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� APPLICATI�,N FOR CONSTRUCI iON PERMIT <br /> CITY UF EVERETT• BUILDING DIVISION <br />` 3200 CEDAR STREET• EVERETT, Wp g8201 •259•8610 <br />� fl DEMOLITION fl COMBINATION fl BUILDING <br /> PROJECT ADDRESS � MECHANICAL (-1 PLUMBING fl SIGN <br /> ,_, — . .� -� � <br /> r -�_ —< <br /> OWNER MAILA��RFSS � �- � — <br />� �q�MC�� D I1JA LL cin ' <br /> ��,I ' zir �,��c.� m�oNE <br />' IENANT J�,� � \ i n—}j � . <br /> MAILADORESS CIIY t��, � L/� ��,�. <br /> <7;�M� Z�P PIIONE <br /> �, <br /> ARCHITF.GT CR OESIGNER MAII q0�RE55 <br /> CITV ZIP PNON[ <br /> GENERALCONTitApOR MnILAODR[55 <br /> 1 ��rv Z1� PHONE <br /> r ^ ��r��� �L �rl/,�l, -7� < l ^ STATELICENSE� <br /> F��CIIANICAICONTR�CTOR '� ! � cry /Z�L�r 56A lS//� � [f��� ,� -�� <br /> /] MN�ADDRE55 ��/'//y <br /> — S�I/•�� ZIP PHONE�""' 1—.'-'��/� � �� <br /> STATE LILENSE� <br /> UMtlINGCONTRqCTOR M�ILAODFESS ��n, ��� <br /> /�/ Z�P PhONE STATE LICENSE/ <br /> CONTNACTPqICEOFWp�K •���v <br /> �S�� — HEATING SYSTEM: GAS ❑ ELECTRIC C1 <br /> DESCRIBEWppKAND50UARE TAGEINVOWED <br /> i � � LONTACTPERSONANOPHONENO. �— <br /> : � � , .� ,r <br /> _ PiP� Fi '��.�t;�,= �� - <br /> I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PN(A'OSEO USE OFBUILDING APPUCATION qND KNOW THE SAME TO BE TRUE AND CORRECT.qLL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGRLDESCqIPTIONOFPROPERTV�SHOWNBELOWOFATfACHT1YpCOPIESI WORK WILL BE COMPUED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> BLOCK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCT N.THAT I AM AUTHORIZED BY THE <br /> OWNER OF T Z�Y ERFORAI THE WORK FOR WHICH <br /> APPLICAF N M ' A I COMPLY WITH THE STATE <br /> PARCELTA%I.D.NUMBER C RACTO L W , <br /> AND 296.200 WAC. <br /> �n O ) > ` '� \ <br /> COhSTHUCTIONLOpNLENDER,qDDRESS,TELEPNONENUMOEq �G r � <br /> 9CGNAiU E l <br /> RT <br /> CITV BIISINESS UCF.NSE N0. <br /> PLUMBING <br /> NO. TYpE OF FI7fTURE OR ITEM MECHANICAL <br /> FEE NO. TYPE OF FIXTUqE OR ITEM <br /> WATER CLOSFT (TOILET) FEE <br /> ' A/C—q/F{NDLGUNITS—H.P. <br /> BATHTUB � <br /> LAVATORY(WASH BASIN) ' FOACED AIR SYSTEMS—B.T. E.A. � <br /> SHOWER ' HEAT PUMP ' <br /> � � <br /> KITCHEN SINK 8 DISP UNIT HEATERS—B.T.U. M � <br /> DISHWASh!ER ' CLOTHES DRYERS � <br /> ' JENTILATION FAN � <br /> LAUNDRYTRAY , <br /> CLOTHES WpSHER ' I RANGE HOOD � <br /> URINAL ' WATER HEATER � <br /> DRINKING FOUNTAIN W�aD STOVE � <br /> FLOOR DRAIN ' METAL FIREPLACE(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � FIREPLACEINSERT(WOOD BURNING) , <br /> � GAS fIREPLACE � <br /> SINK(SERVI�E—BAR,ETC.) � <br /> ' GASRANGE <br /> � <br /> GAS PIPING �� •� , <br /> � EXHAUST FAN � <br /> i <br /> i <br /> � <br /> � � <br /> � <br /> � <br /> SUB T07AL 5 � ' <br /> 5 ' SUB TOTAL S � <br /> PERMIT , PERMIT 5 <br /> TOTAI FEE 5 � TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: � <br /> fRONTSETDACN R[Aq SEIDACK SIDE SETOACK <br /> PIAN CHECK qV,UOf:fi pEE RECEIPT NO. <br /> / �/ /� jl I <br /> USE20NG LOTAREA �/iv`/ � , <br /> vncnNrsire FEES VALUATION FEE ' <br /> nves n No <br /> HEIGHT LIMIiATION OUILDING � <br /> NOOf-UW[LLIYG 512EOFBlDGRi. � <br /> UNIiS <br /> PLUMOING i <br /> OCCUPqNCY NOAFSTONIES OCWPANTLOqD � <br /> GFlOUP PASEMENT <br /> MECIIANICAL � . <br /> ❑YES I' NO � ' <br /> i <br /> F�fiEALARMREO'D REASON ' ADDI➢ONqLPLANCHECK � <br /> r <br /> FIRE SPRINKLER REO'D qEA50N OTNER j �� <br /> i <br /> STATE OUIL�ING SURCHARGE j <br /> iVPE OF CONSi PLANS RPPRpyED PY i <br /> CITY OF EVERETT rueucwonrcs � <br /> LOCALSALES I <br /> ome TAX CODE IS 3105 TOTAL � <br />