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^-. <br /> APPLICATIOrI FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> fl DEMOLITION fl COMBINATION fl BUILDING �MECHANICAL �l PLUMBING fl SIGN <br /> PROJECT AODRESS <br /> OWNER MnIL�ODRESS CITY 21P PHONE ��1`O I <br /> ��Tr:���n� ('��i3�t i '=>� R�{ k� Fe !( ,. �,:.,-� � v.�4.t�" wA 3a3 - g� lL <br /> IENANT MRILA�ORESS CITY Z�P PHONE <br /> S tLIYN-E� _ <br /> MLNRFCTOROESIGNER 6UII�ODRE55 Cltt 71P PNONE <br /> GENERALCONTRACIIXi MAILPO�PESS UIY 71P PIION[ SIATEUCGNSE� <br /> MECH�NICALCONTRACTOR MRILADORE55 Cltt 21P PIIONE STATELICENSF.• <br /> PLUMBINGCONTR�CTOR MAILRDDNE55 CI1Y ZIP PNONE STATEUCENSE� <br /> NTR�CT�filC�OF YIORN <br /> �� �� c'- HEATING SYSTEM: GAS I-1 ELECTRIC �l <br /> DESCRI9E WORK ANO$OUARE FOOTAGE INVOIVED /� CONTACT PERSON AN�PIIONE NO <br /> Ca»VWt k( Ann. <br /> S� y • <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT All <br /> PROPOSEDUSE OF BIIILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> t 5 i D tN�-t WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LDESCRIPTIONOFPROPERTY�SHOWNPELOWORATf�CHTWOCOPIES) NO7. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOi Z 3 e�ocK -3Zo pF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND i COMPLY WITH THE STATE <br /> PARCELTA%ID.NUMBER CONTRAC RS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTION LO�N LENDER.�DDRE55.TEIEPNONE NUMBEA x ������'t,L I p� .''V4� �� �" 5 <br /> SIGN�TURE DATE <br /> CITY BUSINES$UCEN$[NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C-A/HNDLGUNfTS-H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP ! <br /> SHOWER � UNITHEATERS-B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAV ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> URINAL WOOD STOVE � <br /> DRINKING FOUNTAIN � METAL FIREP�ACE(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 /> � <br /> i EXHAUST FAN ' <br /> � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ � <br /> PERMIT S � PERMIT 5 ,5 � <br /> TOTAL FEE $ � TOTAL FEE $ 7 ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SFiPALK RE�R$F.TBACK SIOE SETAACN �IAN CIIECN N B F[F AECFIPT N0. <br /> �/ 1 <br /> �1� � �\ <br /> usE zor+e iot nnen wcnru�sirF FEES VALUATION FEE <br /> f IYES 11 NO O111101NC <br /> MEIGNTLIMIUTION NOOfUWFLIING SREOFBlOQ41 i <br /> UNILS PIUM[iMG <br /> �_ { <br /> � ' <br /> i <br /> OLCUP�NCY NO Of StORikS O(:CU�pNI LOAU BASEMENi M[CIIeNICRL <br /> GROUP _ – -- <br /> fIYE$ II NO <br /> ApDI IIA�`1M.PI.AN CNl,CK <br /> FIRE AUf1M REUD �F450N — <br /> OINER � <br /> flfiF.SPRINNIF.RRf:O�O �FA�ON <br /> Si�tE AUiI�MG SUfiCM4R[E <br /> rvrForr,ovsr rinNsnrrnovFnrv CITYOFEVERETT runiir,wones � <br /> —1-- <br /> LOCALSALES � <br /> uAtE TAX CODE IS 3105 70TAL ' <br />