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APPLICATI� FOR CONSTRUC'T'RyN PERMIT <br /> CITY OF EVEFiETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> f� DEMOLITION fl COMBINATION fl BUILDING I� MECHANICA� ffi pLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> 7 � <br /> ��E � MRiLA0DRE5 <br /> CITY 21AJ'1 PNDNE <br /> � =�/ l.� QUB J�f3�.3 !J✓[� � /J <br /> iC NT • MMLA q[55 CIIV <br /> IIP PIIONE <br /> 1�12�//1!7`� PR-L?7� //�-�a���o?','� <br /> ARC111TCCiORDE5IGHCR MnIlqC7�F55 �Iry )�� <br /> PHO4F <br /> G[NERFLCONiRACipq MAILA�DRE55 <br /> �/yl�J.r� 7�1c 4 .�-R 5� s�7Nc��z��r�r��il -�'r�?7o�N36a-/.��A�sS35E, <br /> MECIIFNICnLCONiPAGTOP MAIIA�DPC55 CITY ZIP PIIOYE <br /> SiAi[II�ENSE� <br /> PLUMBINGCON7RACTOR MaILPp�RESS piv ZIP PNONE ?�3 � STRiELICENSE� <br /> /IJQ'//�i /�S3 I'J1 O. � c Z 7�i 7 �?l.4)2St�f /8ZG30 <br /> CONiqALT PRILE OF WpRK � <br /> - HEATING SYSTEM: f 1 GAS �l ELECTRIC (l <br /> DESCR19E WO R AN�5 U RE FOOTAG INVOLVED GONTACT f'Efi50N AND PN�NF.N0. <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS - <br /> �ROPOSEDUSE OF BUILDM� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL ,,;+�y� <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF � <br /> LEGRLDESCRIPiIONpFPROPERtt(SHOWNBELOWOR�T7AC117WOCOPIES� W�RK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR ' ''I <br /> LOi A��K oF AUTHORTY TOTVIOLATEAOR CAINCELETHE PROVS�ION OF A�NY <br /> OTHEr�STATE OR LOCAL LAW RECULATING CONSTRUCTION OR THE <br /> PEflFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER QF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WItH THE STATE <br /> PAqCEL TN(I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTpVCT10N LORN LENOER,ADDRE55.TEIEPNONE NUMBEF ��dLUY/ WT7 !// <br /> SIGNATUI D4TG <br /> iT-�� q� <br /> qTY OUSINES$LICENSC NO <br /> PLUMBING MECNANICAL <br /> NO. TVPE OF FlXTURE OR ITEM FEE NO. TYPE OF EpUIPMENT FEE <br /> B THTUBLOSET(TOILET) i A/C—A/HPIDLGUNRS—H.P. � I <br /> , FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � � <br /> SHOWER � UNITHEATERS—D.T.U. M � <br /> KITCHEN SINK&OISP i CLOTHES DRYERS <br /> _ DISHWASHER � VENTILATION FAN , <br /> LAUNDRYTRAY � RANGEHOOD � <br /> CLOTHES WASHER ' <br /> � WATEfi HEATER , <br /> URINAL � WOOD STOVE � <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) ' <br /> i <br /> FLOOR ORAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPIACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE —T— <br /> ' GAS PIPING � <br /> S � EXHAUSTFAN � <br /> _ ' � <br /> � � <br /> � <br /> � T <br /> SUB TOTAL $ � SUB TOTAL $ � <br /> PERMIT S � PERMIT 5 , <br /> TOT�.LFEE $ �' TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> fRONTSETOACK REMjETBACK SIUESETBRCN PIANCIIECNNOMOGR FEE PECGIPTNO. <br /> 3�� <br /> USEIONE LOiAREA VRCRNi51iE FEES VALUATION FEE <br /> _ f I VES f i NO pUIL01NC. � <br /> � <br /> N@IGIITUMITATiON NOOFDWELLING SIZEOfOLW?I � <br /> UNIIS <br /> PLUMOIN6 <br /> OCGUP�NCV Np pt5l0aiE5 OCCUPRNTLOAO BASEMENi "� <br /> f.ROUP M[CHANICAL <br /> i <br /> I7YE5 tl NO � <br /> fIRE PLARM REOD qFR50N AOOI110NAL PLAN CN6GK i <br /> � <br /> i _ <br /> O7NER � <br /> fIRF.SPfiINNIERREOD REAFON i <br /> — � <br /> STAiH OUIL�MC Sll(iCHMf.E � <br /> tvrEOFr,oNst Ptnrusarrnoveoer CITYOFEVEHETT runur.�vo�Ks ' <br /> LOCAL SALES �_ <br /> onre TAX CODE IS 3105 TOiAL � <br />