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APPLICATiI.�! �OR CONSTRUCI .ON P"ERMIT <br /> Cll Y i�F EVERETT• BUILDING DIVISION � <br /> 32G0 CEDAR STREET •�VERETT, WA 98201 •259-8810 <br /> / <br /> f i DEMOLITION � l COMBINATION i��UILDING 'i MECHANICAL f i PLUMBING � SIGN <br /> PROJECT ADDRESS ,23 l <br /> K r.c�� � }�c <br /> om+ a ., MARApORE55 rrzv ir � <br /> r��ouE <br /> �o�npG,., ('�u� '� /3vs � 3231 �i2c,,.r� � 1��1 ZSi ��8,6 <br /> TENANT MAILRO�iiE55 Cilv ZIP FHONE <br /> ARCNITECTOROESIGNER ldFILR�pRE55 CiTY ZIP PNONE ^I <br /> GENEiiALCOYiRACTOR M ADDRE55 CIiV )IP K�n ���_' S�� <br /> PHONE STATEUCENSE• <br /> —1'o��n/r fovr�Nz-c1 �as,-F'i'iAyvt�t G�6S /(.S�I /-hv'> >�^ G�tif%wc�llif/� 93'0,;� Tz;�N.�cPro;•yv- <br /> MECHANICAtCONTRACTOR MAILA�DRESF CITV ]IP PHONE SiATELiCENSE• <br /> PLUN�BRlGCONiRACTOR MAILA�DRESS LITY 214+ PHONE STATE�ICENSE• <br /> CONTRACT PqILE OF W��R <br /> 6 I C D 9��p HEATING SYS7EM: Cl GAS �I ELECTRIC I-1 <br /> DESCRIOEWORNRNDSOUAREF T'A/GEINVOLVED WNTnCTPFR50NPNOP lEN(O� �r (` <br /> � J/• t�(— � �CiLt /�L�� �C"SJ /��/��> <br /> F�� G�f'-��C 'UNS _ /- gt'� �z�j - �s�� <br /> � x�� � 4�D �� I HEFEBY CF.RTIFV THAT I HAVE READ AND EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PPOPOSED USE OF BUILOING(�9 ^ ,, ,� ,�� PROVISIONS OF LhWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> ` ,n�,� WORK WILL BE COM?LIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGPLDESCRIPTIONOFpqOPELTY(SHOWNBELOWOFATfALNTW\OCOPIE51 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> iOT r �� � eLocK � !�i or �J� , 1��/ I� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUT'�ORRED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOR��. FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH T�,E STATE <br /> vnaceiinz i. .ruuMeea CONTRACTORS LAW 1827 CW AND 296200 WAC. <br /> 7C - 'J -0/3 - OOc� - � _ n p� <br /> CONSjJiUCiIONIORNLEN ER.ADOtlE55,JELEPNONENUMP.ER � � ,�,�L� �< .Yp /C�— <br /> _, 'U. '7C 1�N�/�riCN ,r�l', . scN u E nTe <br /> �7. �ivX �(g � Lz'ZCc:-✓Lb ��� � ci.r sivEssucar+seNo <br /> PLUMBING HANICAL <br /> NO. TYPE OF FIXTURE OR Il'EM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(101LET) i A/C—NHNDLG UNITS—H.P. <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M EA. ; <br /> IAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UN!T HEATERS—B.T.U. M � <br /> _ KITCHEfJ SINK 3 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN <br /> LAUNDRY TRAV RANGE HOO[1 � <br /> CLOTHES WASHEF7 i WATER HEATER —T— <br /> URINAL � WOOD STOVIE � <br /> DF'.INKING FOUNTAIN i �.IETAL FIREPLACE(WOOD 6URNING) i <br /> FLOOR DRAIN � FIREPLACE INSEAT(WOOD BURNIIJG) � <br /> BACKFLOWPREVENTER`s ' GASFIREPLFCE ; <br /> SMK(SERVICE—BAR.ETC.) GAS FiANGE � <br /> GAS PIPING <br /> i EXHAUSTFA.V i <br /> i <br /> i — � <br /> i <br /> T <br /> 1 <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT S PERMIT S —r <br /> TOTAL FEE 5 TOTAL FEE 5 ; <br /> FOR OFFICE U3E ONLY: � <br /> FRONTFF.TpACN p[�RSFiBACK SIDESETAACN PLANCIIECNNU 0[R P[E � RECEIPTNO. <br /> Zo � s _�,�� l9. �; <br /> use zor+e I I iotnnEn vnenur srte FEES _� VALUATION FEE <br /> �Z p� �IYES �O OUIlOING g�7(p 23_r <br /> IIEIGIIT LIMRqTION N0.OF pW[LIJNG SIZE CF(iLDGT. — <br /> ' llNliS <br /> NA G�.� S.F, �WNOMG i <br /> OCCUPANCY IIp0�5i0R1C5 OCCUPANiLpAO 6ASEMENI <br /> GROUP MECHPNICAL i <br /> V�� I I�TES f.�.'0 <br /> FIqEPURMREO'D REASON <br /> AOOI710NAL?IAN CNECK � <br /> i <br /> OTHER � <br /> _ j <br /> FIRE SPRINKLER REO'0 RERSON <br /> STATEBUIL�INGSURCNr1RGE � ���� <br /> TVPEOFCONST. PlnNSnPPROVE08v CITYOFEVERETT PUBLICWORKS __.�_ <br /> — LOCALSALES ' <br /> -/.� onre `�j 5 9 TAX CODE fS 3105 TOTAL � <br />