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� <br /> ,-. � <br /> APPLICATIVN FOR CONSTRUCI iON PERMIT <br /> CiTY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •2�9-8810 � <br /> C7 DEMOLITION fl COMBINATION fl BUILDING ❑ MECHANICAL r7 PLUMBING f-1 SIGN <br /> PROJECT ADDRESS <br /> �/.`� �.2�c� /�,_l ,q..� <br /> .: L�; { .,� <br /> Ef' M LIIDDAES f,ITY 21P PHONE <br /> l� � ,�� AS <br /> 7E MMLADORE55 CITY 21P PHONE <br /> ARQHRECTQNOESIGNER LAOORE55 TV 21P PHONE ' <br /> ^1�(J�i 3c /7 � Sv 9�a/? 75`�Z/3`Z <br /> ..9MEfUL CONIMCTOi1 MAL�DOHESS CIN ' 21P PHONE SUTE LICENSE• <br /> MECHANICQCONTRACTOR MAIIADDRESS CITY ZIG PMONE STATEUCENSE� <br /> RUMBINGCONTRACTOR MAIL�DCRE55 CITY ZIP PHONE STATEUCENSE• <br /> 6 "— <br /> ca«Tw�cTPr�o�wonc //� .� J HEATING SYSTEM: 'FdGAS Cl ELECTRIC rl <br /> DESCPIBE WORK�NU SOUAiIE FOOTAGE INVOLVED CONT�CT PERSON AND PHONE N0. <br /> ��3 =��/ => ��U <br /> a � � I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALL <br /> vnoroseo use oF eui�no PROVISIONS OF UWS AND ORDINANCES 60VERNING THIS TVPE OF <br /> WORK WILL BE CAMPLIED WITH WHETHER �pECIFIED HEREIN OR <br /> LE(i�LLpESCRIPiIpNpFM10PERTY�SNOWNBELOWORATfACH7WOCOPIE� - NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> �or.��e�ocu oF r / AUTHORITY TO VIOLATE OH CANCEL THE PROVISION OF ANY � <br /> . . OTHER STATE OR LOCAL lAW RE6ULATINO CONSTRUCTION OR THE <br /> PEHFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PROPERTM TO PERFORM THE WORK FOR WHICH <br /> APPLICATI IS MADE AND COMPLY WITH THE STATE <br /> wwcE�r�x i.o.raneeea CONT O S lAW 7827 R AN 296200 WAC. <br /> CONSTRlq710N LOAN lE1AER.ADp7ESS.7ELEPIIONE NUMBEfl ^ / <br /> O�TE ^ <br /> pTY BUSINE55 L6ENSE NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. 7VPE OF ECUIPMENT �E <br /> WATERCLOSET(SOILEn � NC—AIHNDLOUNffS—H.P. ' <br /> gpT�{7�g ; FORCED AIR SVSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> / SHOWER ' UNIT HEATERS—6.T.U. M ' <br /> � KITCHEN SINK d DISP i / CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAY ; / RANCiE HOOD _�_ <br /> CLOTHES WASHER i WATER HEATER ' <br /> URINAL ' WOOD STOVE ' <br /> DRINKINQ FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BUPNING) ' <br /> BACKFLOW PREVENTERS ; / GAS FIREPLACE � � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE ' <br /> � GAS PIPIN6 � <br /> i EXHAUST FAN / � <br /> --- � 4 <br /> � <br /> � ; ! <br /> � <br /> � <br /> i i <br /> � SU9 TOTAL S ' <br /> SUB TOTAL S � <br /> PERMIT S � PERMIT S � i <br /> TOTALFEE S � TOTALFEE S ' <br /> FOR OFFlCE USE ONLY: 5�99� <br /> F110NT SETBIICK REAB SETBACK SIDE SETBACK PUN CNECN NUMBER FEE RECEIPT NO. <br /> � � � r � � g,��q y'9� z3 <br /> usezor+e �or�a� VAC�NTSITE FEES VALUATION FEE <br /> � • "YES " "o 139Z �J ' D <br /> BUIIDINC <br /> HEIOMUTATATION � N��OiTOFDWEUIN(3 SIZEOFBLOO/LI ' <br /> `� Z,a7� S.F. G.vuv� p�UMBIN6 'bU <br /> 6 CUPANCY NG OiSfqtlES OCCINANTLOi1D BASEMENT `` MECHAlIICAL i OD <br /> C:� u-I 2 A �� n No � <br /> FIREAURMHEOD REASON AODIilON4LPLRNCNF.CK ��� <br /> i <br /> OTHER � <br /> FIRESPRINKLERPEO'0 REASON � <br /> STAiE BUILDVIG 54RCMARGE ���,l <br /> TVPEOFf,ONST PlANSMPROVEDBY CITYOFEVERETT PUBUC@ORKS �JiCD <br /> �.I I� LOCAL SALES <br /> /� o�Te 2 IZ-�g 4 TAX CODE IS 3105 TOTAL S ��00 <br />