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� � <br /> APPLICATIG►r�l FOR CONSTRUC7 �ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> f7 DEMOLITION COMBINATION �fQ.BW6DING Yt'MECHANICAL �PLUMB�NG fl £IGN <br /> PROJECT ADDRE�Sp � � � j <br /> O ER MRILAWRESS dTY ZIP PHONE <br /> ,��� � �'��� .�� !��<£y c�y�.�/� �S. 9���2 2c,6-3�� �� <br /> TENANT �/�J � /J CITY IIP PNONE <br /> �RCHI TOR S�EH "" M�IL DDRES CITY 7.IP PHONE <br /> GEN AL ON H�CTOR MRII�ODRESS CILV ZIP PHONE $TRTE LICENSE� <br /> ►��.�i4 I?7�,���yd �i�✓ ,���'8�0�-�f�I.�C.�U(�G <br /> MEC �NICAL CO RAC MAII D E T � CITY ZIP PHONE STATE II�EN$E• <br /> PLUMBINGCONTRACTOR MAILADORE55 Cltt ZIP PHONE STATEUCENSE• <br /> CONTMCT FRICE OF WORK <br /> HEATING SVSTEM: I�'�AS fl ELECTRIC I l <br /> DESC��K�jD SOU�RE FO�,�AGE INVOLy$U � CONT RSON AN HONE NO. � /�� <br /> 2 7 J ti /t �' j,�— <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROPOSED USE OF B�IILoiNc pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> �r � WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br /> �c��oEscnirnorioF ��r+n15 WNBELOWORATT/�CH7WOCOPIES) NOT. THE 6RANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �Ot�_e�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 WOFK FOR WHICH <br /> APPLICATION IS MADE AND I COMPIY WITH THE STATE <br /> PMCELTN(I.D.NUMBER CONTRACTORS LAWJ827 RCW AND 296200 WAC. <br /> /� /�� <br /> CONSTRfICT10N LOAN LENOER,AOdiESS.TFLEMIONE NUMBER X � � y A�/_A� l��� �� <br /> SIGN�TI�E-d�`�`aY��� rATE <br /> CITY BUSINE55 LICENSE NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM FEE NO. TY'rE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) � O q/C—P,HNOLGUNITS—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 DRVERS � <br /> DISHWASHER � VENTILAT�ON FAN � " <br /> LAUNDRYTRAY ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL ' G WOOD STOVE ' <br /> ORINKINCa FOUNTAIN i � METAL FIREPLACE(WOOD BUHNING) � . <br /> �� FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE i <br /> � SINK(SEflVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING <br /> i EXHAUST FAN � <br /> � � <br /> SUB TOTAL $ � ; SUB TOTAL $ ; <br /> PERMIT $ � PERMIT $ i <br /> TOTAL FEE 5 ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FFONT SETP�CK �� REAP SETBACN � SI�E SETBA�K �/, PUN CMECN NUMBFR FEE ^� _ RECEIPT NO. <br /> �i% \� <br /> USEZONE LOTRREA VRCANT51*E FEES VALUATION FEE <br /> - e �J 0 Z ( _.. (i NO gUIL01NC ,LQ i <br /> v <br /> HEIGHT LIMIT�TION NO.OF DWELLING 512E OF BLOGR' " i <br /> 2�� UNIiS / 1�'Z4. f (�\VIt/�i '�' �LIIM9ING + 3� <br /> GARd4E } <br /> OCCUPANCY NO Oi S10alES OCLUPANT L04D BASEME11f �� <br /> GROUP MEGHINICAL � � <br /> R-3 I N �a ��.ES � — � <br /> FIREAURMREOD RFASON AO�IIIONALPLANCHf.CK i <br /> T <br /> OTIIEfI <br /> FIRE SPRINKLER REOD FEASOH <br /> STNE UIIIIOMf,SURCH�nGE / i i�/l <br /> t.LL� <br /> iYPEOFf,ONST PIANSAPCPOVEDBY CITYOFEVERETT PUBIIf.WO�N$ <br /> J�' LOCAL SALES ��J � I <br /> __ —/✓ ontE 12/GG q5 TAX CODE IS 3105 TOTAL � �� <br />