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APPLICATIa:sl FOR CONSTRUC7'�N PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 32��0 CEDAR STREET• EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOUTION (� COMBINATION 13 BUILDING Cl MECHANICAL 11 PLUMBING Cl SIGN <br /> PROJECTADDRESS f,�_ -� �Sr�'- -,� //rl? f•;- -- , , '/ <br /> �(.� •�� C_i ih�,r� .�� �ve.ZT� �i.''�����/ �'�� � .� ;�^,;�/�� �'j�'�_ <br /> OWNEA l MAILADD9E55 Cltt IiP PNONE <br /> �N�c.. � KAnai /�i.;rJrr. 37iCi /Zt1Fi'AL �✓P.-C� l7f��0 / •�5:.� /Sa�f _ <br /> TENANT MAILADDRESS CITV 71P PI/ONE <br /> ARCNITECTOROESIGNEH MPII.AD�RESS e Cltt 7� 21Pp PHONE <br /> JF n7 - �7J^'10 �Nl�j' C�GIi'W(1� (-7 /�7/•� Cih/!It �O�o/ ��' `�c�cJ J <br /> GEN� CON7ARCTOR I �R�DRE55— I �' �_CITv _ �� Zli' P110NE STATELiCENSE� <br /> tC/JL �j� J� O� <br /> , <br /> MECHANICILL CONTRACTOR RIL� CIN ZIP PHONE STATE UCENSE� <br /> �D� <br /> PLUMBINGLONTR�CTOR MAILAODRESS GTY ZIP PHONE STATEUCENSE� <br /> CONTR�CTPRI FWORK <br /> — HEATING SYSTEM: �GAS ❑ ELECTRIC Cl <br /> DESCRIBE N/ORN AND SOUARE FOOTAGE INVOLVED CO• CT PERSON AND MONE N0. ,/ <br /> �✓ c.r, � i'oo s , Fz ^r.a !�I.l� 7'�� �;? <br /> � <br /> � ? 3 1 - 7Cia,l ' <br /> I HEREBY CERTIFY THAT I HAVE REA� AND EXAMINED THIS <br /> PROPOSED USE Of BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �iC rl(l WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LDESCRIP IONOFPROPERT�Y?�SM�OW�NJB owoan cNnvocor s1 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tor 3/,��37etocK_SL11�oF I� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> � � OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE <br /> r PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � <br /> OWNER OF THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA%ID.NUMBEP CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> �37y - 3��- 03(v - oo v / <br /> CO SiqUCT10N L01�N IENDER,ADDRESS.TEIEPHONE NVMBER I.' X <br /> � � LV Q{/"��1� SIGNATUPE DRTE <br /> p'1�•� �l�L�j� �1J rv 339 SjQ-f� CITYBUSINESSLICENSENO. <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � ! <br /> BATHTUB ' 2D7¢� PA�W� C '��= ��'�2Pe'I —�— <br /> SHOWERY(WASHBASIN) � �c� 41VIA1FsG �Z�� = 244�(d1.9p � <br /> � � <br /> KITCHEN SINK 8 DISP i r0 � <br /> �3.�1 1X'C�G�' l3 � : 11�3fi�,Zy —�— <br /> DISHWASHER � -----��� ' <br /> LAUNDAYTRAV ; 31G��{Z� .�I` �_ <br /> CLOTHES WASHER � � <br /> URINAL ' ' <br /> DRINKING FOUNTAIN � � <br /> FLOOR DRAIN � ' <br /> BACKFLOW PRE'✓ENTERS � _�_ <br /> SINK(SEflVICE—BAR.ETC.) � <br /> � � <br /> � <br /> � � <br /> --�-�-- <br /> � ; <br /> � � <br /> � � <br /> � —�— <br /> �_ <br /> SUB TOTAL $ � SU8 TOTAL 3 ' <br /> i <br /> PERMIT $ i PERMIT $ � <br /> TOTAL FEE $ � TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: 07, � <br /> fRONT SFTB�CN REAR SEIDACH � SIDE SETBcACN � PLAN CHE K UNOER �EE � ,/� RECEIPT NO��� <br /> � ✓ " <br /> use zor+ �or naen VACFNT SITE FEES VALUATION FEE <br /> �' - � nves n r+o owioiNc �fj Z — ?q5 I �O <br /> HEIGHTLIMITATIO / UNIiSDW�LING SIZ�Of-0UG/i�n^� � i <br /> 4 el15 ��� UMBING _ � <br /> o� <br /> GROUPANCV NO OG STORIES GCCUPANT LOAO BASEMENT M[GNANIC?. i <br /> M 3 +YYES fl NO i <br /> ADD1T10�4�L PLAN CNECK i <br /> fIR AUAM�R./EO�'D FEASO�N��A /�,�7' � <br /> Y{7y' vT`t'!/y�FYbV�/ OTHEfl � <br /> fIPE SPRINKGLE/R REOD REASON 'jYD .� � , <br /> YY// �� O�� STATE OUIL�ING SURCIIAAG[ J i j�J <br /> TVPE OF CONST. �LANS APPROVED BY CITY OF EVERETT PUBLIC WORKS �� i <br /> •�t'T.� � ,►M LOCAL SALES <br /> y' onrE 9Cj TAX CODE IS 3105 70TAL ,;� � 7�J <br />