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QPPLICATIG.J FOR CONSTRUCT.J1�/ PERMST <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • E`/ERETT, WA 98201 • 2F�-8810 '� <br />f1 DEMOLITION f i COMBINATION �! BUILDING IxMECHANICAL i 1 PLUMBING �i SIGN <br />I J Z..2- $' L f4"`'1 R(�C- c�!�' ��,J � I <br />owruea enm�aooaess ci*r zir vr�c��e <br />Ss�-� Vylon,�oE 3128 L,�*-+e�. �eu� Cv�E.c�— 9 82�3 Z.s� —L,3�8" <br />TENANi NAIL O�RE55 CITY ZIP —t :HONE <br />Sn-w, � <br />MAIL ADDRE55 <br />cirv zir <br />GENEFSIJONTpACTOR k/+ILADDRE55 CITV <br />MECHANIGAL^.ONiPACTOR MFILADGRF$$ CIN <br />)��°ra�L t�l-�NU �f4b2 �'yr �Fe <br />PLUMBINGCONTRACTOR AIAILAD�RE55 CITV <br />��,.,���...,���...��� 2�4y ,. � <br />OESCRIBE YIORK AND 9�IIRFE FOpTAGE INVOLVED <br />PROPOSEO 1/5E OF JUILDING <br />LEGAL DESGRIPiION OF PROPI <br />LOT 6LOCK <br />.� /rA� W '� �-"' <br />2.s �� t�l �rs�� <br />Of <br />CONSTRUCTION I.OAN LEKDER. AD�RE55, TELEPHONE NUMAER <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />KITCHEN SINK 8 DISP <br />DISHWASfiGR <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN7ER5 <br />SINK (SERVICE- BAR, Ei <br />SUB TOTAL S <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />Ff10NT5F.TBFCN Rf:AB5ET0ACH SIpE5ET8ACK <br />USE20NE IOTAREA <br />NEIGIITLIMITpT10N NO.OFOW[IUNG <br />UNITS <br />OCGU{'ANCV NO OF Si0HIE5 OCCUPANT IOID <br />GROIIP <br />FIREPLARMREOD REASON <br />FlRE SPFINKIEF PEO'D REASON <br />TVPEOFCO45i �'LANSAPPROVED9V <br />ZiP PHON[ STATEIICENSEr <br />ZIP PlIONE STATt �ILENSE � <br />!�Ct't', �i�1J3 2J—I''f91� A <br />ZI�^ PHOYE STATE LICENSE � <br />HEATING SYSTEM: /'�l GAS ❑ ELECTRIC f� <br />COtJTACT PEPSON AND PHONE NO <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PRGVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK rIILL BE COMPLIED WITH WHETHER SPECIFIED HERFIN OR <br />NOT. THE GRAN?ING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO ViOLATE OR CANCEL THE PROVI�ION OF ANY <br />OTHER STATE OR LC �AL LAW REGULATI4G P^NSTRUCT;ON OR 7HE <br />PERFORMANCE OF CONSTqUCTION. THAT 1!:^.i AUTHORIZED BV THE <br />OWNER OF THIS PROPER7Y TO PERFORM �S�HE WORK FOR WHICH <br />AP�'UCATION IS MADE AND I COMPLY WITH THc STATE <br />COI �� ^ACTORS LAW 1827 RCW AND'296200 WAC. <br />x�'��-�_ 3� �-�9 S` <br />51 A URE DAi <br />CITV BUSIN655lIGENSE NO. <br />FEE NO. TYPE OF FI%TURE OR ITEM FEE <br />A/C —AMNDLG UNITS — H.P. <br />; FORCED AIR SYSTFMS — B.T.U.�I M E.A. <br />i HEAT PUMP <br />! UNIT HEATERS — B.T.U. M <br />CLOTHES DRYER: <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />GAS FIREPLAC <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL 5 <br />PERMIT S <br />TUTALFEE 5 <br />PLnN C11ECK NUMOGR � I F[E � RECEIPT N0. <br />V4CANT SIiE ttt, <br />f1VF5 f'. NO OUILDRJG <br />SIZE OF BIOG?I. <br />PLUMpRJG <br />9ASEMENT MECMRNICAL <br />f7YE5 f7 NO <br />FODITIONAL PLAN CHECH <br />onren <br />STATE BUILDING SURC11AfiGE <br />CITY OF EVERETT ru[fucwonres <br />LOCALSALES <br />TAX CODE IS 3105 TO7AL <br />