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r, <br /> APPLICAT14�1 FOR CONSTRUC? �ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> f7 DEMOLITION f�7'COMBINATION I-1 BUILDING I-I MECHANICAL �� PLUMBING f l SIGN <br /> PROJECT ADDHESS <br /> 3 -�- ° �. Co u �27 <br /> OV/NER M�ILADDRESS �'ITY 21P PHONE <br /> ��/// i <br /> TENPN7 MRILAODRE55 C��Y ZIP PHONE <br /> ARCHITECTOROESIGNER MRILAOORE55 GITY 21P PHONE SrEbESLOtj/�k <br /> S�v_EnL�TU,un�v� k �t3�s T ����� yYb�z �z��z�sois9 <br /> GENERAL CONTMCTOR MAIL RDDRE55 CITY ZIP PHONE STA!E LICENSE� <br /> MECHANICALCONTRACTOR MAIIAD�RE::S CITY IIP PMONE STATELICENSEY <br /> PLUMBING CONTRRCTOR MRIL ADDRESS CIN 21P 7HONE STl iE LICENSE• <br /> CONTMCT PRICE OF WORK q�9�9_ . <br /> HEqTNIC .:XSTEM: fv�AS f� F.LEC"RIC f-1 <br /> OESCRIBE WORKAND SOUARE FOOTAGE INVOLVED q�nTACT PGFSOd AYD PHONE NO. <br /> S L� , <br /> I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSE use oF ILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIPiIONOFPROPERTY(SNOVMBE�OWORATfALH7WOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or_L�aiocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY . <br /> OTHEF STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE NIORK FOR WHICH <br /> � � _ � � i— � APPLICATI IS MA E AND I COMPLY WITH THE STATE <br /> PMGEL TNf I.O.NUMBER CONTRA S LAW 1 7 R AN 296.200 WAC. <br /> CONSTRUCTIONLO�NLEN�ER.ADDRESS,TELEPMONE NUMBER x <br /> 51 T E DATE <br /> CITV BUSINESS LICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl%TURE OR ITEM FEE N0. TYPE OF EGUIPMENT FEE <br /> WATER CLOSE?(TOILEn � A/C-A/HNDLG UNITS-H.P. � <br /> BATHTUB ; / FORCED AIR SYSTEMS-B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNITHEATERS-B.T.U. M ' <br /> KITCHEN SINK 6 DISP � / CLOTHES�RVERS � <br /> J DISHWASHER � VENTILATION FAN � <br /> LAUNDRYTRAY � RANGE HOOD ; ' <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE ' <br /> URINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(N'OOD BURNING; � . <br /> BACKFLOW PREVENTERS ; / GAS FIREPLACE ; <br /> SINK(SERVICE-BAR,ETC.) GAS RANGE <br /> ' � GAS PIPING <br /> i EXHAUSTFAN i <br /> ' � � <br /> - � � <br /> � � <br /> SUBT^TPL $ ; SUBTOTAL S ; <br /> PERMI: � $ � PERMIT $ � <br /> TOTALfEE 3 ' TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBRCN ' RERR SETBRCK Si1)E SET6/CN PLAN CHECK NIIMAFR FEE O'/ RECEIPT N0. <br /> �o iv ' s � 3 .5�/ = _ <br /> USEZONEo LOTRREA VACANT 7E FEE VALUATION FEE <br /> - h�I � � 7� YES f 1 NO BUILOMG G�5 c/IZ(p 9 � <br /> HEIGHTLIMITATION NOOFDWELLING SIZEOFBI�G�fI i <br /> 2 � UNIiS � �8ZZ $�f �IVIN4 � PLI1MpING 9��_ <br /> sF GA�t�4E <br /> OCCQUPANCY NO Oi510HIE5 OCCUPANTLOAD BRSEMENT � MECHnNICAL � � <br /> � 3 u-� � A rives �trf+� - �_ <br /> FIqE� �RM REOD RFASON pOD1110NAL PLAN CNFCN � <br /> OTMER <br /> FIRE SPRINNLER REO'D REACON � <br /> $TA7E BUIl01NG SUt1CN4RGE �� <br /> TYPEOFf,ONST PIANSAPPP vEDBV CITYGFEVERETT ��19L1f,YlORHS <br /> �I� LOCAL SALES - 2� � <br /> -/J OATE � / (n TAX CODE IS 3105 T07AL I <br />