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APPLICATIOA�FOR CONSTRUCTI6N PERMIT <br /> CiTY OF EVEFiETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 '1'�' <br /> . . �- <br /> C7 DEMOUTION Cl COMBINATION BUILDING MECNANICAI � PLUAIIBING f� SIaN <br /> PROJECT AODRESS �'' � . l <br /> L) f�-=' 1 Gu� ('7•r�l o� (�J J�c.J <br /> OMMER M1uL�Dp1f55• GTY P1qNE <br /> ��.r��,�—T��G—.. o.�-c�n�c P.o �rc��r� �ra� �A .uaxr,-z��s r2�14�z <br /> 7E/MNT MIULIIOORE9a GTY 21P PNON[ <br /> I1NCM7ECTORDESIGNEN MIUt/iDDRE55 Qtt ZIP PNONE <br /> GENERI�ICONTMCTOR MNL/�DDRESS CITY � IIP PnONp STATEIICENSE� <br /> Tiir,o (c.���'u.�('o.� wc� .�.r= ncs .pr('�i Q�2 Ta[vts�lc�'iC�y <br /> M�A�.7�2]N �1� '�1y�1�7E55 �L�171 ST �✓V L NN4//IP -ll1�J� IIONE�`ST/1.�/ST�NOYc�SEL/LL�7/�/ <br /> nI .1 <br /> �� <br /> PLU1As1N6CONTRACTOR MML/i0DAE5S dTV 21P � HOI'E STATELICENSE� <br /> ZF -,,1T��� t � A <br /> CW TfU�T PRILE OF YIORK <br /> HEATING SYSTEM: GAS fl ELECTRIC fl <br /> DESCPIlE NV11R M!p$qJME FOOTIIO iNVOI�ED CONtACT PERSON ANG PNONE ��_ 1 � <br /> O n►G NE�J '" l.� <br /> �1 �i.e 1 C 486-?(e4 <br /> OZO I HEREBY CERTIFI' THAT I HAVE READ AN� E%AMINED TMIS <br /> APPLICATION AND KNOW THE S11ME TO 0E TRUE AND CORRECT.ALL <br /> vnavoseo use oc su�.ano PROVISIONS OF LAWS AND ORDINANCES 60VERNINO THIS TYPE OF <br /> � � WORK WILL BE COMPLIED W�TH WHE+HER SPECIFIED HEREIN OR <br /> � oescmmoKaraorEmrts�awHseiowa+�nncNn�rocar�es� NOL THE ORANT�NO OF A PERMIT DCES NOT PRESUME TO 61VE <br /> �oT �L s�p�c pr AUTHORITY TO VIOLATE OR CANCEL THE PROV�SION OF ANY <br /> OTHER STATE OR LOCAL UW RFOULAiINO CONSTRUCTION OR THE <br /> S�'�T "T , C. �, � -- �j q� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE ,,. <br /> U OWNER OF THI3 PROPERTY TO PERFORM TME WORK FOR WHICH � <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> VNiCELT1IXID.NUMBER CANTRACT AW iB�FY RCW AND 296.200 W�C. <br /> CON5��ICTI OMIIENDER.A0d1ES5.TELEPNONENUMeER /�� % (,�. !� 1 S 1� <br /> �hj SIONA �RE D�TE <br /> ITY BUSINE65lICENSE N0. <br /> PLUM&N6 MECNANICAL <br /> NO. TYPE OF FlI(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATERCLOSET(TOILE'� � NC—NFiNDLOUNITS—H.P. ' <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATOHY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITMEATERS—B.T.U. M ' <br /> KITCHEN SINK 6 DISP ; CLOTHES DRVERS � <br /> / OISHWASHER � VENTILATION FAN ' <br /> UUNDRY TRAY ' � RANGE HOOD i <br /> / CLOTHES WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE ' <br /> DRINKINO FOUNTAIN � METAL FIREPUCE(WOOD BURNIN6) � <br /> FLOOR DRAIN � FIFEPIACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING _�_ <br /> � EXHAUST FAN � <br /> � � <br /> i � <br /> � <br /> , � <br /> SI;B TOTAL S � � ' ' � SUB TOTAL S ' <br /> PERMIT f � PERMIT E � <br /> TOTALFEE S ' TOTALFEE E ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACN�_/ ���/ RE�NSETBALR. _ SIDESETB� �IRNCNEC�/M�� FEE/ REf.FlI'TNO. <br /> L/�i �/v � <br /> USEZONE 1 LOTAREA VACANTSITE FEES VALUATION FEE <br /> �✓ f1VE5 fi NO gUILO�NC 6 9 r ��O <br /> MEIGNT UMITATIOy_ 0 NO OF OWELUNG SRE OF BLOG/TJ. � <br /> /1�/S ur+its IO2 u S�f. Lr���� t vwuewc ,� �Qrl <br /> ��C/ So .c' . G �a£ <br /> GC�PANCY NOOiS10PIE5 OCCUPANTLO�O BASFMENT MELII�NIC�I � <br /> �,.� nres r�o � <br /> �DDIf10NAl PL�N CNECK i J <br /> FIRE MREO'D NEASON �U �Q _ <br /> i <br /> OTMER � <br /> i <br /> FIRE SPRINKLER REO'D AEASOH � <br /> 57�TEBWLO�NOSIIRCH��iGE � �-j7 <br /> ilL� <br /> TYPE OF f,ONST FUNS�PPPO ED BV CITY OF EVERETT �UBUf,WORNS �(.,�� (�(� <br /> LOCAL SALES — ---�,�.� "�; <br /> DAIE �j �J(o TAX CODE IS 3105 TOTA� � <br />