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___ -----.� <br /> APPLICATI�..�i FOR COidSTRUG'� ..'�JW PERMIT V��}�► <br /> CITY OF EVERETT• BUILDING DIVISION v'�/R_ <br /> 3200 CcDAR STREET• EVERETT, WA 98201 •259•8810 �Q��� <br /> ❑ D�MOLITlON ❑ COMBINI�TION p BUILDtNG �1 MECHANICAL �PLUMBING ❑ SIGN <br /> PROJECTADDRESS:�j�O I�o su7l A��L�IA 9S'�O� <br /> Ca���«;��, � �r� /'.,.,�r�tl �fu�._ -�. ������o ' 743-31` ; <br /> OWNER M�ILADpiE55 LItY Zi�' ���ONE <br /> s�mC <br /> IENANT MqUUDPE:7 diY ]IP PIIONE <br /> AFf,HITEGt OR�ESIGNER M�II ADD�E55 CIlV %,�' �HOhF <br /> GENE�AICONiMClO(i IAUUU0�E55 CIIV I�f� P�ION[ Sf�IEUC[NSE• <br /> , 6 -(�rl�� ( I6/l�rrla�,�� 1/i�.,, Or. E���1,3�'�0l 2sa-3nv EV��'�ss�Ju J <br /> IAECNAI ULCONTRACTOR M�IIAGDRE55 Cltt ]P PIIONC STREUCENSE� <br /> PWMBINGCONTReC10R MAILADORESS CILY IIP PI�ONE $TAiEIIGENSE• <br /> � �J - <br /> L A�CT PRIJE O�wOnK <br /> HEATING SYSTEM: J�GAS ❑ ELECTRIC 0 <br /> pE$CRIBE WC9K ANp SOUAR PpOT�GE INVO'VEU f,ONT�CT PERSON AND P IONE O <br /> �, „ , � " � z5a-3l <br /> 0 <br /> I HERE�Y CERTIFY THAT I HAVE READ AND EXFMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROPOSEOUSEOFBUILDINO PROVISIONS OF LAWS AND ORDINANCES GOVEHNING THiS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OP <br /> IEG�IUESGFIPTIONOFPROPEHTYISHOWN6ELCWORATUGMTWOLOPIE$) NOT. THE GRANTING OF A PER�AIT DOES NOT PRESUME TO GP1E <br /> �oT PLOCK O�_ AUTNORITY TO VIOLATE OR CANCEL THE PROVISION Gi :�.NY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 1HE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM f UTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM T1-c WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> — CONTAACTORS LAW 1827 RCW AND 296.200 WAC. <br /> PNiCEL TA%t.D.NUMBEP / <br /> CONSTHUGPON IOeN IEN�ER ADORESS.TELEPHONE NIfMBEP X�' C i�iLl tit� ��4 _ / � <br /> SIGNRiU11E D�TE <br /> CITY BUSMG55 LICENSE NO <br /> PLUMBING MECHAtlICAI <br /> NO. TYPE OF FIXTURE OR�TEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNITS <br /> BATHTUB � FORCED AIR SYSTEMS i <br /> LAVATORY(WASH BASIN) IiEAT PUMP � <br /> SH0IYER � UNIT HEATERS ' <br /> KITGHEN SINK 8 DISP ; CLOTHES DRYERS � <br /> DISHWASHER RANGE HOOD ' <br /> LAUNDRY TRAY ' WATER HEATER i <br /> CLOTHES WASHER WOODSTOVE ' <br /> URINAI MEIi,L FIREPIACE�WOOD BURNIN6) <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) _�__ <br /> FLOOR DRAIN GAS FIREPIACE ' <br /> BACKFLOW PREVENTERS ; GAS RANG[ � <br /> —. ---r— <br /> SINK(SERVICE—BAR, ETC.) � GAS PIPING <br /> EXHAUSTFAN <br /> i <br /> SUB TOTAL E SUB TOTAL 5 �ZJ ; <br /> PERMIT S PERMIT S /S � <br /> TOTAL FEE S ' TOTAL FEE 5 �y' <br /> FOR OFFICE USE ONLY: <br /> FNONTSFTBACK PEPRSFTBACK SIDESETB�CN �UNCIIECNNU�MJpPf1 f[F fiEf.FIPfNO <br /> USE ZONE ioi enen vee�ar site � F E� VALVATION FEE <br /> ❑ves ❑ �+o nunoivr. <br /> IIEIGIITUMITATION NOOFDWEI'JNG 512EOiBLOGRI � <br /> UNILG rwunmr. �1 <br /> l <br /> OCLUPANCY NO O�SIORIFS OCCUPANil040 BASEMENI MFCMnenCRl. � <br /> GROUP -- " <br /> ❑vC5 ❑H� — <br /> — nt>D�Ilnnnl �`InNG�lCN � � <br /> FIRESP81HKlERREO'O �FASON �— <br /> O1NER <br /> FIREAIARMPEO'D AE�50H i <br /> $TAlli OIIItDING$UOf,11AqCE <br /> IYPEOPf.ON51 FlANSAPPROVE�OY CITYOFEVERETf �IIAIIP.WORNS _ <br /> LOCAlBALES -- —— — , <br /> onrc TAX COUE IS 3105 TOTnL <br /> --� --... __ . __ .. _. __ _ � -- <br />