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APPLICATI�.,.� FOR �ONSTRUC7 _JN PERMIT <br /> CITY OF EVERE'fT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETf, WA 98201 •259-8810 <br /> �l DEMOUTIOk fl COMBINATION �'Q BUILDING 3Z( MECHANICAL � PLUMBING f-1 SIGN <br /> PROJECTADDRESS �a3 �. l�,/C1� ES <br /> o� 1 It�'r'' Maanooness cirv zir vr�or+e �y� _ QOy� <br /> YS�I <br /> IENANf MNLAOORF:55 CIIV ZIP PIIONE <br /> ARCHRECTOf10E51GN[R MAILAO�RESS CITY ZIP PMONE <br /> ( � D <br /> GENEiiALW R�CTOR MAILA�DPG55 QtV 71P PNONF STATF.LICENSE• <br /> �-i..;c� ('�n5� ISR'o� a3�`f S�. NE. Snc�i�m�sl� h�d9v 33`I-7��3 /...J}�Gc 'K IOIOFi <br /> MECHANICALCONTR4CTOR A7RILADORE55 CIN ZIP PHOK" ST�TELICENSE� <br /> PLUMBINGCONiRACTOR MAILADDfiESS Cltt ZIP PHONE STATEIICENSE� <br /> ��s � � � � h r,� h a�c � � - �3� AR S ,I �Kla313D <br /> CONTRACi PRICE OF WOR <br /> f p�,`� HEATING SYSTEM: 17 GAS �(1 ELECTRIC I-7 <br /> DESCRIBE WORKANO SOrUAPE OOi�G INVOLVEO CONTaCT PERSON ANO PHONE N0 I' <br /> � <J rp✓ ,� ' IK¢ �lSC.n 33t��" � 7 <br /> .1_2— <br /> �C=J Dc� Gf7 2 � %� <br /> O < I ' �'✓nm�n. i HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS <br /> PFOPOSEDUSE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � ��L � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> Qr I` WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �otpLDESLi S i 4 B�K RTM�s�(�ow�q�crrtw�coP�s��� NOT. 7HE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � e•t W AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> 2 1 I_ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> I��e n+.f. .) -�. 3 Z. S�,)YM�.�'l PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I ('OMPLY WITH THE STATE <br /> PAflCELTA%I.D.NUMBER CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br /> Y391- H71�- oi5 - olo3 ' �//� n (�(� <br /> CONSiRUC 01ytOAN LENOER.AOOHESS.TEL PHONE NO�MBER ^ Q X ���Q� Z/ �GL� % -/��'- /J <br /> eG ✓ [ S SIGNP RE OATE <br /> CITY 9USINE55 LICENSE NO. <br /> PLUMBi�..; MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF FIXTURE OR ITEM FEE <br /> � WATER CLOSET(TOILET) � A/C—AMNDLG UNITS—H.P. � <br /> � BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> � LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS—O.T.U. M ' <br /> � KITCHEN SINK 8 DISP i � CLOTHES DRYERS i <br /> D�SHWASHER � VENTILATION FAN <br /> LAUNDRY TRAY ; � RANGE HOOD i <br /> CLOTHES WASHER � WATER HCATER � <br /> UR�NAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FIOOR DRAIN � FIREPLACE�NSERT(WOOD BUFNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) GAS RANGE � <br /> ; GAS PIPING ' <br /> i E%HAUST FAN i <br /> i i <br /> SUB TOTAL S ; SUB TOTAL 5 ; <br /> PERMIT S � PERMIT 5 � <br /> TOTALFEE S � TOTALFEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETFfACK RE4f1 SETBACR SIDE SETBACK PLAN CNEC NUS�O[R iEE RECEIPT NO. <br /> � ��C� `�, \'�l7 <br /> usezowe LOTAREA Vr1CANTSITE FEES VALUATION � FEE <br /> nves n No � <br /> ouaomc 2 q�a � ; ,v <br /> HEIGNTLIMITAiION NOAFDWGWNG SIZEUFBLOGT. � � <br /> llNliS �xl.,l �(t PL111.1flING J- � L�) . � e.l <br /> 7 (/ <br /> OCCUPANCY NO OFSi0pIE5 OCCUPANiLOFO BASEMENT �,�[CH4NICAL I�� � � � <br /> GBOUP <br /> ,3 ��ES � o , <br /> FIPE RIARM REO'D �EASpN AODIiIONAL PLAN CHECK i <br /> Oi11ER � <br /> � <br /> FIPE SPRINKLER REOD REASOY 1 <br /> STRIE DUIL�MG SURCIIARGE i(`D <br /> TYPEOFCONST PLANSA�OVEDBY � <br /> CITY OF EVERETT PUBIIC WOf1KS <br /> �{ �J LOCAL SALES ���71 <br /> �L-/J DATE q w �s TAX CODE IS 3105 TOTAL 9� av <br />