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APPLICATIa.� FOR CONSTRUCT►JM PERMIT <br /> CITY OF EVER[TT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETf, WA 98201 •259•8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING p MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS: Z'-�I� ?�(GkS;�•�! h�'� <br /> OVMER MMLAppqE55 CITV 71P PHONE <br /> 1✓]iG� ClL�S�F�2 �io31 26'� ,tvE f� �VEf�ET 9BIv$ ZvJ 338-oyz6 <br /> 1EN I ��14�� ES f.ITY IIP t'I�ONE <br /> '.�I��JOtvG,S �C��n���!) P 5����1:���1?�C1/�l� aSZ-s"�jl <br /> ��qp-�li[�TOqDE51GNER MAIIADUNE55 itY JiP PII NF -�--- <br /> ��—l'A�a.,�t�—�f�S=�=C�r�FT� ��J--i�- _ `�11��,Y1�{� - (Jer �'Y���kP Cr�'s��� <br /> GENEMlCON10�CIIXi MULApORE55 CIiV �if PIIONE� Sf�iEIIC[NSE� <br /> MELNAN1CµGONTR�CTOR MAII�DDRESS GiY 71P PIIONE STRELtCFNSE� <br /> PIUMBINGCONiR�CTOR MMLA�DRE55 Cltt ZIP P/�ONE ST�TEIICENSE• <br /> CONTMCTFqICEOiWOR ` <br /> � � HEATING SYSTEM: ❑ GAS ,�1 ELECTAIC ❑ <br /> OESCRIBE WORK AND SOl1ARE FOOTAGE INVpW ED COIl1�GI Pl.fi50N AND PNONE NO <br /> dd coNv�.s o,� oi- z86 s� r <br /> �i 0 A �3602.a�/� D /a;� � <br /> I HEHEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PRpPpSE0U5EOFB19L01NG APPLICATION AND KNOW THE SAME TO DE TRUE AND Ct)ARECT ALL <br /> S1�✓bf�i {� M� PROVISIONS OF LAWS AND ORDINANC'_S GOV�."�!ING THIS TYPE OF � <br /> WORK WILL BE COMPLIED WITH Wr,�THER SPECIFIEO HEREIN OR <br /> LEG�LOESCPIPTIONOFPROI'ERtt-r�1SHOWNBEIOWOf1�li6LNTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ioT �3� eiocr.=i_oF �^����fr AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �/0 LJMnI 8 O% (�L�'fS �(7C PERFORMANCE OF CONSTRUCT�ON.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPER7Y TO PEHFORM THE WORK FOR WHICH <br /> APpLICATION i D AND 1 COMPLY WITH THE STATE <br /> PAHCELTA%I�.NUMBER CONTRACT R AW RCWAND296200WAC. <br /> fYSv-o3 -03 �--ooa6 <br /> CONSTRUGTION LOMI LENUER.AODRE55.iFLEPHONE NIIMBEH x ( /I Q/�� <br /> �� U <br /> SIGN�1UfiE p��� <br /> CIiY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF PIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> . I WATER CLOSET(TOILET) � A/C—MiNDLG UNITS � <br /> BATHTUB ; FORCEDAIRSYSTEMS <br /> LAVATORY(WASH BASIN) i HEAT PUMP � <br /> J SHOWER � I UNITHEATERS � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br /> OISHWASHER � RANGEHOOD , <br /> LAUNDRY TRAY ' WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL ' MEfAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSEflT(WOOD BURNING) � <br /> FLOOR DRAIN � GAS FIFEPLACE i <br /> BACKFLOW PREVENTERS � GAS HANGE � <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING , <br /> EXHAUST FAN <br /> i � <br /> i <br /> � i � <br /> i <br /> —�— <br /> SUB TOTAL E ; SUB TOTAL E / ' <br /> _ PERMIT S PERMIT E <br /> TOTALFEE E � TOTALFEE S � <br /> FOR OFFICE USE ONLY: <br /> fRONISETMCK � 1 RGI15FT6�CK � SI�ESETO�CN PIANCIICC����fJl�� fFf�n '^� I1fCFlPINO <br /> /� t/ <br /> USEZONE ^ ior�nen VACAN151LE FEES VAWATION FEE <br /> _ (% ❑rE5 ❑ �+o ounnwr. C L7L � — <br /> HEIGIIT LIMIUTION q NO OF OWEIIING SIZE OF BIDGRI <br /> / UNIIS PlI1M01NG <br /> � S,F F..ct <br /> OCCUP�NGY NO Ot$IOnIES OGCUP�M 10A0 9ASEMENi i <br /> GOROUP MFCHnNILAI <br /> M1- ❑YES NO - -�.- <br /> FIRESPRINKLERREO'0 Rf�50N �UfllllOqqPI�NCRfGN <br /> — ---i-- <br /> ou�cn <br /> FIREAURMNEO'D Rf�50N <br /> S1AiF[II➢Lp�N65URC,�Inl16E — f� <br /> rroeovr.orusr ainNSMrnovepov CITYOFEVERETT ruAiicwonres <br /> �_� N IOCAL SALES --- — <br /> oAt� '� �(o TAX CUDE IS 3105 TOTAL ;�� <br />