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A�PPLICATI4.. FOR CONSTRUCT�N PERMIT <br /> ' CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> ❑ DEMOLITION ❑ COMBINATIOPI p BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: � <br /> fl . . � / � ��f ���� <br /> ONNER MNlA0DRE55 LITY � IiM1� pHONE <br /> /ho�el jp /A�lo fik���2ee,�! l�vv C�e.ee%/ cc�� 9�''Zf�� Zaln `347 2D(fl0 <br /> TE T IAqL�pDRC55 GIi�' 71P PIIONE <br /> ��• ��� °�____��_�(n �w �� dc7l�� e,e �i 7Ziy �r,s .- Z3s 9l gS <br /> ARGNITECTOROESIGNER M�IIADOnE55 CIiV 7m PMONE <br /> GE�A�NiPACT � �M�bon�ess �� �� �� Cli��u� li���l� PII��'��ISSIATEIICENSE• <br /> MECNANICALCONTRACTOR 1A�ILADDRESS Cltt zlP PMONE S7ATELICENSE� <br /> PLUMBING�ONiRA�TOH AI�ILADURESS CIfY ZIP PHONE STAiELICENSE• <br /> L C� P CE OF WORK QO <br /> � HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br /> DESCRIB[WORK AND SOUARE FOOT�GE INVOIVED �'��r CONiACT PCfi50NAND PHONE NO <br /> �Q �M iS OY � ., 7�S <br /> � � � �h'�u d- ¢ �r1C <br /> ��� ,�, � �µ I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br /> PROPOSEDUSE OF BUIIOIN APPLICATION AND KNOW THE SAME TO BE TRUE ANC CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPlIEO WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALCESCRIPTIONOFPROPERTY�SHOWNBELOWORATT�CMTWOLOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PqOVIS10N OF ANY <br /> OTHER STATE OR LOCAL LAW REGULAT'NG CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT i AM�UTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORI,A THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA%I.D.NUMBER CON�]�L�`W Q$ OWAC. <br /> CONSiflUCTIONLOAN(ENDER,A�DRESS.TELEPHONENUMBER x � 6 <br /> SIGNAIURE D�TE <br /> CITY BUSINE55 LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. 7YPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS � <br /> BATHTUB ' FORCED AIR SYSTFMS � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � �— <br /> SHOWER � UNIT HEATERS � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ' <br /> DISHWqSHER � RANGE HOOD � <br /> LAUNDRY TPAY ; WATER H[ATER � <br /> CLOTHES WASHER � WOODSTOVE ; <br /> URINAL � MEfAL FIREPIACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT(WOOD BURNING) ; <br /> FLOOR DRAIN � GAS PIREPIACE � <br /> BACKFLOW PREVENTERS ; GASRANGE ' <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> ' EXHAUST FAN <br /> � , <br /> � <br /> � , <br /> SUB TOTAL E ; SUB T�iTAL S ' <br /> PERMIT $ , -- -�PERMIT E � <br /> TOTAL FEE S � - OTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�CK RE�RSETB�CN SI�ESETB�CN PUN�II[CNNUMBER FEF pEf.EIPTNO <br /> ��� <br /> USEZONE LOTFREA VACANTSIiE FEES VALUATION FEE <br /> OYES ❑ NO pUILIJINf. � <br /> i <br /> NEIGHT UMITATION NO OF DWELLING 5�2E OF BLDGR� � <br /> UNI!$ PLU1.10ING � <br /> i <br /> OCCUPANCY NO Of5IpP1E5 OCCUPANiL0�0 BASEMENT —i_ <br /> GPOUP 61ECIInWLnI � <br /> ❑YES ❑ NO � <br /> FIRESPPINKIEflREO'0 REASON �DDIIIONAIPLANG�1f.CN <br /> 0t11Ef1 � <br /> �FIREAIMM pE0'D RFASON <br /> $TNE DU�l01NG SUf1C11Ali6° — T� <br /> TYr °CON51 P�ANSAP��OVEDOY CITYOFEVERETT nuaiir,wonns ' <br /> LOCAL SALES —_1— <br /> oaiE TAX CODE IS 3105 70TAL ; � <br />