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APPLICAT11.�1 FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259•8810 <br /> ❑ DEMOLITION fl COMBINATION rl BUILDING Cl MECHANICAL rl PLUMBING r� SIGN <br /> PROJECT ADDRESS � <br /> OWNER M�VL�DORE55 CITV ZIP PHONE <br /> Don Cah6ee 1608 F�aa.i.da Dn.i.ve Evene.t�t 98203 353-48G9 <br /> TE/UNT MMLAOpqE55 CITY 21P GHONE <br /> ARCNIiiCTORDESIGNER MML�DRE55 Cltt ZIP PHONE <br /> GENERAICONTRACTOR MML�ODRE55 QTV 21P PNONE STFTELICENSE� <br /> Eve2et.t B2d24, Inc. 2472E 47.th Ave NE Aa2.ing.ton, 98223 353-7 ) 61 FVERER�301YH <br /> MECNANICIILCONiRACTOR MRILAD�RESS CITV 7.IP PHONE STATELICENSEY <br /> PLUMBINGCON7R�CTOR MRILRDDRE55 Gltt ZIP PHONE STATEIIGENSE� � <br /> CONTMCT PRICE OF NqRK � �- <br /> HEATING SYSTEM: ❑ GAS f-1 ELECTRIC I-1 <br /> DESCRIBEVqBKl1NO5pUREFOOT�G INVOLVEO CONTACTPERSON�NDPHONENO. <br /> Foundat�.on unden ex.�h.t.i.ng home Dann dlann 353- 7161 <br /> I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> PROPOSED USE OF BUILDIN6 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> R ea�.d en.t�.a4 PHOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> . WORK WILL BE COMPLIED WITH W THER SPECIFIED HEREIN OR <br /> �. LEO�LDESCRIPTIONOFPNOPlRTV(SHOWNBELOWqi�TTACHTWOCOPIES) NOL THE GRANTING - A PERMIT ES NOT PRESUME TO GIVE <br /> � �oT' � 9LOCK S ov AUTHORITY TO VIO TE OR CANCE THE PROVISION OF ANY <br /> ��. OTHER STATE OR LOC L LAW REGULA Nd CONSTRUCTION OR THE <br /> TAQ-L Pon.t�.on 0� L0�' ? � BQOCFL S� Led3 xI2 pE CEOFCO STRUCTION.THATIAMAUTHORIZEDBYTHE <br /> ' W Eb# 1 Y O � o t h e S 0 . S 1 #. 0 F L O�L 1 AQ NER OF IS PROP TY TO PERFORM THE WORK FOR WHICH <br /> 6 b APPLICATI S MADE ND I COMPLY WITH THE STATE <br /> PMCELTA%I.D.NUMBER ,l,@ QV Rh 0 VQ4Q �NTRACT R W1B27R ANDQ86200WAC. <br /> � ' V Qa.te P 24 aec o ' " � <br /> � CONSTRUCTION LOAN LENOER,�DDRESS.TELEPHONE NUMBEP SY10 . C 0 . x <br /> ' - � SIGNATURE DATE <br /> ' CITV BUSINE55�ICENSE NO. <br /> � PLUMBIN6 MECRANICAL <br /> � NO. TYPE OF FlIITURE OR ITEM FEE NO. TYPE OF EWIPMENT FEE <br /> WATERCLOSET(TOILEn � A/C—AMNDLGUNfTS—H.P. � <br /> ' BATHTUB ; FORCEO AIR SYSTEMS—B.T.U. M E.A. ; <br /> � <br /> � UVATORV(WASH BASIN) � HEAT PUMP � <br /> � SHOWER ' UNIT HEATEFS—B.T.U. M � � <br /> � KITCHEN SINK S DISP i CLOTHES DRYERS • i <br /> : DISHWASHER � VENTILATION FAN � <br /> . LAUNDRY TRAY ; RANGE HOOD � <br /> CLOTHES WASHEH � WATER HEATER � <br /> . URINAL ' WOOD STOVE ' <br /> . ORINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) ; <br /> �. FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKROW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE � <br /> ' GAS PIPING � ' <br /> � EXHAUSTFAN � <br /> i � <br /> SUBTOTAL S ; SUBTOTAL S ; <br /> PERMIT $ � PEFiM1T 5 � � <br /> TOTALFEE 3 ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETnBAC—N REM SETBACK SIDE SETBACR FUN CHECN NU BFR FEE /D RECEIPT NO. <br /> W � S � i <br /> USEZONE iou/qpA VAC�NT9TE FEES VALUATION FEE <br /> �� I (�,�j�I f1YE5 � O gWIDING O O�I � <br /> HEIGHTLIM�T�TI� NOOFOWEL�ING SIZEOIBLDGRI i <br /> UNITS � � ' � PLUMBING F <br /> OCCUPANCY NO Oi5i0FIE5 OCCUPRNTLOAD BRSEMENT � <br /> � MECHANICRL � <br /> G .� ' IIYES IIINO <br /> RE ALARM REO'D RE/SOfJ ADOIIIONnI.PUN CHFCK � /i� <br /> �J�L <br /> OINER � <br /> i <br /> FIRE SPRINNLER REO'0 REASON i <br /> STATE BUILDING Sl1PG�/BGE � i�� <br /> TYVE OF CONST PLANS APPROVED BY CITY OF EVERETT ���9LIC WORKS •� <br /> LOCAL SALES �— <br /> — o�TE !� TAX CODE IS 3105 TOTAL � <br />