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- -. <br /> APPLICATIOI. FOR CONSTRUCTItiN PERMIT <br /> CITY OF EVERETT•BUILOING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259•8810 <br /> CJ OEMOUTION Cl COMBINATION BUILDING _ MECHANICAL � PLUMBING fl SIGN <br /> PROJECT ADDRESS � �--0�'/ 7 � 1 <br /> %�D� 7 G�tiP_ �c ��� (�Cl <br /> OW;N�ER MulA00nE55. CIIY 21P PMONE <br /> ��1��oi3ST�''v�o..l �1�C- QL� �7� �l�Ca ' L,.�A W Safi-��� l��l� <br /> TENANT Mq��DDRES C.ITY �IP PHONE � <br /> ♦NCMrtECTOROES�GNEH MAILADpRE55 LITY ZIP AHONE <br /> GENEH0.CONTnA�Tdi M�IL�UDRE55, CITY pip PUONL S1�TEUCENSE� <br /> Tuco (�as���,�('p.�. W� .�E � ,prC�� T�lrvti�k� <br /> MECNANILALCONTRALTOR MMI�D E55 � CITY � ZIp �jQ��2� ONE ��ST�TE�IICEiSE• � <br /> �Qt�'�,r�oiJ � 'raJ� � (2asf�r �,nl LuN WCY�D -«�� �1�7 N .2 �Il <br /> PIUMBIN6CONTRACTOR MAILADDRESS CITV Z�p YO E STATELICENSE� <br /> ZF. � r. 1 A <br /> CQNTR�T PRIf,'E pF WpRK <br /> HEATING SYSTEM: GAS fl ELECTRIC I-1 <br /> OESCRIBEWJHKI1Np$pUMEF00TA6 MVOLVEO CONTACTiER50N11NQPNONEN , <br /> O NG fJf� 0� .S F. A �L l..<<.l ���Z-4�-) �i-+c <br /> �1 Gt� i �(�Ic� _ 4is��?f�FS <br /> U I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> P�OSED UJE OF BUILDIlq APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> , � PROVISIONS OF LAWS AND ORDINANCES 60VERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WlTH WHETHER SPECIFIED HEREIN OR <br /> LEG LOESL PTqNpFpiqPERTY(SNOWNBELOWpi�TfACH7YqCGPIES) NOT. THE �RANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ot e�ocK pr AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW RE6ULATINO CONSTRUCTION OR THE <br /> O. E � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> PMCEL T/J(I.D.NUMBER CONI' O 6A�1 1 7 RCW AND 286200 WAC. <br /> C01�STR�C71 OAN LENDER,KqRE55,TELEP110NE NUMBEN W`T��I(Hy W�GL`��/�.�,� �I--iS� <br /> N��LJ SION URE DATE <br /> CITY BUSINESS IILENSE N0. <br /> PLUMBIN6 MECHANICAL <br /> NO. TVPE OF FlXTURE OH�TEM FEE N0. TYPE OF ECUIPMENT FEE <br /> WATERCLOSET(TOILE� � q/C—NHNDLOUNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � <br /> UVATORV(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN cINK 6 DISP ; CLOTHES DRYERS ' <br /> DISHWASHER � VENTILATION FAN � <br /> IAUNDRY TRAY ' ; RANGE HOOD ; <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ' <br /> SINK(SERVICE—OAR,ETC.) GAS RANGE <br /> ' GAS PIPIN6 ' <br /> � a E7CHAU5T FAN , <br /> � , <br /> � � <br /> � � <br /> —�— <br /> SUB TOTAL S � � � • SUB TOTAL E ; <br /> PEiiMIT S � PERMIT E � <br /> TOTALFEE S ' TOTALFEE E � <br /> FOR OFFICE USE ONLY: <br /> FPONTSETBACN � RE�RSETBALR � SIDESETB�CN P��NCIIECNINMBER fEF /� REf.fIPTNO. <br /> .''I� � �/O , � <br /> usEior+ �� IOTAREA wcu+rsrce FEES VALUATION FEE <br /> f1YE5 fl NO —� <br /> B°����"° 63 2�3 y-�c �Xo <br /> MEIGHTUMIT 10 NO.OFUWElUNO SIIEOFBLW�fI -- <br /> UNITC � <br /> i io� S F. !.i✓.N�-r vwr�ewc � I c7d <br /> _c. . Gnen�� <br /> OCCUPANf.V NO O�S�MiES OCCUPANTLO�D BASEMENT � <br /> GROUP M[WUNICRL /—.', i C�._� <br /> n 3 V. � ya nres o — <br /> l%1 � <br /> ADD�710N��PL�N CNECK <br /> FIqE MMM REO'0 REASON � <br /> OTNER � <br /> FI(�E SPRINNIEH REO'D RE�SON � <br /> i <br /> ST�TE BUItOMf.5URC1UqGE i (�� <br /> i <br /> TYPEOFf,ONST PLANS�PPPQVEUBY CITYOFEVERETT PUBUf,'NCNrtti ���i�� <br /> v �' LOCALSALES --���) <br /> �"�"� O�TE 3 ZU 4(p TAl( CODE IS 3!OS TOTAL � � '� <br />