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APPLICATIL.� FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> rl DEMOLITION f-I COMBINATION rl BUILDING � MECHANICAL fl PLUMBING rl SIGN <br /> PROJECTADDRESS ��Z` P���(� <br /> ONRJEA NPILADDRESS CI7Y 21P PIIONE <br /> �'aMN �Fi�s7- 2�L1 PRNA�t/if[v £vs,ee�T 98'zv3 3ss-z�z/ <br /> IEN✓RNT MFIIpD�PF55 CITY ZIP FHONE <br /> /!' T�C . <br /> ARCIIITECTOROESIGNER MAILPDDRESS GI1V 21P PMONE <br /> GENERALCONTPACTOR MAILADORESS CIiV 211' PHONE STATELICENSE� <br /> MECH�NICALCONTRACTOR MAIIADDRE55 pITY ZIP PIIONE STATEIICENSEM <br /> T,ve,�,ps�ri,tlG �" Tft7� <br /> PLUMBING CONTRRCTOR MAILAUDRE55 CITY 21P PHONE STATE UCENSE Y <br /> CONiAACi PRICE OF WORK <br /> �5-�j HEATING SYSTEM: �GAS ❑ E�ECTRIC f7 <br /> DESCRIPE WORK qND SOUARE FOOTAGE INVOLVE� CONTr1CT PERSON ND PHONE NO. <br /> GyE'/z L i � � ' � � , f,' <br /> I HEREBY CEfiTIFY THAT I HAVE READ AND EXAMINE� THIS <br /> PROPOSED 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 BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGRL�ESCRIPIIONOFPROPERN�SHOWNBELOWORA7'TACHTYOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ot e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZEO BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEITA%I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSIRUCTION LOAN LENOER.ADDRE55,TELEPMONE NUMBER X 1 �f/��� �j/9/7� <br /> sic TURE�0�2��—�onr <br /> LITY BUSINE55 LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF fll(TURE OR ITEM FEE N0. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILE'n � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.0 E.A. ; <br /> IAVATORY(WqcH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HOOD ; <br /> CLOTHES WASHER � WATER HEATER --T <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIRF.PLACE i <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' CaAS PIPING ' <br /> i EXHAUSTFAN � <br /> � � <br /> � �� <br /> � � <br /> SUBTOTAL 3 � SUBTOTAL S v � <br /> PERMIT S � PERMIT S � <br /> TOTALFEE S � TOTALFEE S �' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETOACN RGARSETOACK SIOESETBACK PLANCIIECKNUMOER «E RECEIPT�IO. <br /> USE20NE LOTAREA VALRNTSI7E FEES VALUATION FEE <br /> ❑YES fl NO BUIl01NG � <br /> HEIGHTIJMITATI]N NO.OFOWELLING 512EOFBLDGRI, i <br /> UNITS PWMI7ING � <br /> Ol'UPANCY NO OFSi0RIE5 OCCUPANTLOAO BASEMENT j <br /> GROUP MECIIANICAL i <br /> ❑Y@5 ❑ NO i <br /> FIRE AURM REO'D pE�50N ADDIPONpL PLAN CIIECK I <br /> OTNER ' <br /> i <br /> FIRESPFINKLERFlEO'D REASON i <br /> STATE OUILDING SURCHAfiGE i <br /> T <br /> TYPEOFCCNST PLANSAPPROVED9V CITYOFEVERETT rooucwonKs � <br /> LOCAL SAI.ES � <br /> DAIE TAX CODE I� 3105 TO7AL I <br />