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' � � <br /> APPLICAT14.1 FOR CONSTRUCT.JN PERMIT <br /> CITY OF EVERETT•BUILUING DIVISION <br /> 3200 CEDAR STREET•EVERE7T,WA 88201 •259-8810 <br /> ❑ DEMOLITION ❑ COM8INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING J�SIGN <br /> PROJECT ADDRESS: I P�00 �VC--�C9'RE'E�1N lil� <br /> . __�IIC�� MMLMdiE55 pTV ZIP PNONE <br /> � IO �!�!'�E'.i.l WH''( EV L�R• �'$_ 706 <br /> � ��----��_�3�h7:57�03 <br /> ��ewurr � r�u�wpa¢ss T d7Y nr ri�on[ <br /> � to�c�VG�6¢�V Wf�Ci �V�7T WA. R8Z�3 ��7�F7-S763 <br /> 11RLM7ECTORDESIGNEN MA11110DRE55 QTV 71� P E <br /> ��f'1J <br /> Ci11l�0[CdiTMCTOR MNL�OORE55 C17Y 7P PIIONE $GTE IICENSE� <br /> ' �'I�$1(rN� (o•!NG PD.Eajc >37't3 3CA?'fLE� l�tJit.q8133- 37►�13 C�76��'-4z�13 n�E`fEi2�G271GtK <br /> . MECNNNCALCpHTRACTOR AUUlA0DRE55 CITY IIP PIIONE ST�TELI�ENSE� <br /> � PlUA6NGCONiRACTOR MIUtADDRE55 GTV IIP PHONE ST�TEIICENSE� <br /> CONTMC�T ce OF W011K <br /> �I ZUO.00 HEATING SYSTEM: ❑GAS D 'eIECTRIC 0 <br /> oesca�waue�.n saw�roo��n+vaveo cor�ucr rensa+N+o c�+or� <br /> r v Nc ti �aveWttsou � bz -4z43 <br /> l l-W I OsL <br /> I HEREBY CERTIFY THAT I HAVE HEAD AND E%AMINED THIS <br /> ��p����� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> e. �, c�., GS ��,L ry�p PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF . <br /> r����v✓iu.c✓ R l WORK WILL BE COMPLIED WITH WHETHEH SPECIFIED HEREIN OR <br /> �aKoescnvna+arnorEnnis�awNee�owon�rucHnvocomes� NOT. THE aRANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK a AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> � ' OTHER STATE OR LOCAL lAW RE6UUTIN6 CONSTRUCTION OR THE <br /> . PERFOHMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZEO BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> pu�,T�uc�.o.Mr�p CONT ACTORS LA 1827 RCW AND 296.200 WAC. <br /> 28- 2- - �C9 -U <br /> CONSTRUC7NIN LdW LENDER.�0011E55.TELEP110NE NUTABEP ����/g6 <br /> •TUHE D�TE <br /> CITY BUSINE55 LICENS[NO <br /> VLUA�INfi MECHANICAL <br /> NO. TYPE OF FlXTUqE OR ITEM FEE NO. TYpE OF EqUIpMENT FEE <br /> WA'ER CLOSET(TOILET) � NC—NHNDL(i UNIiS � <br /> BAh�TUB ; FORCED AIR SYSTEMS ; <br /> UVA;ORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNIT HEATERS � <br /> KITCHE�SINK 8 DISP ; CLOTHES DRVERS ; <br /> DISHWASViER � RANGE HOOD � <br /> LAUNDRI'TRAV ; WATER HEATER ' <br /> CLOTHES WASHER � WppD STOVE � <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) � <br /> DRINKINO FOUNTAIN ; FIREPLACE INSERT(WOOD BURNING) i <br /> ROOR DRAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GASRANGE ' <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> ' FXHAUST FAN ' <br /> � � <br /> i � <br /> i � <br /> i � <br /> SUB TOTAL S ; SUB TOTAL f ; <br /> PERMIT S i PERMIT S � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBAC� ^ RE��E^N 51�E�ACR PUNIHECKNU23 iEF� rJ,Q NEf.EIPINO <br /> � , - J�� <br /> L <br /> I1SE ZONE 4f1T�R �,( VAC�NT SITE FEES VALUATION FEE <br /> C— 1 S �/GY� Y' ❑rEs �r+o eunowa ,�2U0 1 <br /> M�' iMTLIMITATION NOOFDWELIING SIZEOFBIOG�fI � <br /> (/_�� ��t� UNIf$ � PLUMpING <br /> l`� �� <br /> OCCVPANCY NO Of SI(vtlES OCCUP�NT IOAU BASEMENi ! <br /> GR�p MECH�NIf.�I. i <br /> ❑YE$ ❑NO - � - <br /> •D0111ONnL PI�N Cnf Ck <br /> FIflESPRINKIEqflEO'D REASON . <br /> q111[Il i <br /> FIREAIMMREO'D RE�SON � <br /> � <br /> STq1E Bl11lDIN6 SIIRCIIq116E � <br /> � <br /> —_ {` . <br /> TYPEOFf,ONSi PLAN araovener � CITYOFEVERETT �'Ii911CWO0RS <br /> LOCAL SALES — — -;-- <br /> o�,E . r��• TAX CODE IS 3105 TOTAL � ; �ry� <br />