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ApPLICATIQ'''� FOR COtmS'T�iUCT' lIV PE�811011T <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETf, 4JA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ �UILDING O MECHANICAL O PLUMBING ❑ SIGN <br /> PRO EC ADDRESS: <br /> D E C � � <br /> OWH�-R I�AODRE55 CITY IP PMONE V <br /> TENANT M/JLADORES$ CIIY IIP 1'110NE <br /> ARCHRECTOROESIGNER MNIADDRE55 GITY 711' PMONF. <br /> GENEMILONLi1�C10R MAILADDBE55 GIY 7�P PIION[ SfATBIICEN$E• <br /> ME NIC�ALyry�TR�CTO MAILAODRE55 CITY Ilf' P110NE STATE LILENSE• <br /> �-frf S�� � es i o <br /> PLUMBING ONTRALTOR AIAILAODRESS CIIY IIP PIIONE STATELICE`15F.� <br /> GONTRACTPRILEOFWORK NEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br /> DE RIBE WORK�ND SOUAPE F TAGE IHV LVE� CONTnGT PERSON ANU PHONE NO <br /> S � <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND K��OW THE SAME TO BE TRUE AND CORRECT ALL <br /> PaoroseouseoFeuaov+c PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE C0�9PLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAlDESCRIPTIIXJOFPROPERTY�SNOWNBELOWORATTALHTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORM TH� WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> PMCELTA%I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> GONSTRUCTION LOIJ!LEROER,ADDRE55.TELEPNONE NUMBER x <br /> o- / � � O <br /> SIGNATURE 9 TE <br /> CITY BUSINESS LICENSE NO <br /> PLUAABING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATEfl CLOSET(TOILET) � A/C—A/HNDLG UNRS ' <br /> BATHTUB ; FURCED AIR SYST�MS ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNITHEATERS ' <br /> KITCHEN SINK&DISP � CLOTHES DRYERS � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER ; <br /> CLI�THES WASHER i WOOD STOVE � <br /> URINAL ' MEfAL FIREPfACE(WOOD BURNING) ; <br /> DRINKING FOUNTAIN � FIREPLAC[INSERT(WOOD BURNING) � � <br /> T <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GASRANGE ; <br /> T— <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING <br /> � EXHAUST FAN <br /> � � <br /> � <br /> � � <br /> � � <br /> � � <br /> ---�— <br /> SUB TOTAL S ; SUB TOTAL 5 U ; <br /> PERAtiT $ � PERMIT E � <br /> TOTALFEG b ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETAACK PERR$ET9�CN SIpE SFTp�CN PI�N CIIGCN Nl1MOPfi �fF RFCFIP7 NO <br /> use zor+e lOT AREA V�C�Nt SIIE FEES � VALUATION FEE <br /> — ❑YE$ ❑ NO pU1LDWG � <br /> i <br /> MEIGIITLIMITATION NOOFDWEILING SIZEOfOLUGRI —� � <br /> UNII$ V1�11Af11NG � <br /> _ �� <br /> OCGIIPANCv NOOf510P1[5 OCCUPANTLORD BASEMENT MEC11nNICAI .�� •� <br /> Gf1WP <br /> ❑vE5 ❑ NO – � <br /> fIflESPPINKLE0RE0'D RERSON /DOIIIONAI.PLANC��ECK � i <br /> �— <br /> O�HER <br /> FIREMNiMREO'0 REAS(1N <br /> STAtF.OUIIDWG SURf,HARGE � <br /> i <br /> TVPEOff,ONST PIANSAPPROVEDOY CITYOFEVEREIT runnr.wonKs <br /> LOCAI SALES — — ----- -- <br /> onrE TAX CODE IS 3105 TOIAL --- <br />