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, r � <br />� APPLICATIOrI FOR CONSTRUCT�ON P�RMIT <br />� CITY OF EVERETT• BUILOING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8610 <br /> fl DEMOLITION I-1 COMBINATION �l BUILDING f-I MECHANICAL �d PLUMBING f I SIGN <br /> PROJECT ADDRESS <br /> a/ 3/ �4 �e Sf �vereff� Gr�`t l�8.20� <br />� OYMER MNLADORESS Cltt IiP P110N[ <br /> ElYJMit Teu.,neA�asMon aoG/ ) a8'r''l)vc liJE ? lyivn��ooc1L./�< 9' �'�,3(� (7009�'/� <br /> lENl1NT MAILADDRF.SS f.l1V ZIP PRONE <br /> �RCHITECT OR UE9GNER MRIL A��RE55 CITY 71P PMONE ' <br /> GENERRICONTfinCTGR MAILAD�RESS CI1V bP P�104[ SiR1GLICENSE• <br /> 7a �/nfGi1S/OHS �IG �� I�i]. STSC✓ I.V�7�'7cUODc/C,�A /YU)�o �)O-ILIe9 TOio.O/Cal�'Q(,Zlsf(? <br /> M CHANICALCONTRACTOR MnILA�DFE55 .ITv 21C PHONE ST4TGLIpENSE• <br /> PLUMBINGCONTRnf,TOR MnIL���PE55 QiV ZIP P110NE STATELICENSE� <br /> LON RALT PRICE OF WORK <br /> � — �= HEATING SYSTEM: I 1 GAS �l ELECTRIC f-1 I <br /> DE RIBE WORN�ND SOUARE FOOTAGE INVOWED CONTACT PERSON�YU PIIONE NO. <br /> ?.es r �.� uG - ' ,✓cr <br /> ct- a�L. <br /> I HEREBY CEi7TIFY THAT 1 HAVE READ AND E%AMINED THIS <br /> PROPOSEU USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �•''� �- WOFK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALOF.SCRIPTIONOFPROPERTY�SHOWNBELOWORRTTACNTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE I <br /> toT l.S�f/�n BLOCN���oF/�i�� �anrl r i t AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY 'i <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUC:TION OR THE <br /> n P/ I/o ., 'Y a PERfORMANCE OF CONS7RUCTION.THAT I AM AUTHORI2ED BV THE <br />� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPL�CATION IS MADE AND 1 COMPLY WITFI THE STATE <br /> PARCELT/J(I.D.NVMBER CONTRACTORS LAW 18.27 RCW AND 2 6200 WAC. <br /> CONSTRUCTION tO�N LENDER.ADDRE55.TELEPIIONE NUMBER 7 Z d'/ Q $ <br /> SIGN UP Pi[ �' <br />' dTY BUSME55 UCENSE NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> �— <br /> / WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. ' <br /> / BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTNES ORYERS � <br /> --+— <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HOOD ; <br /> CLOTHES WASHER � WATER HEATER <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE � <br /> � <br /> GAS PIPING <br /> i EXHAUST FAN i <br /> � � <br /> � � <br /> i <br /> SUB TOTAL $ � SUB TOTAL 5 �_ I <br /> PERMIT 5 � PEFMIT $ � <br /> TOTALFEE $ � TOTALFEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> i'RONiSFTPACN PEMSFTOACN SIDESETBACN �lANC11ECKHUMA[R ![E �FCGIPTNO <br /> useioNe ioTnnen VAC4MSIiE FEES VALUATION FEE <br /> i rves r� No Aunnn+c � <br /> _ 1 <br /> HEIGHTLIMITATION NOOFL`WELLING SIZEOFHID(:�fl i <br /> UNIiG PLUMpING � <br /> � <br /> OCCUPANCV NO 0�Si0RiC5 OCGUPFNi I.OA� BASEMENT MGCH4NIC�L i � <br /> cnour <br /> IIVES II NO � <br /> FIREALApMPEOP Rf450N ADpI110NAIPL�NC��GCK i <br /> omen � <br /> rinesrnuuKiennron ncnc�!u — <br /> SiAI[f7U1101NG SUnC11nRGE <br /> ivrEorcor+sr � � vinNsnrrnovenm CITYOFEVEqETT runiicwones � <br /> LOCAL SALc'S --�— <br /> „A,� TAX CODE IS 3105 7o7n� � <br />