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^ ,-. <br /> APPLICA4101. FOR CONSTRUCTIt�N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,Wp g8p01 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING <br /> PROJECT ADDRESS !a MECHANICAL fl PLUMBING CI SIGN <br /> �� MNL�DppESS , <br /> CTr 21P PlIONE <br /> �� TiS�/E�r�r/l 2�s rzy�--�.t-�,-�__El/ �tl.> � 3s';^ 6 �., <br /> M1UILADOpESS <br /> -••• 5P PHONE <br /> AHCHIIECTORDESIGNEN M/ULADDqE55 <br /> CITY 2IP PNONE <br /> OENERK�pry{{y��7pq MAILAOpqESS � <br /> CIIY ZIP PXONE <br /> STATE6ICEN$E� , <br /> MEp1ANICALCONiR�CTOp I.WLAODRESS qTY , �. <br /> Z�P P�E STATE UCEH$E� <br /> �/B7/�/c»/� Si1ZaTAF72v /!G/E /he.11.I�/JYbi✓ /JQ Fj/ S3Sb/ J6L �//S� Efi � <br /> MN��oor+�ss c�n, �.2�GS5/L//}',7 <br /> Z�P P�E STATE LICENSE I <br /> CONTNACT PRICE O�NppK <br /> Z � HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> °E� !v+ ' �wor�oe iNvaveo <br /> CONTACT PERSON AND PFpryE NO. <br /> G � ' � <br /> I HEREBY CERTIFY THAT I HAVE READ AND E7(AMINED TNIS <br /> vnovoseu use oF euarnwu APPLICATION AND KNOW THE SAME TO BE TRUE AND CAqpECT.ALl <br /> / G PHOVISIONS OF LqWS AND ORDINANCES GOVERNINO THIS TVPE OF <br /> �������ERrylyqN'NBEIOWOqATfACNTWpCOP1E5) WORK WILL BE COMPLIED WITH WHE',YER SPECIFIED HEREIN OR <br /> �oT NOT. THE ORANTINO OF q pERMiT DOES NpT PRESUME TO OIVE <br /> B�ocK o� AUTHORITY TO VIOLATE OR CANCEL 7HE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAyy REOULATINO CONSTpUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TME WORK FOR WMfCH <br /> APPLICATION IS MADE AND I COMPLY WITH THE S7�1TE <br /> P.WCELTAX I,D.MM1BEp CONTRACTORS LqW 1827 RCW ANp pgg2pp yyhC. <br /> CONSiH11��7p��pµLENDER.ADpqE33.IELEPIqNE NUMBEA � � <br /> X ` / 3-9'� <br /> &ONAiURE WTE <br /> CIiY BUSINESS LICENSE NO. <br /> PLUMBIN(i <br /> NO. MECHANICAL <br /> TYPE OF FlI(TURE OH REM FEE NO. TYPE OF Fl%TURE OR ITEM <br /> WATER CLO6ET(TpILEn FEE <br /> g�THTUB ' NC—AMNDLOUNITS—H.P. , <br /> ' FORCEDAIRSYSTEMS—B.T.U. M E.A. <br /> UVAT Y(WASH BASIN) i FiEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M , <br /> KITCHEN SINK 6 DISP ; CLOTHES ORYERS <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE H000 � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAI � WOOD STOVE , <br /> DRINKIN6 FOUNTqIN � META�FIREPLACE(WOOD BURNING) <br /> FLOOq DRpIN � FIREPLACE INSERT(WpOD BURNING) � <br /> 9ACKFLOW PREVENTERS ; GAS FIREPLqCE <br /> � <br /> SINK(SEqVICE—BAR,ETC.) � QAS RANCE � <br /> ' L GAS PIPING , <br /> —' � EXHAUST FAN <br /> i ' <br /> i <br /> � <br /> � � <br /> � � <br /> SL'8 TOTAL 'd � � <br /> � SUB TOTAL S ' <br /> PERMIT S i PERMIT y / , <br /> TCTALFEE S ' TOTALFEE S . � <br /> FOR OFFICE USE ONLY: <br /> F����'�K �Aq$ETBACN SIDE SETBACN PIAN CME N NUMBER <br /> /�/n FEE qECE�pT Np, <br /> USE ZONE v"" -U <br /> LOTAREA VAC�NTSITE FEES VALUATION FEE <br /> ❑VES ❑ NO BUILDING � <br /> HEIOHTIIMITATIOH NO.ppOWEWNp � <br /> UNITS SIZEOFBLD(i/f,l. <br /> PLUMBINO i <br /> Q�UPANCY Np.piSTONES OCCUPANTLOAD BASEMENT <br /> u�oHuricu. lo� (,J <br /> ❑rss n No <br /> FIREµApM REO'D qEAgpry �� � ' ADDITIpHAL PLAN CHECK i <br /> i <br /> OTMER i <br /> FIRE SPflINKIER REO'D qEASpH ' <br /> STATE BUILDINO SURCMARGE i <br /> TYPEOFCANST. PLANSMPRpVEC�NY � <br /> CITY OF EVERETT PUBLIC WpqKS ; <br /> LOCALSALES � <br /> wrE TAX CODE IS 3105 TOTAL I <br />