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APPLICATII.N FOR CONSTRUCI rON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 38201 •259-8810 <br /> f� DEMOLITION �COMBINATION 't+�BUILDING I� MECHANICAL pCPLUMBING rl SIGN <br /> PROJECT ADDRESS rj L' ( p , f D ( � <br /> J o n� —f r��i� <br /> !71)f� � l D'9J fJ� �"aa.� ! IL . I`J�'3W� .�VP Y�i7" 1 zir r�ioNe <br /> 0 iv �R'aor � s� � 12�7 <br /> TEN NT MAILAppRE55 CITY ZIP PNONE <br /> Sc�-� us a 1� +.�L <br /> ARLHITECTORDESIGNER MAILA�ORE55 QTY T.IP PHONE <br /> GENERALCONTR/.CTOR MAILP�ORE55 CRY ZIP PHONL STATELICENSE� <br /> ,t�r��, ('�sd is�v� a�«Is,l-�a� ���,�nti 4�'a4d ��N-��33 �.�s� c ��o�oN <br /> MECHANICALCONTRACTOR MAILADOPE55 CIiV ZIP PIiONE STATELICENSE� <br /> PLUM�GCONTRACiOR MPILADORESS Cltt ZIP PHONE STATELICENSE� <br /> �n t c s�G,� � 'G� 4 a ya3� k' s1� �Y �a3 81� <br /> CONTRACTPRICEOFWORK � � o�, HEATINGSYSTEM: y�'GAS S�ELECTRIC ❑ <br /> OESCRIBE WORK AN�SOl1ARE FOOiAGE INVOLVED GONTACT PERSON AND PH N[NO. <br /> � ' � > sin. � �39-7?33 <br /> ��W�crt�c � ,� <br /> I HEREBY CERTIFY THAT I HAVE READ AN� EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSED USE OF BUILOING , � .I • � pROVISIONS Or IAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> � JS WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEGALDF�SCRIPT10L4110�10PERNo1 H.�O'WNBELOWORA �Hiwo OPIE51 NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �p7 (1 '�iccK_�d /_oF�NL AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> !� 1 'I � OTHER STATE OR LOCAL L�1W REGULATING CONSTRUCTION OR THE <br /> I )1� . �� OL[�QR�..� Yo �_,1� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � o! w AFPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTORS Ll�W 18.27 RCW AND 296.200 WAC. <br /> PARCELTA%I.D.NUMBER <br /> CONSTRUGTION LOAN LENDER.PODRESS,TELEPNON�IIMBER �( `_���'/�j���� ��7/� <br /> SIGNATURE DATE <br /> CIN BUSMESS LICENSE NO. Q 2� <br /> PLUMBING • ' MECHANICAL <br /> NO. TYPE OF flXTURE OR�TEM � FEE NO. TYPE OF FIXTURE OR ITEM FEE _ <br /> WATER CLOSET(TOILET) � A/C—NHNDLG UNITS—H.P. '_ <br /> ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � BATHTUB � ' <br /> 1 LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> � <br /> KITCHEN SINK 8 DISP � i CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAY ; RANGE HOOD T_ <br /> CLOTHES WASHEH � � WATER HEATER ' <br /> URINAL ' WOOD STOVE � <br /> DRINKING FnUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> GAS FIREPLACE � <br /> BACKFLOW PREVENTERS � � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE ' <br /> � GAS PIPIPIG � <br /> � EXHAUSTFAN ' <br /> � <br /> i <br /> i � <br /> SUB TOTAL 5 ; SUB TOTAL 5 ' <br /> PERMIT S i PERMIT 5 � <br /> TOTALFEE 5 � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> fRONT SEifiACK REAR SEiBACN SIDE SETOALK PL�N CHECN fjUM4Fi7 �; FEE RECEIPT NO. <br /> 0 ���% <br /> usezove iornnen VACANTSITE FEES VALUATION FEE <br /> nres n r+o � <br /> . BUILDING �; 7 ,� � ��'� <br /> HEIGIIT LIMITATION 110 OF DWEIUNG SIZE OF BLDGRI. � O <br /> 'O <br /> UNIT$ PLUM1IpING � <br /> i <br /> OCC�"ANCV NJ OGSTOPIES C.CUPANTLOAD BASEMENT tdECHANIC4L � <br /> GRO��' IlYES Il NO � <br /> ADDITIOYALPLANChECK ., i <br /> FIRE AURM REO'0 REASON <br /> i <br /> OiHER � <br /> FIRE SPRINNLER REO'D REASON � '� <br /> SiAlEC71l01NG5URCINAGF 1 � �' <br /> i <br /> rvaeoccousr P�nr+snrrnoveoov CITYOFEVERETT rueucwonKs � <br /> LOCAL SALES <br /> oATE TAX CODE IS 310ti TOTAL <br /> ��. �-_ <br />