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APPLICATI�.N FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVEAETT• BUI�DING DIVISION <br /> 3200 CEDAR STREET• EVERETT,WA g8201 •259-8810 <br /> n DEMOLITION 1-1 COMBINATION rl BUILDING �7 MECHANICAL fl PLUMBING f� SIGN <br /> PROJECT ADDRESS <br /> .Z 7�z 3 G � vP ��zczY 6,1 <br /> owtien Mnawoa cin <br /> z�P rriovE <br /> �•��_S9ic�.t �ia�,,.�,.s i p � <br /> TENAMv U �' MAILADO ESS y Cltt <br /> rP PHONE <br /> G�• S G�eK.>rr9 �T.�.3 �'o��.y Avv �v ✓�/� /J/� �j 3�d� �7 d�5� <br /> cNrtEGi OP OESIGNER MqL AU�RE55 CITV zlP PHONE <br /> GENERAICONTAqCTOR MAILAWRE55 CIiY ZIP PHONE STATEIJCENSE1r � <br /> ���/�[7 <br /> Do�,a.�S `�rs'�� C"„`� � n" .��cl`j ��� Sc�Z TRcn�nst k)A `�d�-f�3 /7 AN4 sl i✓O�k <br /> MECNANICA�CONTRACTOq MAILADDFESS Clry ZI� <br /> PIIONE STATE LICENSE� d <br /> PLUMBINGCONTRACTOR MAILADDRESS ��ry -�i -'1� <br /> Z�P PIIDNE STATE LICENSE• <br /> CONTR CT PqICE OF WORK <br /> � rr� "_=— HEATING SYSTEM: L�YGAS ❑ELECTRIC ❑ <br /> DESCRIBE WORK AND SOUARE FOOT�GE INVOIVED CONTACT PERSON pN0 PHONE�0.� (dG z�� <br /> !�' q/� - a � <br /> � '� ��d'Y y� � P� <br /> � I HEREBY CER THAT I HAVE READ AND EXAMINED THIS <br /> PFOPOSEO USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> C/�� ��� PROVISIONS OF LAWS AND ORDINANCES 30VERNING THIS TYPE OF <br /> i WORK WILL BE COMPLIED WITH WHETHER SPECIFIED F�EREIN OR <br /> LEGAlDESCRIPTIONOFPROPERTV(SH0IYNBEL0IYORATfACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />� � ior BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAX I.D.NOMBEF CONTRACTORS LAW 1827 CW AND 296.200 WAC. <br /> I11 CONSTRUCTIONLORNLENOER.ADDRESS.IELEPMONENOMBER X ��. /C� / — Z7 �7 '/' <br /> f �i � •r <br /> ISIGNA UPE' �/ � `% OI1TE <br /> I Cltt OUSINESS LICENSE NO. <br /> PLUMB�NG <br /> i MECHANICAL <br /> I NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNITS—H.P, �— <br /> BATHTUB ; � FORCEDAIRSYSTEMS—E.T.U. M E.A. � � <br /> LAVATORY(WASH BASIN) ' <br /> � HEAT PUMP � <br /> V SHOWER � UNITHEATERS—B.tU. M i <br /> KITCHEN SINK 8 DISP ; CLOTHES�RYERS � <br /> DISHWASHER — ' <br /> ' VENTILATIOP!FAN , <br /> LAUNORYTRAY ; RANGE HOOD i <br /> CLOTHES WASHER ' <br /> I � WATER HEATER , <br /> IURINAL � WOOD STOVE i <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br />, _ FLOOR DRAIN _ � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE—BAR. ETC.) _ GAS RANGE , <br /> — ' GAS PIPING � <br /> t <br /> � EXHAUST FAN -�— <br /> � � <br /> � <br /> � � <br /> — . � <br /> � <br /> 1 ' <br /> SUB TOTAL $ ; SUB TOTAL $ � <br /> � � <br /> PERMIT S � PERMIT S �� � <br />� TOTALFEE 5 � TOTALfEE $ T��� <br /> FOR OFFICE USE ONLY: <br /> FAONT SET�ACN RFAR SET�ACI: SIDE SETBACK PIAN CNEC NOMOER FEE RECEIPT NO. <br /> ��1�3`�' <br />� usezo��e LO7AqEA VACRNT51'E FEES VALUATION FEE <br />� f]VES fl NO <br /> �UILDINC <br /> HEIGHTl1MITAT10N NOOFDWEILING SIZEOFBLOGRI. <br /> UNITS � <br /> PLUMI11N0 � <br />, OCGUPANCY NO OFSi0FlIE5 OCCUPqNTLOAO BASFMENT I <br /> GROUP MECHANICAL <br /> i ❑YES ❑ NO � <br /> � <br /> FIREAURMREO'D REASON ADDITIONALPIANCHECK � <br /> i <br /> OTI/ER � <br /> FIRE SPRINKLER REO'D REASON <br /> i <br /> STATE BUILOMG SUfILHARGE � <br /> TYPEOFCON57 PLANSAPPPOVE�BY CITYOFEVERETT PUBLICWORKS � <br /> LOCALSAIES ' <br /> DATE TAX CODE IS 3105 TOTAL i <br />