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— .-�. <br /> APPLICATI�..� FOR CONSTRUCI .ON PERMIT <br /> • CITY OF EVERETT• BUILDING DIVISION <br /> � 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> Cl DEMOLITION C-1 COMBINATION yp BUILDING C7 MECHANICAL ❑ PLUII�BING fl SIGN <br /> PROJECT ADDRESS <br /> C OMM��,C�AC. Evt 2�fi 98zo"� �s�-ais� <br /> OWNEH MFILADORESS GITV 2ii' PIIDNE <br /> Pio6a4t.DSe��...c��2ca 3003 �(o7ti ST <'�a2d7Ja,A98a�� � SC� sir6 <br /> TENANT M�ILApDRE55 CITY 21P PIIONE <br /> h1 i ff�.. Cojc lo3O7 Commo�2rl�9c_ R!� G✓tQu'7Tw9, <br /> ARCHRnCC,T�OROE516NEP MAILAODRE55 CITV 21P PMGNE <br /> ��lr/�1 t .�¢Sjs' .� <br /> GENERALWNTPACTOR M LRODRES CITY ZIP PHONE STATFUCENSE� <br /> �obe2t- .0 S�kC� �wteQ [�W r�e�(' <br /> MECMANICALCONTRACTOR MAILADDRE55 CITV ZIP PHONE STATELICENSE� <br /> �r:i..�. 5+��- <br /> �{_� PlUM81NG CO4TRRCTOR MAILADDRE55 CITV ZIP PHONE STATE LICENSE/ <br /> iY�'.. � - <br /> �1! �,.� CONTRACT PRILE OF WORK - <br /> HEATING SYSTEM: �'GAS ❑ ELECTRIC ❑ <br /> �'S� � DESCP.:BE WORK AND OUARE FOOTRGE INVOLVED CONTACT PERSON AND PHONE NO <br /> , $ G.92 <br /> � � 8fo0 s FT <br /> I HEREBY CERTIFY TH,.T I HAVE READ AND EXAMINED THIS <br /> PROPOSED USEOF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> G* AA FOR rW�Q '� /� WORK WILL BE C�MPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �EGALDESCRIPTI OFPRQPERTYlSNOWNBELOWOIIATTACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �/Sf7-l9 <br /> to7l� '��� e�ocK �3 _oF N� e H a Y- ,D i J �4 AUTHORITY TG VIOLATE OR CANCEL THE PqOVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATIN3 CONSTRUCTION OR THE <br /> �^I /�/� 3 y �e�o c 5 of �JoAoMiS1� PERFORMANCE OF CONSTRUCTION.THAT I Ak AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> Ca � W'�S� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA7f I.U.NUMBER CONTRACTORS LAW 10.27 RCW AND 296200 AC. <br /> 5' `1y9 ,a /3-or�-000g �v �r� . soo `/�7 o <br /> CONSTRUCiION LOAN LENDER,PDDRESS,TELEPHONE NUN9ER x_�� /� � 7^ �Z� 7� <br /> SIGNATURE DATE <br /> ('� 1 I <br /> V�17 :F��'M�L ' NO /�QalJG/L CITVBl151NE55UCEN5EN0. <br /> PLUMBING MECHANICAI <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TVPE OF FI7STURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNITS—H.P. � <br /> BRTHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> .— <br /> SNOWER � UNITHEATERS—B.T.U. M � <br /> Y.ITCHEN SINK&OISP ; CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HOOD ' <br /> � <br /> CLOTHES WASHER i WATER HEATER � <br /> URINAI ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR ORAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> 9ACKFLOW PREVENTERS � GAS FIREPLACE ' <br /> SINK(SERVICE—BAR.ETC.) � GAS RANGE � <br /> ' GAS PIPING ' <br /> � EXHAUSTFAN � <br /> � � <br /> — i � <br /> � � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL 5 � <br /> PERMIT 5 � PERMIT S i <br /> TOTALFEE S ' TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONT S�I� REAR SETBACN SIDE SETBACK PLAN CHECK NUM�EA F[E _ n RECEIPT N0. <br /> . � � 5 � � � <br /> USE20YE�� LOTAf1EA VACANTSITE FEES VALUATION FEE <br /> K� Z N 9b� S,,' (lYES ❑ NO BWLOING /� ' i 'Z,� <br /> HEIGHT LIMI.TATION NO OF OWELUNG SIZE OF OLOG?.L � � � <br /> •Yi1 `�1� UNITS '_/ � r p�UMBING i <br /> t�J <br /> CJ�J J <br /> OCCUPANCY NO OfSTOPIES OCCVPANiLOA� 6RSEMEYi � <br /> GROUP MECHANIC�L � <br /> (f' � ❑°ES IYT10 � <br /> FIRE!'.ARMREO'D R[ASON AOOITIONALPUNCHECK � <br /> i <br /> OiIiER i <br /> fIRE SPRINNLER REO'D REASON � <br /> STATE UUILDMG Sl1RCHARGE i� .1 <br /> �--� <br /> TYPEOFCONST PIANSAI'PRO�VLEDBY CITYOFEVERETT PU�UCWOfiKS � <br /> �}- /�+ LOCAL SALES , <br /> JL'/J DATE Ql /y, TAX CODE IS 3105 70TAL I <br />