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APPLlCAT14rd F4R CONSTRUC? �ON PERMIT/ <br /> CITY OF EVERETT• BUILDING DIVISION M� <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 � <br /> fl DENIOLITION fl COMBINATION � ���BUILDING rl MECHANICAL �l PLUMBING f l SIGN <br /> PROJE�:T ADDRE <br /> `� � sSaS- <br /> � �L L A . C .LU/' � c v�X�R CNiv w�4- Y �v�'��'?`T'_ �/�'. <br /> OWNER �..���,.,,���v o �ur <br /> � zir A��or�� <br /> R�/ , .v �7eBn;c' : , , ; <br /> TEN�NT � MNLAD�fiF.SS (' n � 71P PMONE <br /> T�l•V STvl�~BA�r�- G/G'D (.ves'� �f�ct�/�o'r 2��lit.Eie Ga ��.KAc�� �0.� -- 0�4� " � 1 a� <br /> ancin�ccronoesicNen uannooness cirv nr �" <br /> y�'�,vYR covsr. !��/3 �ce,vl�v�9 � �P03'> / 1fSG-/�� �'r�/✓��;SpR�,� <br /> GENER�L CONIOACTOR MNLAD� E$$ CIIV 71P S ATE IICGNSF• <br /> � <br /> MECHr1NICALCONTR4CTOi1 MAqADDRE55 CIN ZIP 110 " STATELICFNSE� <br /> F C i Gc-m���'G— � <br /> PLUMBINGCONTRAC70R MAILA�ORESS qTY ZIP PIIONE STAIGLICENSE� <br /> CONTHACT Pfll�WOfiH <br /> HEATIN YSTEM: f I GAS f-1 ELECTRIC f� <br /> OESCRIBE WORN AND SOUARE POOT�GE INVOLVEO CONTACT _RSON�ND PIIONF.NO. <br /> ' I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSE�USE OF OUILDMC APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PPOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS Tl'PE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGPLDESCRIPTIONOFPROPERTV(SHOWNBELOWORATTACHTWOCOPIES� NOT. THE GRANTING OF A PEfiM1T DOES NOT PRESUME TO GIVE <br /> iot o�ocK oF AUTHORITY TO VIOLATE 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 WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAX ID.NUM�E CON7RACTOFS LAW 18.27 RCW ND 296.200 WAC. <br /> �a�- o - �y - c�oo�:: [ (� <br /> CONSTRUCTION IOnN LENDER,AO�RESS.TELEPHONE NUMDER x ���°�� \ �– 3� ']� <br /> SIGNATUFE� �^ � � DATE <br /> �X <br /> CITY DUSIYE55 LICENS[NO <br /> . PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUHE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—NHNDLGUNRS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ' RANGE HOOD ' <br /> � <br /> CLOTHES WASHER i WATER HEATER � <br /> URINAL WOOD STOVE <br /> DRINKING FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR DRAIN � FIREPLACE INSEFT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ' <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ; GAS PIPING � <br /> � EXHAUSTFAN ; <br /> � ' <br /> SUB TOTAL 5 SUB TOTAL 5 ; <br /> PERMIT 5 i PERMIT S � <br /> TOTAL FEE S � TOTAL FEE S � <br /> FOR OFFICE USE ONLY: ��'/)./��7 <br /> FFONTSETPACK RE�fiSFTBACN SIDESETBACK PLM1NCIIECN B[p RF RECEIPTNO. <br /> � c�1 c�v <br /> usezoHe iornnEn vaeaNrsire FEES VALUATION FEE <br /> I i YES f 1 NO BUILDING Q O�J ��( . i �� <br /> HEIGIITLIMITATION NOOFOW[LLVJG SIZEO�fiLDGRI ' <br /> UNIfS � � I <br /> PLUMpING <br /> OGCUPANCY NO Oi SIORiES OCCUPANi LO/D B�SEMENT 4 <br /> Gfl UP � _ MECIIANIWL <br /> – � fIYES � NO <br /> FIRE PL�M)M REO�D REASOY A�DIIIONAL PLAN CHF.GN J�[� ��.):� <br /> /V� <br /> O1MER � <br /> PIRF$PRINKLER RF.O-D RF�SON � <br /> ��,,� STAIE OIIILDING SUf1CHnRGF — ��� <br /> ivrEorr.m�sr rinNsnrnovent�v CITYOFEVERETT runiir,wonKs ' <br /> V�, i� � LOCAL SALES , <br /> u�rE _ � `i s TAX CODE IS 3105 70TAL ��� ;I� <br />