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APPLICATIG�I FCiR CONSTRUCT�ON PERMIT <br /> CITY OF EVFRFTT• BUILDIiJG DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br /> DEMOLITION f 1 COMBINATION fl BUILDING f-1 MECHANICAL �1 PLUMBING f 1 SIGN <br /> PROJECT ADDRESS \ <br /> , <br /> �-�y �,,1 l� s�-��a-t � � � - <br /> OWNER AILADORESS �.� CITY 'ZI�' �'NON[ <br /> �J� � �� � ���s4pi � /�900 ��i/1^ �� " �� ��a�� � �� _-'(�!�� <br /> IENPNT �AILA�DRF.55 CITY ZIP �`NONE <br /> ARGHITCGT OR OES�GIIER MAII.ApDRE55 CITV IIP �'��ONF ����C�./� '—'l <br /> GENEf1�LCONiR�GTOR MMLAOURESS , CITY 71P P�ION[ STAiELICENSEx <br /> 1 � � � <br /> -��,,'.� c�_ �.� , � Y.:�� <br /> '� �') -.'' '--`-? r.. (�L�,.�6T�-, , ^ �'� � J'%S�>C C.�-1 roo��� �.�� A a,_ a� _ �. � , <br /> , i - <br /> MECHANICALCONT0.4CTOR MNLADDRE55 CIN 71P PIIONF STATLLICF.NSE� <br /> PLUMBiNGCON7R�G70R MAILA�DRE55 Cltt ZIP PIIONE STpTCLICE1�5Er <br /> CONTRRCTPRICEOFWORK n / //+ HEATING SYSTEM: I-1 GAS I l ELECTRIC fl <br /> ``�i/ / ' <br /> UESCFI9E WOPK PN�$OIIARE FOOTAGE INVOLVEU - GONTACT P[RSON�ND PMONF HO <br /> G-.O � �i. �.��. �� `;I `1� '�" <br /> j� �� <br /> Ve-.b'IC.� �'' c7CY ����' - ( ,%�C C <br /> � � � I HEREBY CERTIFY THA7 I HAVE READ AND EXAMINED THIS <br /> ��'�Q {' (�tJ c'+- i �� r O ���, '����- APPUCATION AND KNOW THE SAME TO BE TRUE ANU CORRECT AlL <br /> PROPOSED USE OF DUILOING PROVISIONS OF LAWS AND ORDINAIJCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LE�ALOESCFIPTIONOPPROPERT,Y_I�SN./OW�NBELOWORATfPGHTWOCOPIE51 NOT. THE GRANTING OF A PERMIT DOES NOT PRESU�dE TO GIVE <br /> j��or �� �''" � • BLOCK �lt��(l�--or �= =�ti-'�� t� -''� ",� ;� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATF OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � ^`" .;���_� ,•( � , ,) PERFORMAN�E OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> CC �-�-- 'r)(:� J�) � — OWNEF OF iHIS PROPERTY TO PERFORM THE WOAK FOR WHICH <br /> � <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS lAW 1827 RCW AND 296200 WAC. <br /> PARCELTAXI.D.NUMBER � t <br /> � /� 1 � r <br /> '�J��(� ' �hlD � �i � �l "�: ii�:�? ..L_.� �J ly .. �. �'_� � .' . <br /> CONSiRIICTION LORN LENDER.PDDRE55.TELEPNONE NUMBEP x / �� �• " �� .��� �~ � <br /> SIGNATURE �� �ATE <br /> �a.i�-;;.�,�_ <br /> CITY[fUSINE55lIC`eN5[N0. <br /> PLIIMBING MECHANICAL _ <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FF.E <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—hI.P. ' <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. i <br /> LAVATOR'!(WASH BASIN) � HEAT PUMP � <br /> SHOVJER � UNITHEATERS—B.T.U. M �_ <br /> KITCHEN SINK 8 DISP CLOTHES DRYERS ' <br /> � <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRYTRAY ; RANG�HOOD <br /> CIOTHES WASHER � WATER HEATER ' <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS ; GASFIREPLACE ' <br /> SINK(SERVICE—BAR, ETC.) GAS RANGE � <br /> i <br /> GAS PIPING � <br /> ; EXHAUSTFAN ' <br /> � <br /> � <br /> � SUB iOTAL 5 1� <br /> SUB TOTAL S I —�— <br /> PERMIT 5 � <br /> PERMIT 5 � TOTAL FEE S i__ <br /> TOTALFEE $ <br /> FOR OFFICE USE ONLY: aFcrirrNo <br /> ri nn cuecK N in+�en rer <br /> ffiONT SFTPACR RE4R SFTAACN SIOE$ETBACN C �n __, <br /> /� <br /> !i h..J FEE <br /> -— FEES VALUA'WiJ �_ <br /> USE ZONG 1 OT AREA V�CANT SIiE � <br /> fiYES 11 NO pUIL01NC <br /> I� IIEIGIITLIMITATION NOOFDW[LLING SREO��LUGRI � <br /> UNIIS PIJMPING <br /> T <br /> � <br /> OCGUPANCY NO OP510�1iF5 OCGUP4NiLUAD BASEMENT M(CIInNIf.�L __.- <br /> cnour <br /> IITES I1 Np <br /> ADUIIIONAL PLAN GNF.CN __ <br /> FIREALP(1M(iEU'[1 flGASOY -- <br /> i <br /> OiHER <br /> fIRFSPRINKIF��F.O'� �FnSON STNEOUIIDMGSIIRCIIMGE <br /> I —-- <br /> , ivveoFr,oNs* - ninrusnrrnovennr CITYOFEVERETT runucvronKs _ __ _ _____ —_ <br /> LOCAL SALES — ' <br /> TAX CODE IS 3105 io7a� __ _________�-- <br /> unrE -------- <br />