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APPI,ICATIO.� FOR CONSTRUCT►JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING O MECHANICAL �1�PLUMBING ❑ SIGH <br /> k'P WECT/�DDRESS: � 7�3 Co-�-�H � �l/.e�t�� lr�� �L)f} `,�io / �.5-9-79�� <br /> ��� !`Jrrs � 70 -7 �.P�/f ue #7/�' �i/e, <br /> �ryl�ry1'� n a n�one�fs , an 7m r��a+e <br /> Jf' 3 ��3 CD�tlY /�(�e �1����� 16� — <br /> I �TENANT MIADDRE55 ' (71Y 71P PIIOHE <br /> -n�-f'.,.,� �..— C_ - _ ` C n��e r5 <br /> �RCPoTEGTORD GNER M�It110Dt1E55 � Glf !IP �IIONE <br /> GENERALCONTRACTOR MAIL/�DDRE55 GIiV i�P �i�DNE SfAIEIICENSE� <br /> MECN/�NICAICONTR�LTOR MIUL�ODRE55 CATY )m PIIONE ST�iEIICENSE• <br /> �" i7ANC=Sc .� 0 6�ko i3i/ s .�y�"�S� X��1i A 9�'03�- <br /> PIUMBINGCON7RACTOR MAILADOHE55 Gltt Zln PMONE $GfELIGENSE <br /> lr:��T�iP��E��N� >(��— HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> •f <br /> � DESRMEENORKANDSW�AEFOOTM. WVOIVED CONiACTPCIt50NANOP110NEN0 <br /> 1 <br /> I HEREBY CERTIFY THAT I HAVE REAO AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE 1RUE AND CORRECT ALL <br /> rnovoseouseoF'euiarxi PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR � <br /> LEW�pES�pIpTIONpFPROPEptt(5110WNBELOWORATTACNTWqCOMES) NOT. THE GRANTING OF A PERMIT DOES N0T PRESUME TO GIVE <br /> ipT e�ocK aF AUTHORITY TO VIOLATE OR CANCEL THE PRQVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATIN�CONSTRUCTIR?d OR TNE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIlED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTHACTORS LAW 1827 RCW AND 296200 WAC. <br /> iAHCEI TNf I.D.NUMBER �J <br /> Cp/SiRIILT�ONLOIWLENOEfl.AWRE55.TElEPHONEHUMBER Y ///J� ��n �6(�M� ��V"'Z z-- ,.j� <br /> E D�TE <br /> CITY BU5NE55 tILFNS[NO <br /> PLUM&N6 MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. T!PE OF ECUIPMENT FEE <br /> � WATER CLOSET(TOILET) � NC—AMNDLG UNfTS ' <br /> BATHTUB ; FORCED AIH SYSTEMS i <br /> UVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER ' UNITHEATERS ' <br /> KITCHEN SINK 6 DISP i CLOTHES DRVERS � <br /> OISHWASHER <br /> � RANGE HOOD ' <br /> UUNDRY TRAY ; WATER HEAiER � <br /> CLOTHESWASHER � WOODSTOVE ' <br /> URINAL ' MEfAL FIREPIACE(WOOD BURNING) � <br /> DRINNING FOUNTAIN i FIREPIACE INSEflT(WOOD BURNING) � <br /> FLOOR DRAIN � GAS FIREPUICE ' <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINN(SERVICE—BAR,ETC.) � � GAS PIPING <br /> EXHAUSTFAN <br /> � ' <br /> � i�: F�c� e ! ' <br /> � <br /> SUB TOTAL S � SUB TOTAL S i <br /> � PERMIT S � PERMIT f � <br /> TOTALFEE 3 ' TOTALFEE f ' <br /> FOR OFFICE USE ONLY: <br /> iRONT5ET0ACK RE�RSETBACI( S�OESET86CN �IANCII[f.kNllMpf❑ fEf i1Ef.NPINO <br /> 115E20NE �OT�REA VAC/�NtSIfE FEES VALUATION FEE <br /> ❑YES ❑ NO � <br /> OI111biN6 � <br /> HE�GHT LIMITATION NO OP DWELLING SIIE OF BIDGR.I � <br /> i <br /> UNIfS P�I)MOIf�� � <br /> T <br /> I <br /> OCCUPANCY NO Oi 5�(�f5 OLCUPANT LO�D BISEMENi MEC:InNlf.�l. � _ <br /> 6ROW -- — <br /> ❑YES ❑N� <br /> RDpIiIpNM.PI AN C�If CN � <br /> FIRESPI11NKlERREO'0 REASON � �?�' <br /> onrtn <br /> � <br /> FIREAIMMflEO'� AE�SON i <br /> Si�IE OUilOR16 SOf1f,1��OCE i <br /> �_ t <br /> • irrEOFr.or+sr atnNs�rvnoveoer CITYOFEVERETT ruonr.wonKs � __`_ <br /> LOCALSALES I <br /> o�TE TAX CODE IS 9105 TOTAI ' <br />