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AF�P'�.lCAT14.�1 FOR GONSTRUCT.JN 6��R11AIT��%� <br /> CITY OF EVERETT• BUILDiNG DIVISION <br /> 320p CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> �OEMA!.ITION ❑ COMBINA710N J ,❑ BUILGING ❑ MECHANIi.AL (_] PLUMBING ❑ SIGN <br /> T� / <br /> PROJECTADDRESS: l/// ,LC� �/,i��� /��.f � <br /> / <br /> M�iU00AEss iTV r�r r(���oNE <br /> ��ciu���� or- T�ic �dc�,�iWcs ; 332z �,:�� ���C �. G�-Y{L-�.oi 2�b 3� - 3oa� <br /> TEIUNT 4AllApDfif55 C lIP / Pi�OHE <br /> MCNITCGTOROESIGNER !A�ILADORF55 Citt l�P PHONE <br /> -NEi1ALCONTMCTOR r MAIUODRE55 / ❑If lIP p� PIIO [ I' �� � I [ <br /> �i iC C�-.L��, 1-.Xr.t1VAIln1G(NG �<�S/�.Q1�Q_�LZALLS I�—�R �rJv7n,J 9�3?�� -- <br /> MECIUNICALCONTRnGiOR AIRILAODRE55 CIiY PP PIIONE SiA1E1.ICENSE• <br /> PWMBINGCONiRACipR MAII��OPESS CIfV ZIP PIIONE SiAiELICENSE� <br /> CQVTP�CT PRILE OF WORN <br /> HEATING 5YSTEM: (� GAS ❑ ELECTRIC ❑ <br /> OESCRIBE N'OPN ANp COUAHE FOOT�GE INVOIVED CpNTRCT PCRSON�ND PMONE 110 <br /> I HERF.BY CERTIFY THAT I HAVE FlEAD AND E%AMINEU THIS <br /> hPPLICATION AND KNOW THE SAME TO �E Tf;UE AND CORREC7 ALL <br /> PROPOSEDUSEOFBUILDING PqOVISIONS GF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPEC�FIEO HEREIN OF <br /> LEGALDESGRIPTIONOFPROFfRTY�SHOWNBELOWORATTRGIITWOCOPIE51 NOT. fHE GRANTING OF A PERMIT DOES NOT PR9SUME TO GIVE <br /> �07 e�ocK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTNER STATE OR LOCAL LAW REGULATING C6NSTRUCTION OR THE <br /> PERFORMA4CE OF CONSTRUCTION.Ti1AT 1 AM AUTHORIZED BV THE <br /> OWNEa OF TIi1S PROPERTY TO PERFORM THE WOtiK FOR WHICH <br /> APPLICAT!ON IS MAOE AND I COMPLY WITH THE STATE <br /> PMCELTAXID NUTAOER CONTRACTOHS LAW 1827 RCW AND 296300 WAC. <br /> 7�j�'-6���n/7-�>��� _ <br /> CONSTRUCTION lOu!IEN�Ee,ADDRE55.iELEPNONE NUTABEP X _ <br /> $IGN�TUfiE ��T� <br /> Q7Y Ol'$IN[SS IICENSE NO <br /> PLUMBING MFCHANICAL <br /> NO. TVPE OF fIKfURE OR ITEM FEE NO. TYPE OF EOUIPMEKT FEE <br /> T <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNRS ' <br /> BATHTUB ; FORCED AIR SYSTEMS ; <br /> LAVATORY(WASH BASIN� i HEAT PUMP <br /> SHOWER UNITHEATERS ' _ <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS __�__ <br /> DISH WASHER RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER � <br /> _ T <br /> CLOTHES WASHeR � WOJDSTOVE <br /> URINAL � METAL FIREPLACE(WOOD�URNING) ' <br /> DRINKING FOUNTAIN FIREPLACC INSEFT(I^lOOD BURNING) � <br /> FLOOR DRAIN GAS FIREPLACE 1_ <br /> BACKFLOW PREVENTERS ; GAS RANGE _T_ <br /> SINK(SERVICE—BAR, ETC.) GAS PlPllv�i <br /> EXHAUST FAN <br /> — i <br /> _-- � <br /> i <br /> i <br /> SUB TOTAL S � SliO TOTAL E �_ <br /> PERMIT $ i PERAIIT E <br /> 70TALfEE E � TOTALFEE E <br /> FOR OFFICE USE ONLY: <br /> fRONTSETAALK PERtiSFTHRCK SIOESETB�CN �I�NCIICCNNIiAIOfe !EP RFf.FIPTNO <br /> r`7 �1 <br /> usEza+e ior�nen vC�r+rsrtE FEES VALUATION FEE <br /> ❑YES ❑ NO � <br /> �IllLOW(: <br /> IIEIGIIi UMITATION NO O�DWELIiNG SIZE Oi plIX:Rl • <br /> ❑NIIS PlUM01NG <br /> --"T— <br /> _ i <br /> OCCUPANCY 1q Of SIOHIES OCLUPRNL LOA� BASEMENi MfO1nNILAI <br /> GPOVP __'___ — '_ <br /> ❑vE5 0 N� <br /> FIflE SPRINKIER RFp'D RE�SON nDIJI110Nn1.Pl AN G�CCN — ! <br /> ____�— <br /> plll[Il <br /> FlREAIFRMREO'D �F�SON ��`� <br /> SiAIE OIIIIOiHG SIIRCIUIIGE — ' <br /> trrEo�r.or+sr rinNsenvnovenar CITYOFEVERETT runucwonKs _ <br /> LOCAL SALES — — -- <br /> �„� TAX CODE IS 3105 To7A� _ __ <br />