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�. — <br /> APPLICATIOh FOR �CONSTRUCTItiN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION ,� i,� , 4�.�� <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810' <br /> f7 DEMOUTION Cl COM8INATION BUILDIN(i MECHANICAL � PLUMBING fl SIGN <br /> PROJECTAODRESS //�a� � ��� /�� <br /> owr�n rw��oon¢ss . an zir vNw¢ <br /> I Cv O Y'.'tJ.-�I�O..I IJ�C- <br /> TENANT MNIADME GTY ZIV V11pNE <br /> ARQIITECTpqpESMaNER MMlAODiiE55 GTY 21P PNGNE <br /> �1.�� Tl �v�l�.�.'L�1/�..�EI�� � �S Y�\.�4/ 11' PIION[ 1"SLfJLi�sE�� <br /> Ir <br /> ME�✓t���T ����E53(o�� (ZisTST Snl I.UNn1W(1'iD ��3� 110NE�`1��ST��O�,SF��� <br /> MUMOINCCONiRACTOP MMLMDRE55 CITY 21V Iq E STQELICE.NSE� <br /> ZF - � t � A <br /> CONTMCT PPICE pF WORK <br /> HEATING SYSTEM: �GAS fl ELECTRIC fl <br /> OESCFIBEWORK�NOSOWREFOOTKi MYOIVED CONTACTPERSON�NQi1qNEN <br /> O;� fVE►�.) 1 O7 5 �. " �, OZ' 1 F'►.+c <br /> SirlC�i.� �i C 455�—?(�� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED 1HIS <br /> vaovos¢o use a evapr+o APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.l�:'_ <br /> 1 � PROVISIONS OF LAWS AND ORDINANCES 60VERNIN6 THIS TYPE C1F <br /> WORK WILL BE CAMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LE' OESCRIPTIp10FPIqPERTY(5lqWNlELOWORATTII�NTWOCOPIES� NpT. THE �RANTINQ OF A PERMIT DOES NOT PRESUME TO GIV! <br /> �or.�_e�oa oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> � # PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ' OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICM <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PNiCELTNt I.D.MttABER CONTFi�C70R AW 1827 RCW AND 298.200 WAC. <br /> �/�` <br /> Cp15TRUC�y�.OIW LENDER.MDRE55.7ELEPNONE NUMBEH /YVh r L ' n`f�I � — <br /> C1_�j�:�LJJOA SIGN E D�TE <br /> LTY BUSWE55 LICENSE N0. <br /> PWMBING MECMANICAL <br /> NO. TYPE OF flf(TURE OR ITEM FEE N0. TYPE OF ECUIPMENT FEE <br /> WATENCLOSET(TOILET) � NC—NHNDL6UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATOHY(WASH BASIN) i HEAT PUMP � <br /> SHOWER � UNIT HEATERS—B.7.U. M � <br /> KITCHEN SINK d DISP ; CLOTHES DRVERS ; <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ' � RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER � <br /> UR�NAL ' WOOD STOVE � <br /> DRINKIN6 FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNIN6) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ' <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE —T <br /> �_ <br /> ' GAS PIPING ' <br /> � EXHAUSTFAN � <br /> --�— <br /> � � <br /> i � <br /> � <br /> � <br /> SUB TOTAL S � � ' SUB TOTAL E � <br /> PERMIT S i PERMIT E � <br /> TOTALFEE 3 ' TOTAIFEE S <br /> FOR OFFICE USE ONLY: <br /> fRpNTSETBACK _/ RE�RSEtBACK / S�DFSETB�CN / PlRNC11ECNN/U�ER � FEE /� P.Ef.I'miNO. <br /> �I� ��% � S J� � <br /> u5E20NE � IOTARE� V�;�NTSITE FEES VALUATION FEE <br /> f1YE5 fl NO BUILOING 6 'z(�3 �.J3S- <br /> MEIOMT�IMITATIO NO.OF OWELLING SIZE OF BLOGRt. � c3 � <br /> I UNITS ���� ,{;F, Liviti��� p�UA��ING <br /> o r.F. Gna,��. _. ' ��� <br /> GROUP�NCY NJ Oi510A�F5 OCCUPANTLO�D B�SEMENT � � MEGHANiC�L �� i �O <br /> n� U-1 � /�( f1YE5 f�0 ' i <br /> fIRE RNREO'D AEASON 60DITIONALPL�NCHECN � <br /> i <br /> OTMER � <br /> FIRESPRihR�ER47E0'D AEASON <br /> $TATE BUILDING SURGM�eGE �s� <br /> _ _'_ �._ <br /> TYVEOFf,ONST PUNSAPPROV D r CITYOFEVERETT �UBIIf,WORNS L�� <br /> rJv��� <br /> �— LOCAI SALES -- -- " <br /> � "�tl o�TE 3 �o �jG. TAX CODE IS 3105 TOTAL � ; �-'� <br />