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APPLICATIG.� FOR CONSTRUCT.JN PERMIT <br /> CITY OF EVERETT• BUILOING DIVISIGN � <br /> 320f CEDAR STREET• EVERETT, WA 98201 � 259•8810 <br /> �"1 DF.MOLITION fl COMBINATION F( BUILDING F]��MECHANICAL (v�PLUMBING fl SIGN <br /> PROJECT AODRE <br /> yso � � xxX R�D�� RD. ���i(; yy�ao� �� s3-�o�� \ <br /> OWNER MAILADOPESS Cltt ZIP PIION� � <br /> [3oLlr�J CoNST, =(�1f�. Po.Box��1 MwGl�,wa- C353-7o�b� <br /> TENANT MAILAOORF.55 CI1V 21P p110NE <br /> WM. 6ra��FliZ�nlr7v5o 3���_}�R �, T3�i • � q9lS5 935—$'S Z3 <br /> ARCHITECT OR�ESIGNER MRIL ADDREES ptt ZIP PNOYE <br /> $pC�r•/ C,oNST INL �o t3oX'�2lMu.K14'C130.ulR 96L'ts aS'�-�o11� B�I.INL1o1M�_ <br /> GENERALCONiRACTOR MAILPUOPESS CITY ZIP PHONL STATEUCENSE� <br /> �F�C:� 1�Eht'1N�7 2NC... 119�La ao6T►� �R. SE .SMe, v.�r�. �3�oD}�g�{�dlu0 .�C1�Fvc1,H�CJyS t9 <br /> MECNANICfLCGNTqACTOR h1AI�A0�PF5S CIN 21P PIION[ �aTA�CENSE� <br /> �04�Q�}�1u�WfsbJG. 1��d3'ZH�V.99 S.¢85 r�r�c��• I�+u<�,ta-o79z.� Swt=��� Z.�cP\ <br /> PLU4IBM�YT'i�CIDfl MPII,pODRE55 CIiV 21P PMONE ST�TELICENSE+ <br /> l � oZj ODO.Oo <br /> CONTRACT PAICE Of W9PK �� <br /> �� s• F . �"�(t HEATING SYSTEM: !�i GAS ❑ ELECTRIC ❑ <br /> DESLRIBE WOfiK ANO SOUARE FO�IipGE INVOWE� COYTACT PERSON AND PIIONE N0. <br /> 4Un ��_�iq-p�t{,.�E C4 N -3 S 3- o (o <br /> SIN(7�(.,E' FM►!/L I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> PROPOSED USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE CnMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG/LOESC/1PTIONOFPFOPERTY�SM9IVNBELOW if NTWOCOPIE � N6T. THE GRANTING OF A PERMIT DOES NGi PRESUME TO GNE <br /> LOi / BLOCK or �'�M� ��'�- AUTHORITY TO VIOLATE OR CANCEL 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 PERFORM THE WORK FOR WHn;H <br /> .6 s S(A�OG�O-O � AP?LICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> ' PARCELTF%I.D.NIIMBER CONTRACTORS LAW 18.27 RCW AND 66.200 WAC. <br /> E�EQL=17'/�lu'[1w.�.C_ Po �' • <br /> CONSTAUCTIONLOPNLENOER.ADORESS,TELEPHONE Nl1MBER X � <br /> SIGN D TE <br /> CITV OUS�NESS LICENSE NO. <br /> PLUMBIItG MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE NO. TVPE OF FIXTURE OR ITEM FEE <br /> 2_ WATER CLOSET(TOILFT) � A/C—PJFiNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED A�R SYSTEMS—d.T.U. M E.A. ; <br /> IAVATORY(WASH B�SIN) � HEAT PUMP i <br /> SHOWER � UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNURY TiiAY ; RANGE HOOD ; <br /> CLOTHES WASHER i WATER HEATER � <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD F3URNING) � <br /> FLOOR ORAIN � FIREPLACE INSERT(WOO�BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE ' <br /> � <br /> SINK(SERVICE—BAR,E i C.) � GAS RANGE � <br /> GAS PIPING ' <br /> i � EXHAUST FAN / i <br /> i � <br /> i � <br /> SUB TO?AL 5 � SUB TOTAL $ � <br /> PERMIT S i PERMIT S i <br /> —� <br /> TOTAL FEE S ' TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: � <br /> FRONT SE fBAGN � REAR SETO�CN -� S�OE SETORCK fLAN CIIECK NUMOER FEE � ECEIPT N0. <br /> (/� /io � � � J v �� L�' �j i�.. �J <br /> usezor+e,� J LOTAfiEA VACTNTSITE FEES VALUATION FEE _ <br /> � n ves n r+o ouaoiNc Z 9 ys � �- I�^-� <br /> MEIGMTLIMIT.4TION / NOOFOWGWHG SI2EOf[��GRI. <br /> uNirs 4JJ 5.�. r�unmiNc J� '00 <br /> GROUPANGY NO OFSiOR��ES OCCUPANiLOAD OASEMENT MECHANICAL � I <br /> p ► � ❑ves i ro <br /> �v c��� <br /> FIR ARM REO�� REASON /n A�DITIONp�P�,AN GN[CK L l i �L� <br /> OTIIER � <br /> FIRE SPRINKLER REO'D REASON <br /> i <br /> STFTE BULLOING SURCHAIiGE L j S:.� <br /> TYPEOFCONST PLINSAPPROVE�AY CITYOFEVEREIT PUBLILWONKS � <br /> '['� LOCALSALES �� �'� <br /> {L�— DATE � 7 �j 7 TAX CODE IS 3105 707AL , �� ;��'� <br />