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APPLICATIONI FOR CONSTRUCT�ON PERMi4' <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, Wq 98201 •259•8810 <br /> n DEMOLITION fl COMBINATION f 1 BUILDING �-1 MECHANICAL �l PLUMBING �l SIGN <br /> PROJECT ADDRESS � / �t <br /> -��f L 7` LE) U i — .��-1� /'�✓u �C� <br /> owr+en Mni�nooA s <br /> � �D �� cm zir rHONe <br /> S�� TC= /h-- c� x.5-2/07 �-^��', f� u..�- <br /> IENRN `�="�- r <br /> 7L � MA!LApDR/E5/5�,/, Citt � ..� , ��� <br /> / ��//����i�� /l ,/ ` rs h 21P PHONE <br /> ARCN�TECTOHDESIr�,ER M�ILApOqE <br /> / ��ry ��� PNONE <br /> ��✓c:l�. ��> 'Y[:•c/ F' ��9 ,�'S'L!c I � / -7 �y r �/ <br /> GENffU�CONiRRGI MRILAODRE55 � ��L � s / ��S /- <br /> CItV PIIONE <br /> "� �-C�TL-��� IIr StAi[LIC[NSE• <br /> MECHANICAI CONTR�CTOR MNIpD�RE55 C11V <br /> Z�� PHONE STqiF IICENSE• <br /> PWMBINGCONTRAGTOR MnILA07PE55 CIIY <br /> z�P FMONE STA1E LICENSE� <br /> ' CONTq11�T PRICE OF WpRK <br /> 1 it.r.s /� e3�"00 s� �'f- HEATING SYSTEM: f I GAS f 1 ELECTRIC ( 1 <br /> . �6CRIBEWORKAN�SOURREFOOT�GEINVOWED <br /> � � �G �� � CONiACTPER50NANDPMONENO. <br /> I HEREBV CER7IFY THAT I HAVE READ F.ND EXAMINED THIS <br /> PN�PO-SEA U. OFBUILDIN6 APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORREC7 ALI. <br /> i 7���/Z (�/ PROVISIONS OF LAWu AND ORDINANCES GOVERNING THIS TYPE OF <br /> , LEGIILDESCRIPTIpNOPP{iOP�Riy(SHOYMBELOWORATTACNTWOCOv�s�_ H'ORK WILL BE COMPLIED WITH WHETHEFi SPECIFiED HEREiN OR <br /> �oT � � 1` C d�aK� �;C�7 oF � .Y'�-t ��— NOL THE GRANTING OF A PERMI7 DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THF PROVISIOIJ OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PARCEL TAX I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 236200 WAC. <br /> CONSiiill�/lp��.��O�NLENOEq/�� DRESS,TELEPHpq�NU ER / �_�/�,�✓ � �' �/� � / <br /> /5G'•'�-�J ��/(J - .�..�ilq� �/00��. X-G—�?� L-'" CCs ./'G/. `�i. �.�� k� Z..��j � <br /> Gc �� <br /> SIGN�TURE DAiE - <br /> qTY BUSINE55 LICENSG N0. <br /> PLUMBING MECHANICAL <br /> N�• TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> WATER CLOSET(TOILET) -- FEE <br /> BATHTUB � aC—A/HNDLGUNITS—H.P. i <br /> ; FORCEDAIRSYSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) � <br /> � HEAT PUMP <br /> SHOWER � UNITHEATERS-0.7.U. M � <br /> KITCHEN SINK d DISP ; CLOTHES ORYERS <br /> DISHWASHER � � <br /> VENTILATION FAN � <br /> IAUNDRY TRAY ; FANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL � <br /> ' WOOD STOVE <br /> DRINKING FOUNTAIN ; METAL FIREPLACE(WOOD Bi IRNING) ' <br /> FLOOR DRAIN � <br /> ' FIREPLACE INSERT(WOOD BURNING� � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SEPVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING , <br /> � EXHAUST FAN � <br /> � <br /> � � <br /> � <br /> i T <br /> 1 <br /> SUBTOTAL 3 � SUBTOTAL $ � <br /> PERMIT ' <br /> $ ' PERMIT § i <br /> TOTAL FEE $ � TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSEiPRCK REAIiSFTBACR SIDESETBACN PLANCIIECN UAlffjR � FEF ,��. /� NPCEIPtNO. <br /> 115E ZONE `�`� �� <br /> l0f APEA VACpNT SITE FEES VALUATION FEE <br /> IIYES fl NO <br /> ❑[IGII7 LIMITAiION N0.Of DWELLIN6 SIZF.OF 9LDGRI OLIILOING �I ^„� / ; ' <br /> UNIfS v�� - <br /> 3I� TI. C �LUMOING i <br /> OCCIIPANCV NO pf5I0RIE5 OGCUPANTIOAD B�SEME I I <br /> C���� / MECIIANIGL <br /> / 2 {(0 IIVES �NO ! <br /> FIREAUR�/MrREOP pfA50NG'�/�7'y� ApDIiIONR�PLANCNf.CN i <br /> lpi�f G'�("I/ND� � �/�'7V� O1MER ��— <br /> FIRESPRINK/I��.F/R�REQD RF�FON i <br /> YFiJ STAiE�UII�INC 5'JRCH4RGE / ��/� <br /> 1YPEOff,ONST P�pNSnPPPpyE00V i��= <br /> JM CI7Y OF EVERETT runr.;wonKs ; <br /> �'_ � �-� / IOCAL SALES — __ �_ <br /> onie /0 ,/ � TAl( CODE IS 3105 7oTAL �77� /`� <br /> Y <br />