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APPLICATIG.J FOR CONSTRUCT JN PERMIT <br /> CITY OF EVERETT•BUILOING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION L'�COMBINATION f7 BUILDING CS MECHANICAL f/S PLUMBING �, �,f7�SIGN <br /> PROJECT ADDRESS •• � <br /> 5 2 C tv� c c.; �� a., � E.� �Y cft- <br /> OWNER MAILAOORE55 LITV Z�p PNONE <br /> �iOr.�t� Qor.aS�d� 5 .1 6 MCC�, \\ ILVk �Jt+1T� QQLOQ7 35S \32(a <br /> TENRNT MRILRDDRE55 CITY ZIP PHONE <br /> AqCHITECT OR DESIGNER MAILADORE55 GITV ZIP PHONE <br /> GENERQCONTRACiOR MRI�ADUfiE55 qTV 71P PIIONE STATELILENSE� <br /> �1CCHANIL�L CONTPACTOR MAIL ADDPE55 CITY ZIP PHONE STATE UCENSE� <br /> � �Wv�iJ <br /> PLUMBINGCONTRRCTOR MAILAWRE55 CIiY 21P pHONE ST�TELICENSE� <br /> � OWV�lf <br /> CONTH�CT PRICE OF WORK <br /> HEATING SYSTEM: fYGAS ❑ELECTRIC ❑ <br /> DESCRIBE WOFiK�NU SOUARE POOTAGE INVOLVEO CONTACT PERSON ANO PMONE NO. <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PRp�OSED USE OF BUILDIN6 APPLICATION AND KNOW THE SAME TO BE 7AUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES 60VERNIN6 THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEQ��DESCRIPTIONOFPROPERTV�SHOWNBELOWORATfAC11TWOCOPIES) NOf. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � <br /> �or 5 BLOCK�oF Zi�� �• �"��5`^� � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REQUUITINO CONSTRUCTION OR THE <br /> V o\"�n.� \\ 'I ���taS.n �0 c � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> , � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> SY�c��� Cuuv� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> r�wcEiT�x i.o.NUMeea ' CONTRACTORS LAW 18.27 RCW AND 296200 WqC. <br /> `\%oz ooa oos 000g x �/� <br /> CONS7AULTION LOAN LENDER,ADDRE55.IELEPHONE NUMBER �'�,q- �S <br /> SIGNATURE OATE <br /> Ol/�1 <br /> . QTY BUSINE55 LICENSE NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF flKTURE OR ITEM FEE NO. TYPE OF flXTURE OR ITEM FEE <br /> WATER CLOSET(TOILEn � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ' FORCEDAIRSYSTEMS—B.T.U. M E.A. ' <br /> i <br /> IAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRYTRAV ; qAN6E HOOD � <br /> CLOTHES WASHER � WATER HEATEH � <br /> URINAL ' WOOD STOVE � <br /> DRINKINO FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNIN�) � <br /> BACKFLOW PREVENTERS ; DAS FIREPLACE ' <br /> � <br /> SINK(SERVICE—BAR,ETC.) � OAS RANGE � <br /> ' 6AS PIPING ' <br /> � ExHAUST FAN � <br /> � � <br /> i � <br /> i � <br /> � � <br /> SUB TOTAL $ � SUB TOTAL E � <br /> � PERMIT $ � PERMIT S � <br /> TOTALFEE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACN PEAR SETBRCK SI�E SETBACK PIAN CH N ER FEE RECEIPT NO. <br /> USE20NE LOTAREA V�Cr1Ni51TE FE S VALUATION FtE <br /> IlYES Il NO 0111LDING i <br /> i <br /> MEIGMT LIMIT�TION NO OF UWELLING SIIE OF BLOGR.I. � <br /> UNITS P�UM9ING i <br /> IX'CUPANCY NO Of Si0RIE5 OCCUPANT LOAD BASEMENT MECHANICnL � <br /> GROUP <br /> ❑VES ❑ NO � <br /> FIREAI/1RMRE0'D REASON � <br /> ADDITIONAL PIAN CHECK <br /> _ ' <br /> OTHER i <br /> FlPE SPPINI(LER REO'D REASON - <br /> i <br /> STATE BUILDING SURCl/RRGE � <br /> TYPEOFCONSi PIANSAPPROVEDBY CITYOFEVERETT PVBLICWORNS � <br /> LOCALSALES , <br /> DATE TAX CODE IS 3105 TOTAL ; <br />