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�\ �� <br /> APPLICATI�.�N FOR CONSTRUC'� .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOUTION rl COMBINATION fV BUILDING C7 MECHANICAL fl PLUMBING f_l SIGN . <br /> PROJECTADDRES �C���C�,S ��� I-�� � . ��Z� ) ?�?) -� ,(�j <br /> O��S� 1 IW�"�A� I�S��U� CS / 1 A��IP PHONE <br /> TENANT MAILPDDRESS C17V ZIP PHONE <br /> ARCHITECT QR DESIGNER MAIL ADURE55 pTY ZIP I I PMONE G� I <br /> �,�,�C ��t" AP S�i'�C. (,�f�D �.A W'� L �Y SL� V�2�c. Z�—� 3� I f o SSJ N <br /> GENERRI CONTi1RCTIXi M91 AUORESS GITV 21P PHONE SUTE LICENSE t <br /> MECNANIC�LCONTRRCTOR MAILADDFESS CITV 21P PHONE STATELICENSE� <br /> PLUMBINGCONTR�CTOR MAILAODRESS CITV ZIP PHONE STATELICENSE� <br /> CONTR�CT PRIGE OF WORN � �� <br /> HEATING SVSTEM: O GAS ❑ ELECTRIC ❑ <br /> DESCRIBE WORK ANO 50 ARE FOOTAGE I V LVED GONTpCT PERSON AND PHONE NO. <br /> ! r <br /> C , � <br /> I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLI�ATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> noroseous�oFevaoiNo PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEGALDESCRIPTIONOFPROPERTYISNOWNBELOWORATTACNTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> iot BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTflUCT10N OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> n r OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> 3 O� -1 O S ^ � O Z J � D OU I CONTCAC ORS IIAW 18 27 RCW AND 296.2ppLWA�WITH THE STATE <br /> PARCEL LVt I.D.NUMBER /� <br /> CORSTAUCTION LOAN LENOER,�ODRE55,TELEPHONE Nl1MB[R X � /I � � S ! � <br /> SIGNAiVR UATE <br /> CITV BU ESS LICENSE NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF flXTURE OR ITEM FEE <br /> WATER CLOSET(TOILEn � AIC—A/HNDLG UNITS—H.P. ' <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) i HEAT PUMP ' <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAY ; RANGE HOOD i <br /> CLOTHES WASHER � WATER HEATER ' <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PRFVENTERS i GASFIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS AANGE ' <br /> � GAS PIPING � <br /> � E%HAUSTFAN ' <br /> � <br /> � <br /> � <br /> � � <br /> � <br /> � <br /> � <br /> SUBTOTAL 3 ' SUBTOTAL $ i <br /> � <br /> PERMIT 5 i PERMIT $ � <br /> TOTALFEE 5 � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK / RERR SETBA' � SIOE SETBACN / PUN LNEL NUMOER FEE /G' RECEIPT NO.� <br /> ,�' 2/ 9.�"- <br /> usezor+ LOTAREA WCANTSITE FEES VALUATION FEE <br /> � f7YE5 fl NO BUIl01NG Z � i� <br /> HEIGNTLIMITRTION UNIT�OWELLJNG SIZEOLF�WR�. p�UM�ING i <br /> n / C . - <br /> 4 J i <br /> OCCUPANLY NO OFSTOPIES OCCUPANiLOAD BASEMENT MECNANICAL � <br /> G �U-1 I w/n �c A <br /> ❑VES 0 i <br /> ADDITIONAL PIAN CHECK � <br /> FIRE PURM REO'D REASON � <br /> Q ' <br /> OfHER —� <br /> PIRE SPRINKLER REO'0 REASON i/=O <br /> STRTE BUIL�ING SUPCHPRGE � <br /> � � <br /> TVPEOFCONST. PUNSAPP OV�BY CITYOFEVERETT Pl10UCWOFKS � <br /> LOCALSALES ' <br /> ���( o�TE TAX CODE IS 3105 TOTAL � <br />