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APPLICATI�.nI FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> f7 DEMOLITION fl COMBINATION f l BUILDING f 1 MECHANICAL f l PLUMBING f� SIGN <br /> PROJECTADDRESS Ii� I q �aL�2 5 ��1'1 � <br /> lJ � <br /> OWNER MAILr1�URESS DakeS P�.�c. G��/�rci'F" �$E� � ����J�� 1 <br /> �1 t✓l �\l_I O l�1 �5 � � <br /> IENANT b1NL��ORF.% CIiY ItP PIIONF <br /> ARCHITF.CTORDESIGNEA MAILA�ORE55 Cltt ]iP PHONE <br /> GENERALCONTRACTOR MAR�DORESS CIIY 21P PHO4F: ST�TGLIC@NSE� <br /> ME/C�ICALCONTRACtOR MAILADORESS Cltt ZIP PIIONE STATELICENSE• <br /> / AC)/L�'v <br /> LP UMBINGCONIR�CTOR MAILAODl7E55 CIfY ZIP PHONE STATCLICE�15Er <br /> CONTRRCT PRICE Of WORK <br /> HEATING SYSTEM: I 1 GAS Cl ELECTRIC fl <br /> OESCRIBE WORK ANO SOUARE FOOTAGE INVOL CON1ACi FERSON AN�PHON@ NO <br /> .TV�S�x-�� 3 IY� � <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORAECT.ALL <br /> PROPOSEDUSEOFBl11LUING PROVISIONS OP LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> S�� � WORK WILL BE COMPLIED WITN WHETHER SPECIFIED HEREIN OR <br /> LEGRLUESCRIPTIONOFPROPERTY�SHOWNBELOWORATfAC11TWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tor eiocK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHEi7 STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNE7 OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> PARCELTAXLD.NUMBER <br /> CONSTRUCTIONLOANLENDER.ADDRESS.TElEP110NENUAIBER �'��'�' �'/ �/_�� <br /> SIGNATURE DA <br /> CITY BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAI <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TVPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A!C—AMNDLG UNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEAIS—B.T.U. M E.A. T_ <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTIIATION FAN ' <br /> LAUNDRY TRAY ' RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DFAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS i <br /> GAS FIREPLACE � <br /> SINK(SERVICE—BAR. ETC.) GAS RANGE ' _ <br /> � GAS PIPING � <br /> � EXHAUST FAN � <br /> � ' <br /> i i <br /> SUB TOTAL S � SUB TOTAL 5 i <br /> PERMIT 5 � PERMIT S � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OPFICE USE ONLY: <br /> FRONTSET�ACN PE�RSET�ACN SIDESEi9ACK PIANCNECKN�GR FEE pECE1PTN0. <br /> usEzoNe LOTAREA vncaNrste FEES VALUATION FEE <br /> �7VE5 fl NO � <br /> ounoi�+c 1 <br /> HEIGHT LIMITATION NO OP DWELLIkG 512E OF OlDG41 � <br /> i <br /> UNITS PLUMOING � <br /> i <br /> OGGUPANCY N00�51CRIE5 OCCUPANTLOAD BASEMENT !,•[ClIANICAL i <br /> GROUP <br /> ��YE$ fl �10 I <br /> A�OITIONAL PLAN C4ECK � <br /> FIRE PIARM qE0'� fiEA50N � <br /> � <br /> OTHER � <br /> i <br /> FIRE S�'A�NKLER REO'0 REASON i <br /> STATE OUILDING SUfiC11nRGE � <br /> r <br /> rvreoFcorisr. c�nNsnrrnovEoov GTYOFEVERETT runi.icwonns � <br /> LOCAL SALES { <br /> ontE TAX CODE IS 3105 TOTAL ' <br />