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APPLICATI4�! FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 320U CEDAR STREET• EV.:7ETT, WA 98201 •259•8810 � <br /> fl DEMOLITION fl COMBINATION �I BUILDING fl MECHANICAL t� PLUMBING f-1 SIGI <br /> PROJECT ADDRESS <br /> �/_�On �/O�E�1xz���- T.T_ <br /> OWNER MAILADORESS CITY ZIP PHONE <br /> C/�it�i� ,4Tl��sa.v S��Za�/,'iLt'C,�.�z�.�/' �v �-'c� ' .Zs�' 69 sd <br /> 7ENANT MAILAUDRE55 CITY 21V GNONE <br /> ARCHITECT OR OESIGNER Mell A�ORE55 CITY 21P PNONE . <br /> GENER/iLCONiR�CTOR MAILAOORE55 CIP' 21P P�IONE S1�TEUCENSE� <br /> MECH�NILAL CONTRRLTOR MAII�DORE55 CITY 21P VMONE STATF UCENSE� <br /> �/7Y�i/ 3i S/E_t% s'tE`�i�c /f/E./J��/Y�/=v�t� /�R. c'✓. �S3.�o/ :t5'�-?//S� EG� X'ISS��/ -- <br /> PLUMBING CONTRFCTOR MRIL A�DRE55 CITY ZIP PHONE STATE LICENSE• <br /> CONTfUCT PRIGE OF WORK <br /> J,�-��tc� HEATING SYSTEM: ,: GAS I-1 ELECTRIC rl_ <br /> DESCRIBE HK ANO SOU�RE FOOT�GE INVOLVEO CONTACT PERSON AND PHONE NO. <br /> ��79 C n 1J ii C .!� � l — ' � ' 3�i'- <br /> f P/,n <br /> I HEFEBV CERTIFY THAT I HAVE READ AND E%AMIPIED THIS <br /> APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROPOSED USE OF BUIl01NG PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �//1j� -- G WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEIiEIN OR <br /> LEGALDESCRIPTIONOFPROPERttISMOWNBELOWOf1ATUCNTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 1'O GWE <br /> wT BLOGK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINC CONFiTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED B1'THE <br /> OWNER OF THIS PROPERTY TO PE(iFORM THE WORK FOR W1iICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRA S LAW 1027 RCW AND 296200 WAC. <br /> PARCELLVII.D.NUMBER <br /> CONSTRUCiIONLO/JiLENDER.A0DRE55,iElEPMONENIIMBER X � � `— S —� <br /> 51� UPE O�TE <br /> //q ^���^/�'� CIiY BUSINESS IICENSE NO, <br /> PLUMBIN6 MECHANICAL <br /> NO. TVPE OF FU(TURE OR ITEM FEE NO. TYPE OP FOUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNfTS—H.P. O ' <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ' <br /> � <br /> LAVATORY(WASH BASIN) i HEAT PUMP ' <br /> SHOWER � UNITHEATERS—B.T.U. M i <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAY ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> UPIK.�L ' WOODSTOVE � � <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) � _ <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOWPREVENTERS ; GASFIREPLACE rNS- <br /> SINK(SERVICE—BAR.ETC.) � GAS RANGE ' <br /> � " GAS PIPING � <br /> ; EXHAUST FAN ' <br /> � ' <br /> SUB TOTAL $ � SUB TOTAL $ - L i <br /> PEHMIT $ � PERMIT E �'� � <br /> TOTAL FEE S ' TOTAL FEE E r' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETPACN RE�RSEiB�CK SIDESETB�CK �UNCIIECNNUMBEfi FGE RECEIPTNO. <br /> usezor�E �otenen Vl�CAtITSIIE FEES VA_UATION FEE <br /> IIYES 11 NO � <br /> OUIIDING � <br /> HEIGHT LIMITATION UN'OF UWCILING SIZE OF 6LOGRI • � <br /> PLUMUING <br /> —r— <br /> i <br /> OCCUPANCY NO Ot S�OpiES OGCUPANT LOAO BASEMENT MECII�NICR� � <br /> GROUP fIYES fl NO i <br /> AD01710NAL PUN C��ECN <br /> FIREAWiMREOD RFASON � <br /> OTHE� � <br /> i <br /> GIfiESPRINNLERREO[1 RFnSGN � <br /> S1�TE�WIDING SI1RCIlARGE � <br /> i.— <br /> TYPEOFf,ONST PLANSAI'PROVED�Y CITYOFEVERETT �UOLICWORN$ <br /> LOCAL SALES j <br /> oqtE TAI( CODE IS 3105 TOTAI <br />