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� APPLICATION FOR CONSTRUCTIiON PERMIT <br />� �ITY OF EVERETT• BUILDING DIVISION I <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • (425)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: '� r' o - / <br /> i : � <br />' o�,E—`�1°'-L�� i=i n�L�.V y�i�'�( �c��G�c C�c ( r 1( ,�� � z —� > <br /> � -� � <br />, MAIL�pCyS _ CIiY :�� ��P�oNE� � � �[n � <br /> \ - �J1C <br /> M�IL ADORESa� LITY zIP pNONE <br /> AqCNRF.CT OR DESIGNER M�II�D�RESS ��ty <br /> 71P PHONf <br /> GENEfIRLCONTR�CTOR MAI�AODRE55 ��ty -- <br /> . A � '� \ � � (� ^/ �� T�� PIIlJYE CfAfE LICENSE� <br /> 1V l!V VV 1 � ' �-'i���'� ���fYl lF(/',� S� <br />� MECN�NICRICONTRACTOR MAIL�DDRE55 Clry �� �—dR� Z�Z ���� �r�2i�-Il�)rlJi�)�� <br /> �� PIIONE STATF.LICENSE� <br /> PlUM81NCaCON7P��TpR M1ILADDRE55 Cltt <br /> z�P PHONE STATELICENSE� <br /> CON�MCiPRICEOFWppK r� l l— <br />` - f� �'� HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br />. DESCRIBE WORN�NO SOUAqE FOpTAGE INVOLVEO <br />�� ' CONT�CT PFNSONAND PHONE NO � ` — <br /> I `' <br />� , ` /�=�' c_ � �I � ) "1 <br /> I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> PAOPOSED USE OF BUIL�ING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7 qLL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG�LOESCRIPTIONOFPRppEqry�SNpyyHBELOWORATTACMIWOLORES� 'NORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />� - _ NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> ��T B��K �F AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />� - � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNF_R OF THIS PROPERTY TO PEF�FORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AN OMPLY WITH THE STATE <br /> PMCEL TA%ID NUMBEq CONTRAC70RS LAW iB.27 f�i�D 96200 WAC. <br /> _ '�� �(( o �('>�� �'� �'�� (`�'l'� � ` /j�'�'') <br /> CONSTRI IONLO�NLENDER.AOORESS.TEIEPHONEHUMBER i' / C�� V / �[ <br /> x � i- <br /> SIGN�TURE �, �/ D E " <br /> GTY BUSINE55lICENSC NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATEH CLOSET(TOILET) � q/C—NHNDLG UNRS , <br /> BATHTUB � FORCEDAIRSYSTEMS � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' <br /> ' UNIT HEATERS � <br /> KITCHEN SINK d DISP � CLOTHES DRYERS <br /> DISHWASHER ' <br /> � RANGEHOOD , <br /> LAUNDRY TRAY ; WATER HEATER � <br /> CIOTHES WASHER � WOODSTOVE � <br /> � <br /> RINAL � METAL FIHEPLACE(VJOOD BURNING) � <br /> ORINKING FOI�NTAIN ; FIREPLACE INSERT�WOOC BURNING) ' <br /> FLOOR DRAIN ' <br /> ' GAS FIREPIACE , <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> � <br /> ' EXHAUST FAN <br /> � <br /> i <br /> i <br /> i <br /> � � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL S �S' � . <br /> PERMIT E � PERMIT S /,�}' � <br /> TOTALFEE S ' 70TALFEE S � <br /> FOR OFFICE USE ONLY: <br /> �RONTSFTp�CN PEARSF.TBACK SIOESEiB�CN PL�NCIIEGNNUM9ER !EF RFCFIPTNO <br /> use zonF IOI�REA y11CAN1 SIiE FEES VALUATION FEE <br /> ❑YES ❑ NO �T— <br /> — flUR01N6 <br /> HEIGNT IIMIT�TION NO OF DWELLINC SIZE Oi BLOGRI ' <br /> UNIIS <br /> I <br /> riuuewc <br /> OCCUP�NCY HJ Ot S�ORikS O(:GIIP�Ni 10�0 B�SFMENI —T— <br /> GPOVP MFf.IUNICM i <br /> ❑YES ❑ Nn __ <br /> FIflE SPRINKIER REO'0 RF�SON pDD1IlONA1.PIAN C��f.CR <br /> �i-- <br /> 0111En ' <br /> FIREAlARh1RE0'� nFASqV i <br /> $LAI[OIPIUMG SUIICIIAOCE � <br /> TvvEorr.o�+sr rinNsnnrnoveoor CITYOFEVERE7T rupur.wonKS <br /> LOCAL SALES - ___ __. __�__ <br /> oA�e TAX CODE IS 3105 Toia� <br />