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� _ <br /> /�PPLICATIG.� FOR CONSTRUCT.JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERE7T,WA 96201 •259-8810 <br /> ❑ DEMOLITION O COMBINATION p BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS:��Q3 �� s T G��� ,d ,� ti. <br /> OV/NEP MMLADp1E55 GTY IIP PNONE <br /> �� H �us � Se �, ; r. r„ er 7�'o3 �as7'G/rnl ,�� �uere7�' g�aa3 353/as5 <br /> �T MNL�OORE55 GTY 7iP PIIONE <br /> M'L <br /> �RLMTECT OA CESIGNFA M�tl�DDaE55 � GIfY 7m �' p11pNF <br /> �� ' ���'�T o_at�d�m�( �J..� �,�N�; Is.- __9.R�92 ��a��4.ryss <br /> 0 `' <br /> GcEN'EM{L�CONiR�C /� MAILAODRESS CIIY 1^ jIP PIIONE S1ATElLL:ENSEt <br /> �d 17ur�V C.onS�ruct� o/� �:�0018o7�'s]" 4t . �n�,Q ��, �Q�Q/2 33.ef�a31 f(l9LL'�RC1d � KY <br /> MECN�NICACON ACTOR MAILA E55 CITY IIP PNONE STATEUCENSE� <br /> la'3 .� •=i�9�0 <br /> PWIIBnNiCONTRACTOR M�IL�OqiE55 CIfY IiP PNONE ST�TELICENSE� <br /> CONT 1 PpICE OF WORN <br /> y y� � – � p 7� HEATING SYSTEM: ❑GAS �LECTRIC C'Y <br /> OESCRIlE WORK 11ND$OUARE F007/WE MVOIVED GONTACT PERSON MIO PHONE HD � <br /> •, � - e� d �� �a c � , o ,� <br /> t,,,,��o�M - r v 3 3 8 a a 3 <br /> a �Jr et 7� {�t. d �X,'��" il/G ('r I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> rnovoseo use oF euu APPLICATION AND KNOW THE SAME TO BE TRUE AND COfiRECT ALL <br /> s rr, . 'Sj° WORKSWINL BE COMPLIED WIT�H WHETHER S ECIF ED HE E N OR <br /> �c��oescr�vnor+oFriqreanlsNowr�eeiowa��rr�cNTwocories� NOT. THE OHANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br /> lOT �L B�oCu�D O 00 pF E�o r e eN! ��lI AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHEH STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY 'HE <br /> OWNER OF THIS PROPERTY TO PERFOFM TME WORK FOR WHI�H <br /> APPIICATION IS MADE AND 1 COMPIY WITH TF�E STATE <br /> VMCEL UU!I.D.MIMOER CONTRACTORS LAW iB27 R-�98200 WAC. <br /> ��/v� o00 oa � o000 `r-� ' .5( l�.-. 9� <br /> CONSTHIIC d/LONllENOER.�OD11E55.lE RIONENUTABER x/I/I��„ ' ( .' � 7�{.f/E. <br /> ,. LL, a I o bSs'"/4o0� saH�Tune � —� o�Te <br /> Sa ' 1 � �e l �'. d .. CT�'BUSINESSLICENSENO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FlXTURE UR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATEH CLOSET(TOILET) � A!C—NHNDLO UNfTS ' <br /> N BATHTUB ; FORCEO AIR SYSTEN�S ; <br /> �/ UVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS ' <br /> i KITCHEN SINK 8 DISP ; CLOTHES DRVERS � <br /> DISHWASHER � �/ RANGE HOOD _` <br /> LAUNORY TRAY ; /�/ WATER HEAiER ; <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ' A/ ME7AL FIREPLACE(WCiOG BURNING) ' <br /> DRINKING FOUNTAIN i N FIREPLACE INSERT(W�)OD BURNING) i <br /> FLOOR DRAIN � GAS FIREPLACE ' <br /> ,{/ BACKFLOW PREVENTERS ; N �5 FiM1GE ; <br /> /V SI�'K(SERVICE—BAR,ETC.) � ,V GAS PIPING <br /> ' IXHAUST FAN ' <br /> i � <br /> � � <br /> � � <br /> � � <br /> � � <br /> SUB TOTAL S � SUB TOTAL S ; <br /> PERMIT S � PERMIT ' S � <br /> TOTAIFEE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FHONTSETBACI(� �. Y REMSETBI�CK / SIOESE7B�CN PlANC11ECl(N��E�n� iEF /J�� FCEIPINO <br /> «�•/ �1n j <br /> c/ � <br /> u5E zone lOT�REA v�cu�r s�tE FEES VALUATION FEE <br /> `� ❑YES ❑ NO --�— <br /> B���o�N� 30 � 2 i�Xi <br /> HEIGHT LIMIUyQN,) NO OF OM'ELLING S�ZE OF Blo�rt 1 � <br /> �/iCff uwis /6 -S•F. G Ri��t Pl11MBING � � <br /> <� C/ _{-- <br /> OCCUP�I/CY NO Of SI(%tlE5 OCCUF�Nf LO�D B�SEMENT MECN�NIC�I �-' <br /> GRIXIV ' <br /> �3 _I ❑YES O � <br /> FIRESPNINKIEflNEO'D RF.ASON ADD�fION�LPLANC��F.CR �. <br /> OiNER � <br /> i <br /> � <br /> FIREAURMpEO'D NEACON i <br /> STAIE BUilDINO StIRCH�RGE ��� <br /> —" �_� <br /> TYFE OF f:ONST PLANSMPRQVED BY CITY OF EVERETT �IIBI If.WORKS — — � <br /> J{�' LOCAL SALES '— <br /> oaE S �J ��o TAX CODE IS 3105 T07AL ����'1 <br />