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APPLI�:ATIO►�� FOFt CONSTRUCTL„�N PERMI'tT <br /> CITY CF EVERETT•BUILDING DIVISION �`��0� <br /> 3200 CEDAR STREET• EVERETT, WA 98207 •259-0810 �rl <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUiLDING O MECHANICAL (�PLUMBING ❑ �IGN <br /> . <br /> PROJECT A�DRESS:y0 3 / Kra�,�,t2 r}Jr EJ��7- Lo7� <br /> owr�en V�ILAp011E55 cin zir ri�or+c <br /> 1)A��y i-�or�?E�S , =r1C• 3�8 - �77U <br /> IENANT MqL�00RE55 CIIY IIP PI�ONE <br /> ARCHITECTOR[1ESIGNER MuIA�ORE55 Cliv 7iP PIIONF. <br /> GENERKCONiMG1IXi M�ILAODRESS GIIY 7i1' P�IONE $f�TE11C[NSE• <br /> MECHANICALCONiRACTOR M�ILADDRE55 Cltt 71P PIIONF $tAfEULENSE� <br /> PLUA�BING CONTR�CTO{i MUL ADDRESS C17Y IIP NIIONE SiATE UCENS:� <br /> YACiF�[.r��27NaJE5T �cu.w�,aG, i�c. �.�. 3ox8'a3.39 R'e���ceE cJ� 8o�r�. �ia-!�Rc� �R�Z'Fti�Pi(�yC,a-i _ <br /> conr�uct vnicE oF wonrc <br /> HEATING SYSTEM: ❑GAS � ELECTRIC ❑ <br /> DESCflIBE WOBN ANO SOIMRE FOOUGE INVOLVED CO�IiALI PCpSON�ND PMONE NO <br /> �LNv ..I <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EitAMINEO THIS <br /> PiqPO5E0 USE OF Bl11LDING APFLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILI BE COMPLIEu WITH WHETHER SPECIF�E6 HEREIN OR <br /> LEGALOESCPIP710NOFPPOPERTY�SHOWNOELOWOqATiACHTWJCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK oF AUTHOF�ITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTFiER STATE OR LOCAL LAW HEGULATING CONSTRUCTIUN OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS F`ROPERTY TO PEFFORM THE WOqK FOfl WHICH <br /> APPL�CATION IS MADE AND I COMPLV WITH THE STATE <br /> ru�c¢iT��.o.wuueea — CONfRP.CTORS L9W 1827 RCW AND 296.200 WAC. <br /> CONSTRUGTIONLON1lENUER.AUURE55.lELEPHONENUMBER X Q-�Y,.,_.,,,�/__� � � ,�G ,e,�� S(/S/9� _ _ <br /> SIGN�t511fiL v7 �j' DAIE <br /> GTY BIISMf:SS LICf.NSL NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR iTEM FEE NO. 7YPE OF EOUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) � A/C—PJHNDLG UNfTS ' <br /> BATHTUB ; FORCED AIH SYSTEMS ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNITHEATERS ' <br /> KITCHEN SINK 8 DISP i CLOTHES DPYEflS i <br /> DISHWASHER � RANGE HOOD � <br /> / LAVNDRY TRAY � _ WATER FICATER _�_ <br /> / CIOTHES WASHER WOODSTOVE <br /> URINAL ' MEfAL FIREPLACE(WOOD BURNING) '�_ <br /> ORINKING FOUNTAIN i fIRFPIl�CE INSERT(WOOD BUPNING) i <br /> FIOOF DRAIN GAS fIREPLACF ' <br /> BACKFLOW PREVENTERS ; GAS RANGE � <br /> SINK(SERVICE—6AR,ETC.) GAS PIPING � <br /> � [XHAUST FAN <br /> i � <br /> � — i <br /> i <br /> _ - <br /> SUB TOTAL S � SUB TOTAL E � <br /> PERMIT $ � PERMIT S � <br /> TOTALFEE 8 � TO7AL FEE S <br /> FOR OFFICE USE ONLY: <br /> FRONTSETO�CN RE�{iSFTBACN SIDESETB�GK PI�NCIffCN IMOfIt fEF �Ef.FIPiNO <br /> USEZONE IOIMEA VAC�N1511F. FEES YAUlATION FEE <br /> ❑VES ❑ NO pWL01NG � <br /> NEIGMT LIMITATION NO OF pWELtING SIIE OF BIDGRI ; <br /> UNIfS Pl11MpWC <br /> ___ __��..� <br /> OCGUPANCY Np OiSIMtlES OCCUPANTlOnO B�SEMENT MFOInNIf.�I <br /> GRWP _ <br /> ❑VE$ ❑ NO <br /> FIRESPRINKLENREO'U �F�SON �OD�IIONAL�I�NG��(f.M , � <br /> �— <br /> OIIIUI <br /> FlREAUHMREO'0 Pf45pN "— <br /> ST�I C 01111 DING SUfiC1Uf1GE <br /> TYPEOFf,ONSi PL�NSAPPPOVE�BY CITYOFEVERETT rur,iir.wonxs ; <br /> LOCAL SALES --� <br /> n�iE TA% CODE IS J705 TOTnL _ <br />