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-. ^ <br /><<,. . . <br /> APPLICATIt�N FOR CONSTRUCI �ON PERMIT <br /> " :�'� CITY OF EVERETT•BUILDING DIVISION <br /> � ` � 32G0 CEDAR STREET.•EVERETT,WA 98201 •259-6810 <br />�• '::' : <br />'; '' ❑ DEMOLITION C] COMBINO�TION ,, BUILDING �MECHANICAL � PLUMBING rl SIGN <br />: " ' ` <br /> p�'� 4� , PROJECT ADDRESS <br /> .r--- .. . � <br />�t:.. , . � MA� F�/ER�f1� WA . <br /> OWNER MAILADDRESa. CITY ZIP PNONE <br /> . U CoCor�►STr�uGi;o..1 1nlG 'Po Rx�Ic��'� F�['�I�i.a. �„!a �So�Ft ?�hc �1402- <br /> TENANT MNL/iDDi1E GTY ZIP PNONE <br /> ARCMRECTORDESIGNER MAlLA0DRE55 CI7Y ZIP PNONE <br /> Lq�., � . GENEfUICONTRACTOR MNUOORE55. CIiY 21P PHONE STATELICENSE� <br /> TILEo ra15f2..��.� In1C� �cr�..� As ��r(1 ri 2 T�1faCs�dC��'4 _ <br /> MECNANICALCONTRACTOR AwLADD ES�� ��� � ��D �BO77 /�,,�/rJi(c�2+. TA�OY�I5��71� <br /> U ,/�'�-��J l-�'r,��--I ��,�oi���r��.,�� <br /> lIQ1'� ��n. Z�p HO E STATE IICENSE <br /> PLUM6INGCONTPACTOR MAILADCRESS <br /> rLF C—�cvrk�L��_. �- ' a <br /> CONTNACTPRICEOF�q� �J � HEATING SYSTEM: " GAS Cl ELECTRIC fl <br /> ,/ <br /> OESCRIBEMIORKANDSOUMEFOOTK+ �NVOWED / CONTAGTPERSONANQPHONEN D^ ^ 1 �+ � <br /> 1`�S pl.IC� f� ��X /`J � l.l , C fr+C <br /> (' � 1 � I 5 X �a t�$6..'7(�� <br /> a� Y �� I HEREBY �CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> qPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> rAovos¢o use a euaar+a , � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />� ; � pc(� WORK WILL BE COMPLIED WITH WHETHER SPECIfIED HEREIN OR <br />. �E pEURiPnp�acpporEqTyt gELOWORATfACHTWOCOPIESL . ,�; NOT. THE ORANTINQ OF A PEPMIT DOES NOT PRESUME TO GIVE <br />�,, , �oT.�_B�aK��� 'NIS AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />' '.' .�� � n OTHER STATE OR IOCAL LAW REGULATINO CONSTRUCTION OR THE <br />!� � � VDIi� �I f G. 30 RTSG, PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br />�� . �i ':� � � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> . �' ,. � � � ' APPUCAT �J ADE AND I COMPLY WITH THE STATE <br /> � . C NT C RS W 1 27 RC D 298.200 WAC. <br />'� PARCELTA%I.O.NUMBER <br /> �{' 8 ?� 015 Gb -'� , ti�n � rtE'S � �3 " l <br /> �pNSTqIICII OAN LENOER.�DDRESS,7ELEPHONE NUMBEH �( <br /> N.J� 516N RE DATE <br /> CI D SINESSLICENSENO. <br /> PLUMBIN� � MECHANICAL <br /> NO. TVPE OF fl%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> --r <br /> WATER CLOSET(TOILET) <br /> � A/C-NHNDL�UNITS-H.P. ' <br /> BATHTUB � FORCED AIR SYSTEMS-B.T.U. M E.A. i <br /> UVATOFY(WASH BASIN) � � � HEAT PUMP ' <br /> � � UNIT HEATERS-B.T.U. M ' <br /> K TCHEN SINK d DISP ; CLOTH[S DRYERS ' <br /> DISHWASHER � / VENTIL4TION FAN � <br /> LAUNDRY Tf�AY ' � RANOE HOOD � <br /> CIOTHES WASHER � WATER HEATER ' <br /> URINAL � WOOD STOVE � <br /> ORINKING FOUNTAIN ; -METAL FIREPLACE(WOOD BURNINGJ ' �i <br /> FLOOR ORAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFIOW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE-BAF,ETC.) � GAS RANGE ' <br /> � GAS P;PIN6 � <br /> � EXHAUSTFAN ' <br /> � <br /> i <br /> i <br /> � � <br /> � <br /> � <br /> � <br /> � . SUBTOTAL S ' <br /> SUBTOTAL S� � • , <br /> PERMIT S i PERMIT S � <br /> TOTALFEE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FEE AECFiPTNO. <br /> FRONTSETBACK AEMSETBALN SIDESE7BACK PIANCNECKN MBER �. � j �� <br /> 26 2 � 5 r•�`'�S � ' <br /> USEZONE LOT� VACANTSITE <br /> FEES VALUATION FEE <br /> �- 00 r�s n No aunoinc p y � � SO <br /> � <br /> HEIONT LIMIT�TION NO.OF DWELLINU 512E OF BIDC✓f L /�� �i7v <br /> ^�i UNITS �•L3S 2�5 ,�_�f. VIUMBING _ � � .� <br /> L .—._ <br /> pC�PANCY NO Of SiqtlFS OCCUPANT LOAO BiISEMENT � MECH/�NICAL ��J 'y� <br /> f7YF5 MF.P � <br /> •3 V'I •1' -- A�WiION�lPLN1CHEGK � <br /> FIREALMMREO'0 RE�SON <br /> i <br /> OTHER � <br /> FIRESPRINNIERREO'D REASON �/ � <br /> ST�IE BUILDING SURLHARGE �y' ;SJ <br /> TYPEOFf,ONST PUNSAPPROVEQBV CITYOFEYERETT P�B����RKS �(> v^� <br /> LOCAL SALES � �+ � <br /> —IJ o.re / 9 TAX CODE IS 3105 70TAL � 1li' '6� <br />