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APPLICA7'14A FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259-8810 <br /> �( DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS: 2 �0 6 Ev�e� �ve ELe�� <br /> ONTlER Ln /� M111LADdiE55 GITV ZIP PIIONE <br /> �YHO/L/ //O�Mwha y�i/O 7</�SiSk� /`'�'�� /�O ��Z7� 3 y7-�d27 <br /> TEN�NT u�ILADORE55 GIIY 71P OIIONE <br /> 11RLPo�ECTORDESIGNEf1 MN1110DqE55 CIfY I�� PMONE <br /> GENEMICONTR�GTOB MAILApURE55 CIIY �If POONG SIATEIICBNSE• <br /> MECHANICAI LONTR�CTOR MAIL ADDRESS Cltt )IP PnONF ST�tE ULENSE• <br /> PIUMBINGCONTRACTOR MAIIADDRE55 CIfV IIP PNONE STATELICENSE� <br /> LONTMC PoCEOFWORN <br /> 3Sp0 HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> �ESCRIBE�NANOSW�EFOpT EINVOLVED ^ CON LiPEf150 ANOP o�NO <br /> ` wr ." o,✓ o�(- .� y` w r.r ? Jo27 <br /> w ii O S <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br /> PRpPOSED USE OF BUItdNb APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEWlDESCRIPTIONOFPROPERry�5/qWNBELOWORARACNTWbCORES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMfi TO GIVE <br /> toT�aiocK�oF S tI ' AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> ' / / � [ /^ �L � OTHER STATE OR LOCAL LAW RECaULATINCa CONSTRUCTION OR THE <br /> � I]S�oH 70 CUc/�!/ we�+dJ,�.-R]�'I.p �� gYPo PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> /J ���r OWNER OF THIS PROPERTY TO PERFORM THE WORK FOH WHICH <br /> YflOVGr q� q g�� Sh ,y� �` � APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> v�qcE�r�z i.o.r+uMeen CONTRACTORS LAW 1027 RCW AND 296200 WAC. <br /> 5936 —63.�—D07 —�s�� �1 ` <br /> CONSTRUCTION LOAN LENOER,ADpRE55,TELEPHONE NUMBER x f������� 7[�I'Z/Gf'^/ <br /> 51.(� ��E lo <br /> DAIE <br /> CITY BUSINESS L10EN5[NO. <br /> PLUMBIINi MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. T/PE OF ECUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNRS � <br /> BATHTUB ; FORCEDAIRSYSTEMS � <br /> UVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNIT HFATEqS � <br /> KITCHEN SINK d DISP ; CLOTNES DRVERS ; <br /> DISHWASHER � RP.�GEHOOD � <br /> LAUNDRV TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOU STOVE , <br /> URINAL � METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT(WO00 BURNING) ; <br /> FIOOR ORAIN � CaAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GAS RANGE ' <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> IXHAUST FAN � <br /> � , <br /> � � <br /> � , <br /> � , <br /> � , <br /> SUB TOTAL S ; SUB TOTAL S ' <br /> � <br /> PERMIT S � PERMIT S � <br /> TOTAL�EE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> iRplT SETBACK RE�R SETBACK S�DE SETB�CK PUN CIIECR NU Efi fFF RECEIPT NO <br /> J <br /> USEZONE IOTAPFA V�C�NfSIfE FEES VALUATION FEE <br /> ❑YES ❑ NO OUIL�ING i <br /> � <br /> NEIGHT LIMIT�TION NO OF OWELUNG 512E OF OU%iR.l <br /> UNIiC ' <br /> PLUMOINO � <br /> � <br /> OC�COPpANCY Np Of5I0Pof5 OCCUPANTLO�D B�SEMENT T— <br /> 1AFpinNif.�t i <br /> ❑YES �NO - � - <br /> FIRESPfiINK�ERPEO'D RF�SON �DDIIIONRLPl�NC11fCK <br /> omcn ' <br /> FIREAWiMREO'0 RE�SON <br /> SiR7E OUIl01NG S�IRCII�IIGE �0 <br /> TYPE OF f,ONST PLANSAPPPOVEDBY CITY OF EVERETT �I1011f.WOfINS <br /> LOCAL SALES — —�— <br /> D�TE TAX CODE IS 3105 TOTAL <br />