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r� <br /> APPLICA'�Il.�l FOR CONSTRUC7 �ON PERMIT/ <br /> CITY OF EVERETT•BUILDING DIVISION yC� <br /> 320U CEDAR STREET• EVERETT, WA 98201 •25Si-8;10 � <br /> fl DEMOLITION I� COMBINATION I-1 BUILDINC �MECHkNICAL t� pLUM81NG fl SIGN <br /> PROJECT ADDRESS <br /> Isolo 1-�Ew �-rT Av� <br /> 0� MRILAU�RE55 /�� /� • 1CITY 21P p40NE <br /> iENRNT� ��ANEYMAILAD��NAV�"1�/�JIT ��O�IPN�WI��11AV� . <br /> 5A-nnE <br /> ARCHRECTORPESIGNER MAILADDRESS CITY ZIP PHONE <br /> GENEf1ALCONiMCTOR MAILAOOBE55 CILY ]IP p110NE STRiELICENSE� <br /> MECHANIC�LCONTRA�TOR M�ILADD5E55 CITY ZIP PIIONE STATEUCENSE� <br /> PLUMBI4GCON7P�f,TOR MAILA�URE55 dI1' ZIP PIIONE 5(AIELIf.ENSE• <br /> CONTMCT PRICE OF WpqK <br /> HEATING SVSTEM: f 1 GAS rl ELECTRIC fl <br /> OESCRIBE WOBK AND SOU�RE FOOT�GE INVOLVED CONTACT PEBSON AND PIIONE N0. <br /> 1 HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL 6E COMPLIED WITH WHE7�HER SPECIFIED HEREIN OR <br /> LEGALDESCRIPTIONOFPROPERIV�SNOWNBELOWORA7TRLHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT eiocK or AUTHORITY TO VIOLPTE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE • <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF TH�S PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLIC:AI"ION IS MADE AND I COMPLY WITH TI1E STATE <br /> r�ece�Tnz i.o.r+uueen — CONTFiACTORS L.4W 18.27 RCW AND 296200 WAC. <br /> CGNS7AUi.TION LOAN�ENDER,AOlf�ESS.TEIEPHONE NUMBER ��(..,/ " �/��/�L <br /> _ S . ilt1E OAtE �T-- <br /> CITY BUSINE55 UCENSE N0. <br /> PLUMBING MECHANICAL <br /> N�• TYPE UF flXTL'RE OR ITEM FEE NO. TYPE OP EGUIPMENT FEE <br /> WATERCLOSET(TOILE� � A/C—A('rINDLGUNfTS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ' <br /> � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK 8 pISP i CLOTHE3 DRYERS ; <br /> DISHWqSHER � VENTILPTION FAN � <br /> LAUNDRY THAV ; RANGE HOOD � <br /> � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL � WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR ORAIN � FIREPLACF INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIFEPLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE � <br /> ' � GAS PIPING FT � � <br /> i EXHAUSTFAN � <br /> � � <br /> � x1'En>D EX�s P ro � <br /> � N6w mE'fF �ool� ro � <br /> SUB TOTAL S ; pER W N C� SUB TOTAL $ ; <br /> PERMIT $ i PERMIT $ � <br /> TOTALFEE S � TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETPACK RERRSF.TBRCK SIDESETBRCN PlRNC11ECKNUMOPR FEE RECEIPfNO. <br /> � � <br /> usezoNe ioranen vatnwsitE FEES VALUATION FEE <br /> f1VE5 f1 NO BWI�ING i <br /> i <br /> IIEIGIITIIMITATION NOOFDWELLING SIZEOFBLDGRI � <br /> UNITg <br /> PIUMpING � <br /> OCGUPANCY Iq OtStpRIES OLCUPANT�0�0 9ASEMENT I <br /> CROUP M[CIIANIf.AL ��On�1.- �/\ �oD <br /> t11E5 I1 NO �� <br /> FIqEAURMREO'D RFA50Y n�01110NaLPUNG�(CK � <br /> otr�En �SSUG � � �DO <br /> FIAESPRINKLEBPEO'D qEASON <br /> r <br /> 5141[OUILDMG SUnC11nRGE � <br /> TYPEOFf.pNST PIANSAPPROVEDOV CITYOFEVEREtt ���AlIf,1VORN5 <br /> LOCALSALES ;-- <br /> �q7E TAX CODE IS 3105 TOTAL � S 'OO <br />