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APRLI�:�d►7'i�.N FC?R CQNST9�l1C'. e1CYF9 P�RM�T� <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STFiEET • EVERETT, WA 98201 •259-881Q <br /> i� DEMOLITION �� COfdBINATION � BUILDING f 1 MECHANICAL f 1 PLUMBING I l SIGN <br /> PROJECT ADDRESS <br /> 3s' ��� - kr � �r�z r) ti-E L�-�r-� rt- w�� 9J � �i <br /> GWNER MPILAppqESS CITV 21P PHO4E <br /> r � � J1-'j— ��� G <br /> �D �� � -lavr�� 1 3�l io- �-ul,,-,,, on� 11�e ; �:�.-f, ��n -.a11/v 1,�,�G� 9�'I�L <br /> TENANT IdNLA0�RE55 CITY lio PHONE <br /> ARGHITECi OR DESIGNER 1dn1LA�ORE55 J CITV :IP P110NE <br /> G[NER�LCOYTpACiOR MAI�ppOPE55 CItY LP Pt�JNE BTATELIL[NSEb <br /> �:�r>i,1c- .�s �w.vc,� �n �cv�d= �z � � 7 <br /> MECHFNICALCONTRACTOR MRILA��PESS CIiY 21P PHONE STTELICENSEu <br /> PLUMBINGCONTRFCTOR MAILADDRESS CITV ZIP PHONE STATELICENSEN <br /> CONTPACT PRICE OF WORK <br /> HEATING SYSTEM: �I GAS Cl ELECTRIC G <br /> DESCAI9E WORK AND SOUARE FOOTAGE INVOL 0 GONT�LT PEREON 4N0 PHpNE N0. <br /> �1L� v n < — _ /'� . � .0 v� vEs �3LP- 3 � <br /> �.:y3 s� �T ��.zo� <br /> I HEREBV CERTIFI'' THAT I Hl:VE READ AND EXAMINED THIS <br /> :�a��P�seo use or suaort�c APPLICATION AND KNOW 7HE SAME TO 6E TRUE AND CORRECT.ALL <br /> / PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THIS TYPE OF <br /> ,�a�„ .��, ,.� ��t� �p_t��c� WORK WILL BE COMPUED WITH WHETHER SPECIFIED HEREIN OR <br /> ' �'st IP�TIONOFPROPERTV SN014NBBfiWOFATTAC117YJOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �_BLOCK uF � V� � A 7 AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> I-D/?EST D�)a�/`. OTHER STATE OR LOCAL LAW REGULATING CONSTHUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> O�'.NER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH TH[ STATE <br /> PARCELTA%I.D.NQIIfABER / CONTRAC e�Il S LAW 7827 RCW AND 296200 WAC. <br /> J��� � l — � �� — .S1 � 7 �� %/ � � � <br /> CONSTPl1C110NLOANLfN�ER.ADDf1E55.TEL�PHONENU1dBER x / ��.- r_� ��-'—� .S - I'� Y� <br /> SIG� � DATE <br /> / <br /> CITY BUSINESS LICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF FIXTURE OR ITEM FEE <br /> T <br /> WATER CLOSET(TOILET) AIC—NHN�7LG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) HEAT PUMP � <br /> S WER � UN HEATERS—B.T.U. M ' <br /> KITC N SINK&DISP i CLOT DRYERS i _ <br /> DISHWA EFl � VENTILATI FAN ' <br /> LAUNORY T Y ; RANCiE HOOD i <br /> CLOTHES WA: i WATER HEATEF � <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOO URNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD NING) ' <br /> BACKFLOW PREVGNTERS ; G45 FIREPLACE � <br /> SWK(SERVICE—�BAR,ETC.) � 6AS RANGE <br /> � GAS PIPING ' <br /> i EXHAUSTFAN � <br /> i i <br /> SUB TOTAL S � SUB TOTAL 5 � <br /> PCRMIT S PERMIT 5 � <br /> TOTALFEE S � TOTALFEE S ' <br /> FOR OFFICE US[ ONLY: <br /> FfiONT SETBFCK FEAR SETAACK SIDE SETBnCK PLnN L 1ECN NUA'DER FEE RECEIPT N0. <br /> -z p, z � ' S� ��.77�� 30 /�/s7 <br /> usezorve �otnnEn �/ vncnHr�ite FEES VALUATION FEE <br /> � 81-�6 �s nHo euaoitia '��1 �OS �7 1�C� <br /> H[IGHTLIMITATIOK NO.OFOWELLING SIZEOP9WGRI ,�3�� � � —J � - <br /> / <br /> 2 Q UNITS � SF��`�•�4 '* pLUM�iNG � <br /> �� �a�E <br /> OCGUPANCV NO CGSi0R:E5 OCCUPnNTL0A0 BASF.AIEN7 U? � <br /> GROUP MECHANICRL _ -- i <br /> K-3 � � nvEs +� ; <br /> FIREALFRM(iE0'D FE450N hDDIilON4LPLANCHECK i <br /> — T <br /> � OTNER ,'��.� I -1 i''- /D iO� <br /> PIRESPRINKLERREOD AEASON � <br /> � SiATE CUIL�ING SUPCHA�GE � �j;', <br /> 8 <br /> TVPEOFCONST PIANSAPPROVEDBV CITYOFEVERETT PUBLICWORKS � �[7 <br /> �J�}- �ocn�sn�es — ��`� "" <br /> -�J onre 3 �/ TAX CODE IS 3105 707AL ����/ ��(� <br />