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APPLICATIC.nI FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION �j 1,� <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 `�� <br /> fl DEMOLITION fl COMBINATION fl BUILDING fl MECHAMICAL t 1 PLUMBING f� SIGN <br /> PROJ¢CTAD�pEJS� I�'If�r��.Lr �UE/Z �TT 9u �0I .ZS.l-3yI(0 � <br /> X �� <br /> OWNER MAI�AODPF.SS CITY ZIP PHON[ <br /> x .���r�� e� z � � ,�,� _s � <br /> �EN�NT M�IL� �RE55 CITY 21P CIIpNE <br /> ARCMITECTOROESIGNER MAl1.ADDRE55 �ITY TIP PNONF. <br /> GE LCONIMCTOR M�ILRD�qE55 ('l1Y )IP P�ION[ SIAiELICENSE <br /> �//�YIC>i�� <br /> CF�NICALCONTRACTOR MAILAD�RF55 CITY 71P PIIONE STATEUCFNSE� <br /> PWMBINGCONTRACTOR MAILA�DRE55 CITY ZIP PHONE STATEUCENSE• <br /> CONTRACT PqICE OF WpRN <br /> HEATING SYSTEM: I l GAS �l ELECTRIC fl <br /> DESCPBE WORK ANO SOUARE fOOTAGE INVO�VEO CONTRCT PERSON AND PIIONE NO. <br /> � � <br /> 1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE OF BUILDING APPLICATION AND KNOW THE SAME TO �E TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LDESCqIPTIONOFPROPERTY(SHOWNBELOWORATTPCHTWp�OP1E5) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> l0T' BLOCN oF AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOPM THE WORK F6�1 WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEITA%I.D.NUMBER CONTRACTORS LAW 18.27 RCW�AN`D 29�6.2)00 WAC. <br /> CONSTRUCTION IO�N LEN�ER,AODRESS.TESEPNONE NUMBER X � C�/GtL++�- (.+� ✓!T�-C <br /> SIGN/ RE � OATE <br /> GITY BUSINE55 LICEN$@ N0. <br /> PLUMEING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDL6UNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � HEAT PUMP � � <br /> SHOWER � UNITHEATERS—B.?.U. M � <br /> KITCHEN SINK 8 DISP i CLOTFiES DRVERS ; <br /> SHWASHER � VENTILATION FAN � <br /> UNDRY TRAV ; 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 /> GAS PIPING <br /> � EXHAUST FAN <br /> � i <br /> � i — <br /> SUB TOTAL 5 ; SUB TOTAI S ; <br /> PERMIT 8 � PERMIT $ i <br /> TOTAL FEE $ �� TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> fRONT SFTPACK REAfi SFTBRCN SIDE SETBRCK �14N CRECN NU Efl fEE � � R[CEIPi N0. <br /> � � � 1 <br /> �i <br /> USEZONE •� IOTAREA VACANi51iF FEES � VAL A ON FEE <br /> lIYES V� OUILDINC �3 '166 ` (,L• �`_ <br /> O <br /> HEIGIIi tIMITATION � NO OF DWEIUNG SIZE OF BIUGRI � <br /> 1� UNITS ` •" �^ • PLl/M01NG � <br /> � ~ d' � <br /> OCCU�NCY NOO�SLONIES OCCUPANTL RD BASE1dENi MGCHnNIC�L � <br /> u ' <br /> �iYES �,<o <br /> FIRE ALMM REO�b �Fr150N <br /> ADDIIIONAL PI�N G��f.CN <br /> _�O oi�+En <br /> FIRF.SP IqNyL[FREO'D RF��ON — — <br /> �� srnie ouaowc suna�nace __— (}.I� <br /> tvPe or r,oNsr PLTNS APPnOVED BY CITY OF EVERETT ruoi ir,wonKs ; <br /> �t ! � LOCAL SALES <br /> �� unTE 7 y¢ TAX CODE IS 3105 70TAL <br />