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APPLICAT14.d FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> fl DEMOUTION fl COMBINATION fl BUILDING fl MECHANICAL �pLUM81NG f 1 SIGN <br /> PROJECT ADDRESS <br /> l3�'1 �.L.LlD� �-r/A�i <br /> O ER MAILAODRE55 Cltt ZIP PNONE <br /> ��9N �n�i�nx �030�7 E«�D��� r�q� �v�tr�� <br /> iENRNT MAILADDRF55 fllY l�p <br /> {'HONE <br /> ARLHITECTORUFSIGNER MpILA00RE55 g�ry ��� <br /> PMONE <br /> � vYt� � /� `�+�,�� �olo�JJd1lL i9i� �'✓dE;^ �9.vi') ln�A. ��9�1'AG'l�Sll,y� <br /> CENEqnLC NiRACiO(i MqILpDDRE55 ��iy Zi� <br /> PIIONE S7AT[�ICFNSE r <br /> MECNANICA��ONTRACiOR MAq nDDRE55 �4 � � � ��� <br /> . ��N Zi� PIIONE STATE UCF.NSE� <br /> PLUMBINGCONTRAf,TOR MAILA�DRE55 CIN ZIP <br /> PHONE STAIE UCENSE� <br /> CONTMCT PRICE OF WORN on <br /> �� �" HEATING SYSTEM: GAS fl EI.ECTRIC I l <br /> DESCRIBE WORK AND SOURRE FOOT�GE INVOLVED �ONTRCT PERSON�ND PNONE NG. <br /> 1 HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> ��S�P�V� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THiS TYPE OF <br /> LEGALOESCRIPTIONOFPROPERTY�SHOWNBELOWOf1ATTqCHTWOCOPIES) WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ot e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF AN'! <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT�ON OR THE <br /> PERFORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PMCEL LV(I.D.NUMBER CON CTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LEN�Efl.A�OPE55,TELEPHONE NUTABER SIG � ��'�f V �' /� � <br /> D�TE <br /> .I BUSMGSSLICENS[NO. <br /> PLUMBING ECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE N0. TYPE OF EGUIPMENT FEE <br /> WATERCLOSET(TOILET) � q/C—A/HNDLGUNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' <br /> ' UNIT HEATEFS—B.T.U. M � <br /> KITCHEN SINK&DISP i CLOTHES nRYERS ' <br /> DISHWASHER ' <br /> ' VENTILATION FAN � <br /> LAUNDRYTRAY ; RANGEHOOD � <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 PREVENTERS ' GAS FIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE , <br /> ' GAS PIPING TO ' <br /> � E%HAUSTFAN <br /> � � <br /> i � <br /> � <br /> � � <br /> � � <br /> SUB TOTAL $ � SUB TOTAL 5 ' <br /> � <br /> PERM�T S � ;ERMIT S � <br /> TOTAL FEE S � TOTAL FEE 5 � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETpACN REARSETOACK SIDESETB6CN PlANC11ECRNUMOGfi P[E RECEIPTNO <br /> use zoNe iornnEn VACRNi 51TE FEES VALUATION FEE , <br /> I IVE$ I i NO OIIIIOWG � <br /> � <br /> HEIGIIT LIMI7AilON NO Of UW[(LING 512E OF OLDGRI <br /> UNIiS <br /> PLUMpING <br /> OGCUPANCY NOOtSf0uiE5 OCCUPRN�LOAD OASEMENi --F � <br /> fiROUP MECII�NICAL � <br /> i <br /> IIYES I1 NO ---- <br /> FIRE�Uf�M 6�0'D RFASON AU011104�I.PLAN GRf.GK � <br /> —�_'_— <br /> on�en � <br /> fIRF.SPRINKIERREO'D REASON <br /> _'_ <br /> STN[OUILDINC SUqL11ARGE � <br /> Tvreorr,or+sr vinNsarrnovenov CITYOFEVERETT runncwonKs ' <br /> LOCAL SALES — ----- -----I— <br /> DAiE TAX CODE IS 3105 TOTAL <br />