEVERETT PUouCWOPKS � <br /> LOCAL SALES � <br /> oATE TAX CODE�S 3105 TOTAL � I <br />