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APPLICATI� FOR CONSTRUCT�N PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 90201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: I O D D 6 u td c'j�-e-c„� � <br /> NI� {�� � .. � -�g--_-- <br /> OWNER MAILAOONES. CITV Ilr' PIIONE <br /> TENANT MNlA00RE55 CI7Y 71P P110NE <br /> FRCIIITECTOROESIGNER MAllA0DRE55 CITY )IP p110NE <br /> GENEN� CpN�CTOiI M�IL�DDRE55 CIY )II� � P�IUNfi Sf�IHIICENSE• <br /> '�► I �C�a��..� �G.C���e�� <br /> MECHANICALCONTRACTOP MAIIADDRE55 CIIY 71P PIIONE STATELILENSE� <br /> PIUYBINGj�CONIF�GTOR 1MAI�A1O�f1�E55� I� CIIY IIP p110NE ) STATELICEqHSE� <br /> �� C .�. lt5�i"1 �F 1-\4✓tiqiK ar(��/�-� � _/� '�G�1"/ 33J-� ZJ�I �� 1> [ d <br /> 1 <br /> CONTRACi iRICE OF WORN � —� - I L AI � <br /> — /..S NEATING SYSTEM: ❑GAS ❑ ELEC7RIC ❑ <br /> Dc$CNIBE WORK AND SOU�RE F T�GE INVpI.VEO CONUCf PCfi50N�Np PHONE N0 _/ <br /> _ ��✓'� � ��') <br /> � � <br /> '� � �v.J J � . <br /> 335- ►�-z� �( <br /> � <br /> Y$' I HEREDY CERTIFY THAT i HAVE READ AND EXAMINED THIS <br /> PNOPOSEDUSE OF BUILDINO APPLICATION AND KNOW THE SAMc TO BE TRUE AND CORRECT qLL <br /> PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDESLRIPTIONpFPROPERTY�SHOWNBELOWORATIACHTWOCOPIES) WORK WILL BE COMPUED WITH WHETHER SPEGFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERM�T DOES NOT PRESUME TO GIVE <br /> �oT BLOCK oF AUTFIOPITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LqW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PqOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PMCELTA%I.D.NUMBER CONTRACtORS LAW 18.27 RCW AND 296200 WAC. <br /> LONSTRUC710NLOANLENDER.AOORES5.7ELEPMONENUMBER X��/ . � l, 7 �� 7 <br /> SIGNedfiF. f DA E <br /> CITY DUSIN�55 LICENSE NO <br /> PLUMBING MECHRNICAL <br /> NO. TYPE OF FU(TURE OR ITEM FEE NO. TYpE OF EOUIPMEHT FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNRS � <br /> BATHTUB ; FORCED AIR SYSTEMS � <br /> LAVATORY(WASH BASIN) � I1EAT PUMP ' <br /> SHOWER '— ' _ <br /> ' UNIT HEATERS � � <br /> KITCHEN SINK 6 DISP i CLOTHES DRYERS ' <br /> � <br /> DISHWASHER � RANGE HOOD � <br /> LAUN�RY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE , � <br /> URINAL � ME�AL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN ; FIREPLACE INSE!iT(WOOD BURNING) ' <br /> � <br /> FLOOR DRAIN � GAS FIREPLACE , <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> i <br /> SINK(SERVICE—BAR. ETC.) � �AS PIPIN3 , <br /> ; EXHAUSTFAN � <br /> � <br /> � � <br /> � � <br /> SUB TOTAL S ' � �� <br /> � SU6 TOTAL E � �� <br /> PERMIT S 2U � PERMIT E � <br /> TOTAL FEE S � TOTAL FEE E � <br /> FOR OFFICE USE ONLY: <br /> FRONTSE7AALK PEAqSF.T6ACN SIDESETBACN PInH�II[CNNIIA111f❑ ![F RECEIPiNO <br /> usEzoNe �oianen VA��NISIfE FEES VALUATION FEE <br /> OVES O NO —�'— <br /> — 01111 OINC � <br /> HEIGHTLIMITATION NO OF�WELLING SIZE OF OLDGRJ � <br /> UNIIS -- <br /> i <br /> Pl IIMpINO <br /> WCUPANCY NO pi51pwF5 OGCUPAN�IO�D BASEMENT ��— <br /> GROUP MECIIANILAI <br /> ❑YES ❑NO —�--- . _ � <br /> i <br /> FIRE SPRINKI.Ffl R[O'D I !iFASON AI]DI I IONAI PI AN 1:1If f.e <br /> —�-- <br /> 011l[ft � <br /> FIIiENMMREO'D REnSON <br /> i <br /> 9n1[�11IIDit1651��C11�p:�E <br /> TvaEOFr.ONSr rtnHServnovEoov CITYOFEVERETT rumir.wanHs '� <br /> LOCAL SALES ---- —_I_ - <br /> onrE TAX CODE IS 3105 TOTAI ; <br />