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,�. -, <br /> APPLICATI�.r�l FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR Sl AEET•EVEREIT, WA 98201 •259-8810 <br /> f7 DEMOLITION rl COMBINATION fl BUILDING r7 MECHANICAL �l PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> ot/3/ �rz,o% 5����� c� /�a l`��'n2o/ <br /> OMMER MIULADDRE55 , CITY ZIP PNONE <br /> G�i�wea .Tto .�.�p,(jfar.rs� S/6�Q1�,� sl'sli/ /y✓nrl�d000�G!/v 9PU�36 �70-//6 9 <br /> TEN�NT MMLADDPE55 CIiY �r 21P �IIONE <br /> ARCHI�ECT O(i DESIGNER M�II I�O�RESS GITY IIP �'MONE <br /> 7c�a ,Di.nC�lsions �/!10 �'i.7 s'�S�-�/ �vnnu/OaCl� Lt/ct 9Pd.?' 6 70 -/GG S <br /> GENERRLCONTRACTOq "RIUODRE55 GIY I.IP PNONE SIATEUCENSE� <br /> —t=� J TD P,0/C�GG��8 <br /> MECHIINIC�LCONTRACTOR M�IUDOPESS LIN 7.IC PNONF. SiAiF UCENSE� <br /> PLUMBINGCONTRIICTOR M1ILAODRE55 CIN ZIP PHONE ST�IELICENSE� <br /> CONTPAGT PRICE OF WORK <br /> HEATING SVSTEM: f 1 GAS I�l ELECTRIC f� <br /> DESCRIBE WORK AND SOU�RE FOOt�GE INVOLVED � CONUCT PERSON AND PIIONE NO. <br /> SN I <br /> I HEl1FBY CERTIFY THAT I HAVE READ AND [%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TPUE AND CORRECT.ALL <br /> PROPOSEO VSE OF BUILDING PROVISIONS OF LAWS AND ORDINAN�ES GOVERNING THIS T'/PE OF <br /> �',�y.�� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED f1EREIN OA <br /> LEG�LD'c5Cf11PilONOFPROPERiY�51101NIBEI.OWORATTACMTWOCOPIES) NOL THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or�,,'�LLI¢_a�ocK_�� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW HEGULATINO CONSTRUCTION OR THE <br /> 1 .f PERFnRMANCE OF CONSTRUCTION.THpT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PRGPEFTY TO PEItFORPA THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I GOM?LY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> PIVILEL TA%I.D.�UMBER �} ( <br /> s��..s7-v d - •f"�d� IA/ � \ �_ / / <br /> t•ONS7RUCTON Ln�N IENDER.�DDRE55,TELEPMONE Nl/MBER (� 2� �i r <br /> N� R E �� <br /> CIiY B�ISINESS LICENSE NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF Fl7RURE OR ITEM FEE NO. TIPE OF EQUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNfTS—H.P. ' <br /> BATHTUB ' FORCEDAIRSYSTEMS—B.T.U. M E.A. i �� <br /> UVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ' . <br /> DISHWASHER � VENTILATION FAN ' <br /> � � RANGEHOOD � <br /> LAUNDRY TRAY � <br /> CLOTHES WASHER i WATER HEATER � <br /> URINAL ' WOOD STOVE . <br /> � <br /> � DRINKINO FOUNTAIN ' METAL FIREPLACE(WOOD BURNING) � <br /> � <br /> � � FIREPLACE INSERT(WOOD BURNING) ' <br /> FLOOR ORA:N � <br /> BACKFLOW PRE�ENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) GAS FlANGE � <br /> GAS P�PING <br /> ; E%HAUST FAN ' <br /> � <br /> i <br /> � <br /> � <br /> i <br /> ,� 1 <br /> � <br /> � SUB TOTAL E � SUB TOTAL $ � _ <br /> PERMIT 5 � PERMIT S ' <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: nEcemrr+o <br /> FPONT SETP�CK PE�R SF.iB�CN SIDE SEiB�CK PIAN CBECK NfR�UF��J <br /> ret <br /> � ��` FEE <br /> FEES VALUATION <br /> USE ZONE lOT nRE� VRCANi SITE � � <br /> f 1 YES f 1 NO 8����p�NG � � <br /> I' <br /> � HEIC+HT LIMIUTION NO OF UWELLING SIIE OF BLOGRI ' <br /> UN175 PLUMOMG __.�-- <br /> 1 � <br /> � � — <br /> OCCUP�NCY NOOf5t0Al[5 OCWP.1NTlOAU BASEMENT MECINNICAL <br /> i GNOUP — <br /> I (IYES il NO � <br /> Ap01110NFL PL�N CNf GK <br /> FIRE MARM REOD RFASON i <br /> OiM[R <br /> I ' "l <br /> FIRE SPRINNIER RFO'D �FASON SiNE�UILDMG 511RCII�fiGE <br /> �.� <br /> TYPEOFf,ON51 �LANSAPPROVEDBY CITYOFEVERETT runur,wonKs �_ <br /> LOCAL SALES <br /> DAiE TAX CODE IS 3105 7nTAL <br /> — <br />