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APPLICATI�.N FOR CONSTRUC'� .ON PERMIT <br /> CITY UF EVERETi• BUIIDING DIVISION <br /> 3200 CEDAR STREE- • FVERETT.,WA 98201 • 259-8810 <br /> �DEMOLITION f-1 COMBINATION � BUiIDING I I MECHANICAL �'.,(�1 PLUMBtNG fl SIGN <br /> PROJECT ADDRESS n .�, <br /> !' �l'� �^ � ��r//.r� <br /> OWNER MNLAD�PE55 CIiV 21P PIIOYE <br /> / <br /> � <br /> �n r� � /, i . .%f' ��. <br /> �'��• ,','�j.��� ��r L � � i. �,. _ �� � :�� _ <br /> ierunrvr � Mnannnness ' cnv � nr ri+or+e <br /> PRCIIR6TOROESIGNER M�ILA�DRESS Q Zlt' PHONE <br /> c;/e<mar%,��Ar<<i,����c /2� �i�.e �S �G�'v �'i���s�.�/-U� 98��� BZ�- /e�� <br /> GENER4LCONTPIICTOP MNL��Df1E55 GiV ]IP �•,PIIJY[ ,/- STAIELIGENSE• <br /> ��� //G2o �/�f�,-rl�./��„�u.�� �_ ���iu�/ ��.4 '" �.�,;, '=�24� ����TIIZIs"-=i <br /> MECH�NICAL CONTR4CTCR MNL�DOPF.SS � CI ZIP PIIOhE STATC IICENSE M <br /> PLUTABIIlGCONiRACTOR MAIL�DDRESS CIN ZIP PNONE _SI�TELIGENSEx <br /> CON CT PRIGE OF WOnK <br /> �,8� OO/, HEATING SYSTEM: f 1 S ELECTRIC I_ <br /> DESCRIBE WOR ANO SOUARE FOOi�GE INVOLy!�0 / �� COYT T PE1?SON Ay OyNONE NO. _ ��n / <br /> CU r,� fT? �%�� .�4.n-�`-Y '�7 �� lv r-!�i � !�- Cf'4'Si7�o!^E' � ' /9rey� �L� f <br /> � s y �7i�"• �PjC�� <br /> Y✓1!/��� li�J>.r � ��iN 'G' �//'�� .f�.r�.,r' <br /> i J� � I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> ��C�-�' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSED U� OF 9UILOING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE OF <br /> �osl� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEWLDESCRiPTIONO�P1P.ROPERTV SMOWNBF.LOWORATfAC11TWO�CGOPIES) NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or��2-o{'LG',27ei.ocK �8 or�� T - ��" AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR t.00AL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT�AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERT T(� PERFORM THE WOFiK FUR WH'CH <br /> APPLICATION IS MA ANd I COMPLY WITH THE STATE <br /> CONTRA ORS �v.1 27 RCW AND 296200 WAC. <br /> PARCELTA%I.D.NWAOER / <br /> 8 0�l� D � �/�� � 2- 'Z " ��J <br /> GONSTRUCIIOY LOAN LENDER.PDDiiE55.TELEPIIONE NUhIBER X 7"-" <br /> .NttIIRE OAT[ <br /> ITY BUSINESS UCENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE N0. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � NC—NHNDLG UNITS—H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS <br /> DISHWASHER � VENTIIATION FAN ' <br /> LAUNDRY TRAY ' RANGE HOOD i <br /> CLOTHES WASHER i WATER HEATER ' <br /> URINAL ' WOOD STOVE � <br /> DRINI�ING FOUNTAIN i METAL�IREPLl�CE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSENT(WOOD BURNING) ' <br /> GAS FIREPLACE � <br /> BACKFLOW PREVENTERS i ' <br /> SINK(SERVICE—BAR.ETC.) � GAS RANGE <br /> � GAS PIPING � <br /> ; EXHAUSTFAN ' <br /> � ' <br /> � � <br /> � — <br /> -- , �'_ <br /> SUB TOTAL 5 � SUB TOTAL S � <br /> PERMIT S i PERMIT 5 �_ <br /> TOTALFEE 5 ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: � ' ;/�J ,(jj � � �� ` �7 <br /> FRON�SETDaCK �EARSETOACN SI�LSETO/CK � PLA CII[C NU\�A�R �GE n'' RECEIPTNO. <br /> � �/� � <br /> usezoNe iornnen vacnvr;rtr FEES VALUATION FEE_� <br /> nves n No auuowc $ C�',b �' � <br /> �- <br /> MEIGH�LIMITATION NOOPDWEWNG SIZEOPEILOG41 �/ i <br /> UN17S pLlIMf1MG � <br /> SF u��N --T- <br /> OCGV�ANCY Hp Of SLORIES OCWPANi 10A0 PAS[MENI M[CHANIC�L - „�J �_ <br /> R.3 2 A �,.�5 ✓ � <br /> pDUITIOY�L PLAN CHLCK <br /> FIREAIARMl7E00 i1EASON � <br /> _ i <br /> b on�Fn '-� <br /> Flt1E5P(iiNNLERREO'0 RE�50Y � <br /> STATL OI11l�MG SURCH�RGE �� <br /> ,7 - � <br /> TYPEOFCONST. PIAN$�PP�OVEOOV CITYOFEVERETT runucwonKs � <br /> J�-� LOCAL SALES �. � � <br /> �_ UAIE 2 $ TAX CODE IS 3105 70TAL _ <br />