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�. ,�, <br /> APPLICATIuN FOR CONSTRUC110N PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • (425)257-8810 • ' ?� +'_1�!r�.. <br /> . ��.t ;, , <br /> �'j DEMOLITION ❑ COMBINATION p BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN � . �' <br /> PppJECT ADORESS: .p <br /> //. <br /> own—� M , _ L�' 6sz�.f la�il,.a,r��S/_�__/ <br /> cm zm rHor+� ��'J0.33 <br /> 1ENANT MNL AOOHE55 LITY 71P PNONE <br /> I <br /> ARCNiTf.CTORDESIGNER MMI�D�RESS C�1Y ]iP PHONE � `-' �' `;��� <br /> GF.NEIULCONTRAGTOR MMI�D�RE55 C11Y I�P PNp4E ��SIAI[U�NS�� <br /> �/� 1 .S � _r�'✓r.�e�/ rz c / O 2,�D—�.���.—r �Lr /� ��r�i/��P �7 <br /> MFC � ILA�CONTRICTOR MMUDDRE55 CITY II!' PI10NC STAiPl1�EN5E� Of10;� <br /> la.� <br /> /�L�iGOXx � o'T"S <br /> PI.UMBINGCONTF�f,IOR M�ILAOIXIE55 CITY Z�P PNOHE C STATELICENSE/ <br /> Cp1fRALf H�CEOFWpqR ��ZJ�� I <br /> 6 '� HEATING SYSTEM: O GAS ❑ ELECTRIC ❑ <br /> DE KD{iKAND50WREFOOi�GEINVMVEO CONTACTPCPSON�YOPNpNENO <br /> � " u�e oJ 3s�o �Q <br /> �� �� � ��� ���, �— I HEREBY CER?IFY THAT I HAVE REPD AND EXAMINE� THIS <br /> Pnoroseouse euaon+a APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PHOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALOESCPIPTIONOFPRpPERry�SNOWNBELOWp1J1T7ACHTWOCOPoE51 NOT. 7HE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE <br /> �oT etocK ov AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WMICH <br /> APPIICATION IS MADE ND I COMPLY WITN THE STATE <br /> v�ate�t�x i 0 n.�eEA CONTRACTOR, W 1B, RCW AND 296200 WAC. <br /> � � '� 00l� U�.7 Ooc�7 - 3Sio � / / <br /> CONSTRrUCTIO,N/`O�N 1 ENOEq,�ppiE55.TELFPHONE NUMBER � <br /> O�Y �� Q�� � 3� SK.N� qE p <br /> pTY BUSINE55 LICENSC NO <br /> PLUMBING MECHJINICAL <br /> NO. TYPE OF fl)(TURE OR ITEM FEE NO. T'PE OF EpUIpMENT FEE <br /> WATER CLOSET(TOILEn � NC—NHN�LG UNITS <br /> BATHTUB � � FORCED AIR SYSTEMS � <br /> � <br /> LAVATORY(WASH BASIN) r HEAT PUMP , <br /> SHOWER � UNIT HEATERS <br /> KITCHEN SINK 8 DISP ; CLOTHES DRVEHS ; <br /> DISHWOSHER � RANGE HOOD � <br /> LAUNDRV TRAY ' WATER HEATGR <br /> CIOTHES WASHER � WOODSTOVE , <br /> URINAL � A7ETAL FIREPLACE(WO00 BURNING) � <br /> ORINKING FOUNTAIN FIREPLACE INSERT(WO00 6J9NING) ; <br /> FLOOF ORAIN � GAS FIREPLACE i <br /> BACKFLOW PREVENTERS � GASRANGE ; <br /> SINK (SERVICE—BAR,ETC.) GAS PIPING � <br /> ' E%HAUSTFAN <br /> � <br /> � , <br /> � , <br /> � � <br /> � � <br /> SUBTOTAL E � SUBTOTAI E ' <br /> PERMIi S , PERMIT E � <br /> TOiALFEE 3 � TOTALFEE 5 � <br /> FOR OFFICE USE ONLY: <br /> (PONT SFiPRCK RFAp$fiB�CK $IDE SE�B�LM PUN CnELN NUM9fN PFF REf.FlPT NO <br /> �� D <br /> us�°zovF 101�aEA V���Nf SIIE FEES VALUATION FEE <br /> _ OYES ❑ �+0 q��il�iN6 � <br /> i <br /> ��EIGN111MITIIIION NO OF DWCLLING SIIE OI BLOGRI � <br /> ������ PIUMBING � <br /> OCCUP�NLY NO O�SIPn'�.k5 IX:C�PRNItO�D B�SEMENI , <br /> GROUP Mff,MANIC�I � <br /> ❑YES ❑NO — — <br /> FIRESPRINKL[qREO'� �F�SON pDDiiIONnI.PIANG�f.CK <br /> '__T_ <br /> on�en <br /> I <br /> FIREpIAqMP[0'0 RFASOV JJJ <br /> S1�1f0111LUIN(SSIIfiCllAiiCE — � �� <br /> 7YPEorr,ovst PL�NSAPPROYEDOY CITYOFEVERETT runiicwoa.s <br /> LOCAL SALES — — }--- <br /> oATE TAX CODE IS 3105 TOTAL <br />