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APPl.ICATIO.� FOR �OM�TRUCTI.�N �ERNAIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETI', WA 98201 •259-8810 <br /> ❑ DEMOLI3'ION ❑ COMBINATION ❑ BUILDING C� MECHANICAL p PLUM8ING ❑ SIGN <br /> PROJECTP,DDRESS: ZUI D Lc� r�rz-� �v� <br /> ROIiEILT /���To� 'Ld � � !.-a�^a�ru> A,/e F✓PnE� 7 �2 - 4�0.�5 <br /> OWNER MAIL�DDRc55 C�n' ZiP ���ONE <br /> TENANT ��IIAUURf:55 GTY ii� ��IONC <br /> �PGHITECTOROESIGHER M�IlA0DRE55 G�n' IU PIIONF. <br /> GENEMLCONiMGT0i1 MARr1DD0E5S f.IIY 1iP �nONE cfRIELICFNSE� <br /> Rgsowte (�fts S[R.�rcEs PD 6oti Iz-5�3 /�na C�2c-t-x 6�iF 9�D�i2 �HS-3g9() /}85o�G5o55/'+= <br /> MECHANICALCONTRRCTOR MRIUDDRESS Cltt Z�P PIIONG STATE UCENSE� <br /> PLUMBINGCONTRAGTOR IARIIADDPE55 Ciil' LIP PNONE STATELICENSE� <br /> 1 ��"��� _— <br /> CONTR�GTPPIGEOFWOf1N HEA'i1NG SYSTEM: t::.S ❑ EL�CTRIC O <br /> DESCRIBEWORYANOSOUAREFOOTAGEINVOWED CONT�CTPEf:50N�N�PHONENO���r G�E��wE /�S V��✓ <br /> Cn/� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAA!INED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORh'ECT ALL <br /> PilOPO5EDU5E OF BUIIDING /� _ PROV�SIONS OF LAWS AND URDINANCES GOVERNiNG THIS TYPE OF <br /> Si ���E FA^��L� I''t' • WORK WILL BE COMPLIED WiTH WHETHEfi SPECIFIED HEREIN OA <br /> LEGALDESGRIPTIONOFPROPERTYISNOWNBELOWORATT�CHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT BLOCN or AUTHORITY TO VIOLATE OR CAYCEL THE PROVISION OF ANY <br /> . OThIEF STA�E OR LOCAL L.4W REGULRTING CONSTRUCTiOh OR THE <br /> PERFORMHNCE OF CONSTRUCTION.THAT I AM AUTHORIZED 6Y THE <br /> OWNER OF THIS PROPERTY TO PEFFORM THE WOFiK FOR Wh�CH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STAI�� <br /> CONTRACTORS LAW 1827 NCW AND 296200 WAC. <br /> 7MCEL TAX IA.NU1ABEfl 0 yI�/ p <br /> CONSTFUCTION LOAN LENDER,AODRE55.TELEPHONE NUM:1l8 X ��/1 1 ��M� � 'I ^ /� <br /> SIGNniURE DATE <br /> CITV OUSINE55 UCENS[NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM F�E NO. TYPE OF EUUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—NhiNDLG UNRS ' <br /> BATHTUB ' I FORCEDAIRSYSTEMS � <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER ' UNIT HEATERS ' <br /> KITCHEN SINK&DISP i CLOTHES DRYERS � <br /> DISHWASHER � RANGE H000 ' <br /> LAUNDRY TRAY ; � WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAL � MEfAL FIREPIACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPL4CE INSERT(WOOD BURPlING) � <br /> FLOOR DRAIN � GAS FIREPLACE : <br /> � <br /> BACKFLOW PREVENTEflS ; GAS RANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING ' <br /> EXHAUST FAN <br /> � � <br /> � � <br /> i � <br /> SUB TOTAL $ � SUB TOTAL $ O i <br /> PERMIT S i PERMIT $ /S � <br /> TOTAL FEE 5 ' TOTAL FEE $ ' 7. ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETFI�CK REAl15FT0ALK $I�ESETBACN �LANGI[C1(NUMIfR IEF �ECFIPTNO <br /> usEzorve �OTAREA �AC�NISIIE �FEEC VALUATION FEE <br /> i <br /> ❑vES ❑ N� OUItDiH6 <br /> NEIGMTUMITRION NOOFUWEWNG 512EOFOLDG/il i <br /> UNRG p�UM01NG + <br /> OCCVPANGY NJOi5I01iIE5 OCCUPANiL0�0 9�SEEIENT MEC���NICnI � <br /> GROUP <br /> ❑YES ❑ NO <br /> RDDIIIONAL PUN CMFCN <br /> FIRESPRINNIEflREO'D fiEA$ON — <br /> i <br /> Oi��E� � <br /> FIREAlAAMflEO'D REASON � <br /> SiAIE�UIIDINf.SIIRCHr1RGE i <br /> __ r-� <br /> TYPEOFf,ON$T PLANSA�PROVE�BY CITYOFEVERETT �IIOI�f,WOfiHS � <br /> _�_i_�_ <br /> LOCALSALES I <br /> oATE TAX CODE IS 3105 TOTAL <br />