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�1PP€.ICATII,N FUR CONSTRUCI i�N PERMIT <br /> CITY OF EVERETT • BUILUING DIVISION � <br /> 3200 CEDAR STAE[T• EVERETT, WA 98201 •259-89 i0 <br /> i i QEMOLITION 1 COMBINATION i i BUILDII�G i MECHANICAL Cl PLUMBING fl SIGN <br /> PROJECT ADDRESS � ��� n � <br /> OVMER O I � . % ��.�e �'B 2 D <br /> MRIL AJpqE�S --�}� PHONE <br /> `�/" � �.� ��?'JCe�� 1/'TM.P�W/ �(�(�i lc��.v/ � �✓ Z� �� I <br /> M I DDRE55f�A/ . ZiP PHONE <br /> ^� �//CN <br /> RRCHRCCTOR SIGNER � MRh.A0DRE5$ ��Ty Z�r <br /> PHONE ! <br /> G[N[�R4"L�CONTq�q/C-TOR �) MAIL AD �ESS � �/C GO/�� t O(ojrJjE <br /> i � / / l �'/��/t. V �• ONE /� S�TL/.I�EN�r�0� V <br /> �,�. ` i l Gl Z '� s'� �"� i o , <br /> MECHAWCA�CC�.T,7A�Tpp MF�LADDRE55 CITV ZIG PHONE ST4iELICENSE� <br /> t'lUMBINGCONtqA�Tpq 1ApI�qUDRE55 � O�Py / qp PHpNE ',!;�i� <br /> ,/7 Lv/ C LICENSE� <br /> I/ <br /> CONiRACi PRICE OF WOqK � _ <br /> � HEATING SVSTEM: Cl GAS ❑E!�C7RIC ❑ <br /> CRIB Wp{iK AND SOUAqE FOOTAGE INVf1LV 0 . CONTACT PEP.507 allo N[NO. <br /> un _ F C'- z- � i� ar�1� � �� <br /> AL � 2h^ Z Z <br /> ��j,� ��(�� /J�� � Q �� Fv� �riEREBY CERTIFY TNAT I HAVE READ AND EXAMINED THIS <br /> nao � p p5E� ��—� FPLICATION AND hNOW'HE SAME TO BE Tf7UE AND CORRECi ALL <br /> � J��. PROVISIONS OF LAWS AND ORDINANCES GOVERN�NG THIS TVPE OF <br /> LEG�L $�Pitt�p!IIN�PR(N�EHTY�SHOWNOELOW(%iqTTA�MTWOC^PIfS� W09K WILL BE COMPLIED WITH WHETHER SPEGFIEU HEREIN OR <br /> NOT. THE GFANTING OF A PERMIT DOES NOT PRES'JME TO GIVE <br /> «T e��K oF AU7HCRITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STA7E OR LOCAL lAW REGULATiNG �'ONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATIUN IS MADE AND I COMPLY WI7H THE STATE <br /> PARCELTA%I D.NUMBER CON7RACTORS LAW 18.27 RCW AND 296200 WAC. <br /> CONSTRUCTIDN LOR�{LENDER,RO�RE55 TELEPNUNE NUMBEP �� �� <br /> UL �Gl �� 2 lZ C �.p.eqG- i�Nn.unE / /� � <br /> o�re <br /> PLUMBING aTveusinEssuc[Ns�No.�LY �r�� m'-mn ����,� � <br /> MECHANICAL <br /> NO. iYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATERCLOSET(TOILET) � A/C—AMNDLGUNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> LAVATORV(WASN DASIN) � HEAT PUMP <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DAYERS � <br /> DISHWASNER ' <br /> � VENTILATIQN FAN --i— <br /> :AUNDRY TRAY � RANGE HqOD � <br /> CLOTHES WASHER ' <br /> � WATER HEATER � <br /> URINAL � WOOD STOVE i <br /> DRWKING FOUNTAIN METAL'FIREPLACE(WOOD BURNING) <br /> FLOOR DRAIN I i FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS �f� � <br /> i GAS FIREPLACE <br /> _ SINK(SERVICE—BAR,ETC.1 i GAS RANGE , <br /> ' GAFi PIPING <br /> i EXNAUST FAN ; <br /> � <br /> i <br /> i � <br /> � � <br /> i � <br /> _ SU0 TOTAL $ � SUB TOTAL $ � <br /> � <br /> PERMIT $ � PERMIT $ � <br /> TOTALFEE $ � TOTALFEE S � <br /> FOR OP.'•ICE USE ONLY: <br /> FRONTSF.TBACK R�ARSETBACK SI�ESETBRCK PIAYCH[CKNl1AA ER f[E PECEIPTNO. <br /> usemN=_ LOTARE� vnenNrsrte FEES VAWATION FEE <br /> llYES ❑ NO BUILOINfi <br /> r� , <br /> HEIGMT LIMITATION Np OF DWELLINO SIZE OF BIOGRI. <br /> UNIiS <br /> i <br /> MUTABINO i <br /> OCCUPANGY f10 OF Si0RE5 OCCUPANT LOA� BASEMENT M[CHRNILQ � <br /> GROI/P <br /> f7YE5 fi NO <br /> FINEFURMREO'0 RERSON ADDIiION�LPUNCHECN � <br /> i <br /> O1HER i <br /> FlqE SPPINKLER RE70 PEASON � <br /> STATE BUILDING SVRCHhRGE ./l � <br /> TYPEOFCOi15T PLANSA7PAOVEDBY CITY OF EVERFTT �UpI1C WOPNS i <br /> LOCAL SALES ' — <br /> onre TAX CODE IS 3105 7oTAl � - <br />