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� APPLICA,TIF V FOR CONSTRUCZ�DN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-BB10 <br /> i-1 DEMOLITION f 1 COMBINATION BUILOING �MECHANICAL �d PLUMBING I 1 SIGN <br /> PROJECT ADDRESS Or <br /> U LvT � <br /> � ONMEN M�ILAOOpESS CITY ZIP PMONE <br /> ,v.�T f/on�Es aiia� sr �T 9 � r✓uuoi.v✓;//� 9807,� a� v8� -�rs�s- <br /> 7ENANi M�4lA0pRE5S CIIY 21P PIIONE <br /> � �RCHRECTOFiDESIGNER M�IIAOIX1E55 GITY IIP Pk10NE <br /> , GENE��LCONTMCTOR MMIADI%tESS CIIY ZIP PIIONE SUTEIICENSE� <br /> UES/FH -rNliE-3TN,�"7YT �F�rY ����,t� Sr ,Pr 9's'F uiuov�r✓v,//C D�si�Ros,-oL. <br /> MELN�NICAI CONTRACTOR MAIL ADpRESS CIiY 7.IP PIIONE STATE UCF.NSE� <br /> � f/ // / 1 / 1 ' <br /> ' PLUTABMIp CONTRK,70p MAIL�DDRESS Gltt IIP PHONE ST�TE IICENSE� <br /> i <br /> �� /� // / / <br /> � CONIMCT PRICE OF N/OiiK <br /> /,�y�!3 � HEATING SYSTEM: y0.GAS I I ELECTRIC f I _ <br /> � DESCPoBEVNNKIINDSOU�REFOOlAG[WVOWEO CONTACTPERSONANDPIIONENO <br /> � _SF/e NE�.v tc,��STR ic /a 5 Efi - f/AR215 ZC�. �/�9- 76'�G �i�ye� <br /> —`l'v 'J �'l � 2uG. Y'/- Sstts ar7icE <br /> �. � � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> «� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> vHoroseouseacauaana PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> SFR WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEOALDESCflIPT10NOFPROPERIY�SHOWNBELON'ORATTACNTWOCOPIES� NOT. THE GRANTING 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 CONSTqUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PflOPEflTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATIUN IS MADE AND I CONPIY WITH THE STATE <br /> VMCELT�%10.NUW'+F.R CONTRACTORS LAW 1827 CW AND 296200 WA( <br /> CONSTHUCTION IOAN LEp�J fl,�DqiESS.TELEPNONE NUMBER � �(�t�ff�1 �/ <br /> LI �OfY (/LL b SIONATURE D�TE j' <br /> � — (�'� CITY BUSINESS IICENSE NO. <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FIXTUpE OR ITEM FEE NO. TYPE OF EOWPMENT FEE <br /> . ,3 WATER CLOSET(TOILET) � � A/C—AIHNOLG UNRS—H.P. ' <br /> � BATHTUB / � / FOHCED AIR SYSTEMS—B.T.U. M E.A. � <br /> � LAVATORV(WASH BASIN) � HEAT PUMP ���— <br /> / SHOWER � UNIT HEATERS—B.T.U. M ; <br /> / KITCHEN SINK 6 DISP ; CLOTHES ORYERS ; <br /> /. DISH ASHER � VENTILATIONFAN � <br /> LAUNDRYTRAY ; / RANGE HOOD ' <br /> � <br /> / CLOTHES WASHER i / WATER HEATER � <br /> URINAL ' WOOD STOVE ' � � <br /> DRINKING FOUNTAIN i METAI FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BUflNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' S GAS PIPING ' <br /> � EXHAUST FAN � <br /> � <br /> � � <br /> i � <br /> � � <br /> � � <br /> SUB TOTAL S � SU8 TOTAL S � <br /> PERMIT $ � PEflMIT S � <br /> TOTALFEE S ' TOTALFEE S ' <br /> R OFFICE USE ONLY: <br /> iNONT SETRACK� � ) REM SF.�/�{Ir / SIDE SE�� PIAN CIIECK NIIMOF FEF��� PECFIPT NO <br /> �/ � U <br /> USE20NE � �, tOT�RE� VRCANf51TE FEES _ VALUATION FEE <br /> f1YE5 IiNO BUIIDING � L <br /> IIEIGIITLIMITAIIOpL f� NOOFOWEILING SREOFBIDGRI __ �S �/SZ _� ;J <br /> =i� IINIfS 2o3cf s.F• c.ivwu + PIUMBING i <br /> 77 S . GA C.6 --- — ---.��}�^-}__ <br /> OC�P�NCY NOOLSfOPoFS 07CUP�NTL0�0 B�SEMENT MFCIIANIGAL _ XU � <br /> � � '[� �__—" <br /> •3 �-� 2 IIYFS WJO — -- -- —'— i <br /> FIRE�IMM REO�O RE�SON pUf)I IIONPI PI AN CIIGCN i <br /> — _ _'___"_—�___ <br /> i <br /> OIIIER <br /> FIRESPRINKIERPEO'D REASON ---- —} � <br /> ( i--- <br /> S7RIEBIIILUINGSUflf,114fiGE .-- — "—_ �[J -�O <br /> — _ _1' � <br /> TYPEOFf,ONST P��NSAPPROVEDBY CITYOFEVERETT PIIOIIGW']IINS � <br /> JI� LOCALSALES ��� � ��� '�— <br /> '/'� o�ie Z 9G� TAX CODE IS 3105 TOTAL _ 1 — <br />