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. A��LICATII.i FOR CONSTRUC7 .dN PERMIT/ <br /> CITY OF EVERt iT•.r,UILDING DIVISION {�CMr�� <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259-8810 � �tr <br /> . / <br /> ❑ DEAAOUTION ❑ COMBINATIO / BUILDING O MECHANIGAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS� ��G�/�� <br /> ONT/EN M�ILAUdiE55 GI/Y Im VIIpJ[ <br /> `7i�nev 0%fla�� <br /> 7EN�NT MNL�UqiE55 f.liY 11h CIIONE <br /> �RCMTECTpRp($IGNER MNLilWRE55 CITY 7u' PIIONE <br /> CENER�LLONiP�CTOfi MNL/�WRE55 GITY I�P pIIONE Sf�IEULFNSE• <br /> MECHAVICA�CONTH11ClOR M�ILADDRESS CIl' ZIP PIIpNE STRELICENSE� � <br /> PLUMBINGCONTR�GTO!1 YAll�00PE5S C17Y jIP PHONE STATEIICENSE� <br /> CONTMLTFPICE OF WO{il( — <br /> HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> DESCRIBE NORK ANO SOUARE FOOT�E INVOWED GONTACi�ERSON ANO PIqNE NO <br /> / <br /> I HEREBY CERTIFY THAT I HAVE REAC AND E%AMINED THIS <br /> rnowseo use ov evi�aua APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PqOVI510NS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK 1YILL BE COMPLIED WITH WHEiHER SPECIFIED HEREIN OR <br /> LEG�LDESLPoPiIONOFPqpPERTYf��BELOWORATTALHTWpCO%E5� N07. TFiE GRANTING OF A PERMIT OOES NOT PRESUME 7U GIVE <br /> �oT eiocK oF AUiHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTNER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.TNAT I AM AUiHORIZED BY THE � <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOfl WHICH <br /> APPLICATION IS ADE AND I COMPLV WITH THE STATE <br /> PMCELTA%I.D.N!1MBEl CONTRACT L 1 C7 ND 6.200WAC. ' <br /> CONSTRIICTON LOM!LEN�ER,ADDRE55.TELEPHONE NVM9ER �p'i' <br /> X <br /> SIGN U E DI1TE <br /> CITY BUSINESS I�CENSE NO <br /> PWMBIN6 MECNANICAI <br /> NO. TYPE OP fl%TURE OR ITEM FEE N6. TYPE OF EpU1PMENT FEE <br /> WATEfl CLOSET(TOILET) � A/C—/�HNDLu L'NRS � <br /> BATHTUB ; FORCED AIR SYSTEMS � <br /> � <br /> UIVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS � <br />� I KITCHEN SINK 6 DISP i CLOTHES DRVERS � <br />. DISHWASHER � RANCaEH00D , <br />' UUNDRY TR�Y ; WATER HFATER � <br /> CLOTHES WASHER � WOODSTOVE , <br /> URINAL � M�AL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN ; FIREPIACE INSERT(WOOD BURNING) ; <br /> _ FLOOR DRAIN � GAS FIREPIACE � <br /> BACKFIOW PREVENTEFS ; GAS RANGE � <br /> SINK( ERVICE—B ,ETC.) � GAS PIPING , <br /> ' EXHAUST FAN <br /> i ' <br /> � � <br /> � � <br /> � � <br /> � � <br /> SUB TJTAL S � SUB TOTAL E ' <br /> PERMT S � PERMIT S � <br /> TOTALFEE f � TOTALFEE f � <br /> FOR OFFICE USE ONLY: <br /> iRONTSETBACK REARSETB�CN SIDESETB�CK O�ANCIIECNNUMBER / FEF 11Ef.EIPfNO <br /> s�C%E� <br /> USEIONE IOTAREA VACIINTSI7E FEES VALUATION FEE <br /> ❑YES ❑ NO BUItMNC � <br /> HE�GNTLIMITATION NOOFUWEWNG 512@O�BIDCRI <br /> i <br /> UNIfC pLU�l01NG 7 <br /> OCCVPANLY /q Oi51MUE5 OGCUPANTIO�D B�SEMENT � <br /> GRWP MECNnNIC�I � � <br /> ❑VES ❑NO - � <br /> FlRESPfiINNLERREO'0 �E�SON <br /> RD0�710N�L PLAN C��f.CR � <br /> —T— <br /> on�cn ' <br /> FlREAUqMREO'D RE�SON <br /> � <br /> SUIE OUIt01N0$URGIIAl1GE � <br /> TYPEOff,ONST PLANSAPCROVED6Y C�TYOFEVEREIT �IIOIICWOIINS ' <br /> �ocn�sa�es --�— <br /> o�TE TAX CODE IS 3705 7oTAL <br />�L <br />