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APPLICATIt„nl FOR CONSTRUCZ oaN PERMIT <br /> CITY OF EVERET7• BUILDING DIVISION <br /> 32J0 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> f7 DEMOUTION fl COMBINA710N f� BUILDING I-1 MECHANICAL �1 PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> /D/�3/ ��s-��ti-ce,� �L�� "��—� <br /> OWNER MpIIAU�RESS Cltt ZIP PIIONE <br /> s r'�K�� AroA�rT,'�s 9!S /(d'�`�fE Qc<(�dvc 9�D(�J .�o6 -YJ'�/600 <br /> T NANT AIAILAUORESS CITV ZIP PHONE <br /> Sp��N S�q�A �-� /0/.�! /•',�[�'ar�r�. [.ly �►`.zx C,icrcTC 9Pz0Y 206 -3l6- 9(!z <br /> ARCHIT TOR ESIGNER MRILAODRESS--� IlY 21P PNONE <br /> GENERRICONTR�CiOA MAILADOPE55 Cliv ZIP PMONE SiATGUCENSE� <br /> �J'G/� �n,trlr. 6y!'/ .U1yT'�fi. .(.cJ.'�1od [�,.�oo�! 9l�0 m6•7IP•.v9i s��co*+�o8yo� <br /> IAECHANICALCONTFACTOR MAILADDRESS CIN ZIP PIIONE 5T4TEUCFNSE• <br /> /-/D-9l0 <br /> PLUMBINGCONTRRCTOR MAIL�ODRE55 QtY ZIP PHONE STAiELICENSE� <br /> CONTRACi PRIf,E OF WORN f <br /> r�yOOO.00 HEATING SYSTEM: fl GAS fl EIECTRIC I 1 <br /> DESCRIBE WORK ANO SOU�RE FOOTAG[INVONED CONTFCT 1'ERSON�ND PIIONE NO. <br /> �1uoJr_ aA//o1� dv [,:.�.r /-rc.r d ..rt;roti � i' J -�f4 <br /> cJalCd . l/1 ree[ �er�i.rr�. .ti ' / � - JJ- 0� _ <br /> � /t C1.. C. 0.CAt �,� G CL I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL <br /> PROPOSEDUSEOFBUILOING PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS iYPE OF <br /> CU V���HK WILL BE COMPLIED WITH WHETHER SPECIFIED HEfiEIN OR <br /> LEG�L CRIPTIO�OFPROPERTY�SNOWNBELOWORATTAGN7WCLOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVE <br /> �oT e�ocK or AUTHORITY 70 V�OLATE OFi CANCEL THE PROVISION OF ANY � <br /> OTHER STATE OR LOCGL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAi I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> FAflCEIiA%ID.NOMBER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENOER,AD�RE55.TELEPHONE NUMBER /����. �C _ in/;p/4,f <br /> �y�GNATU E OATE � �- <br /> CITY BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET(TOILET) � A/G—NHNDLGUNITS—H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS•—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK&DISP i CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HOOD i <br /> CLOTHES WASHER � WATER HEATER � <br /> U71NAL ' WOOD STOVE ' <br /> :�AINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> SINK(SERVIC�—BAR,ETC.) GAS RANGE <br /> � ; GAS PIPING ; <br /> i EXHAUST FAN i <br /> , — � <br /> � � <br /> SUB TOTAI S ; SUB TOTAL S ; <br /> PERMIT S � PERMIT S � <br /> TOTALFEE $ ' TOTALFEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> fRONTSETBACN REARSETB4CK SI�ESETBACK �LANp1ECNNUMeER FEE �ECE�PiNO. <br /> — ,' X , S -��I Gr — C?� /�'�v <br /> usezoNe iornaen V/CFHTSITE F ES VALUATION FEE <br /> C � / f1YE5 � NO pUIlOING I � i �' <br /> � <br /> IIEIGHT LIMITFTION NO OF DWELLING �I2E OF BLDGRI <br /> llNlfS /,� ^O �� f�LUM0ING � <br /> 1 G(/ � _ <br /> OCCUPANCV NO O�S10aIS OCCUPANT�OtiO BASEMENT ITECNaNICAL � <br /> GBOUP ' <br /> I !� I1vE5 '�(NO i <br /> FIREALARMREOD RF�SOY ADD1110NnlPLaNG�[CK � <br /> r-- <br /> Nb on�en ; <br /> FIRF.SPRIYKLERREO'D RE450N i <br /> �D STAlE9UIL�lYG5URC11AfiGE .� �� <br /> rvaEOFr,oHst ainNsarrnoveoer CITYOFEVERETT �nni.ir,vrorKs ; <br /> �� JM LOCALSALES — --�'— <br /> oaiE I( /' TA% CODE IS 3105 TOTAI �7 �� 1 <br /> �-�-- S.(Z <br />