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APPLICATI�,.� FOR CONSTRUC7 .JN PERMIT <br />, CITY OF EVERETT• BUILDING DIVISION <br />' 3200 CEDAR BTREET • EVERETT, WA 98201 • 259-8810 <br /> f7 DEMOLITION fl COMBINATION - BUILDING I 1 MECHANICAL Il PLUMBING fl SIGN <br /> PROJECTADDRESS /O// <br /> /�f� � ST, �r/�/zE ��, "r,rJQ• 98zo/ <br />�I O�IER MAILPDORESS CITY ZIP PIIONE <br /> ��. 9/�7ES �i�S /D// /h�P[� ;T // ,�.��T �l'�Z6/ �0 6 -Z S'z Zm6 3 <br /> TENRNT MAILAODRESS CIlV ZIP f'HONF <br />'� �� m�- <br />` ARCMRECTOfi0E51GNER MAILAUDRESS �IIY 21P PHONE <br /> — �/+-M-�_ <br /> GENERALCONTRACTOR /�� MAILPODRESS CIiV 21P PHpNG STATELICENSE� <br /> %V <br /> MECHANICAICONTR�CiOR MAllP00RE55 CITV ZIP P/IONE STATEUCENSE� <br /> /V � <br /> PW6181NGCONTRACTOq /�MAILADDRE55 CITV ZIP PHONE STATEUCENSEr <br /> ��/ <br /> CONTRACT PRICE OF WORK /� ��/ _ <br /> jV HEATING SYSTEM: ❑GAS fl EIECTRIC O <br /> DESCRIBE WOPK AND SOUA E FOOTpG LVEO p, /y /�+ CONTACT PERSON FNU PHONE NO. <br /> 7� ' I�� /l.�T"�G <br /> ZX� fi��r�� � Ns i�u�T1e�/ <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> Pao ED USE OFBUII�ING APPL�CATION AND KNOW THE SAME TO 6E TRUE AND CORRECT.ALL <br /> A- MO iC'.. E�l G�S PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIPTIONOFPROPERIV�SHOWNBELOWORATTACH7WOCOPIES� NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE <br /> �or 4a 8�N/��e�ocn��oF � F AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> 7� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE � <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH '�. <br /> APPLI ATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA%I.D.NUMBER CONT l�CTORS LAW 1027 RCW AND 296.200 WAC. <br /> 4387- 19z- 000 - l70/ y � n /J /� � / <br /> CONSTRlICT10N LO�N LENDER.ADDRE55.TELEPMONE NUMBER \;�/!� � ' �W✓ �._(C r�S-! <br /> �I ATl DATE <br /> CITY BUSINE55 LICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FI)CTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNITS—H.P. � � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.LU. M E.A. ; � <br /> LAVATORY(WASH BASIN) � HEAT PUMP i I <br /> SHOWER � UNITHEATERS—B.T.U. M � � <br /> KITCHEN SINK&DISP ; CLOTHES DRYERS ; , <br /> DISHWASHER � VENTILATION FAN � � <br /> LAUNDRYTRAY ; RANGEHOOD ' <br /> � <br /> CLOTHES WASHER i WATER HEATER � <br /> URINAL � ' WOOD STOVE ' <br /> DRINKING FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING <br /> i EXHAUSTFAN i <br /> � i <br /> � i <br /> SUB TOTAL S ; SUB TOTAL S ; <br /> PERMIT S � PERMIT S i <br /> TOTALFEE 5 ' TOTALFEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SLTBACK REAR SETBACON f. SiOE SET��BACN PLAN CHECN N MUER � F[E ' � /� AECEIPT�. � <br /> / Z I�'M� � (J�7 <br /> usezor+e LOTPREA VACFNTSITE FEES VALUATION FEE <br /> 59SZ nres No em�oiNo � C � <br /> HEIGHTUMITATION � NOOFOWEILING SIZEOFBI:IGRI. <br /> n A, UNITS � �l 4� p�pM�ING i <br /> D <br /> GOUPANCY NO OFSi0R1E5 OCCUPANTLOAD BASEMENT � � MECMANICAL i <br /> . � IlYES t{YRO i � <br /> FIREAURMPEO'D �E450N AODI➢OYAIPLANCNECK j <br /> T <br /> � OTHER i <br /> FIRE SPR NKLER PEO'D REASON <br /> i <br /> � STATE BUILDMG SURCNpRGE �D <br /> TVPE OF CONST PLANS APPROVED Qr CITY OF EVEREIT PUOUC WORNS � <br /> / �i N LOCAL SALES , <br /> ��3 DATE � Lf 9 S TAX CODE IS 3105 TOTAL ,� ; <br />