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APPLICATI�.rd FOR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STAEET • EVERETT, WA 98201 • 259-8810 <br />I 1 DEMOLITION �I COMBINATION I! BUILDING rl MECHANICAL �., PLUIdBING � SIGN <br />PROJECT ADDRESS <br />35 27 �?ccKC,�eL�.� Rv'[_ . <br />owruFa n�naaooness cirv zm rHa�e <br />,.��. zm r��oNe <br />AtiC111TCCT OR �ESIGNEA MFII AD�fiESS CIN 71P PIIONE <br />GENERALGONTR�CTOR M411.p00RE55 CItt 71P PI104[ STATFLICENSE� <br />�hAcoY CQM'.ST�uC/ici.i "�� Ac�L. iJ o4 , i�,si�c aN, q�'z�� 6s�-�Ga� �u��crr. - v 77oA <br />MECNANICALCONTRACTOR N.PIIADOPE55 � CITV ZIP PHONE STATELICENSE� <br />PLUMBINGCON7RqCTOR MAl1,A0DiiE5S <br />--��/[�AN�i I�LII,M�/.JU <br />-- __3'f 7S « <br />OESCi1I�E WORN AND SOUARE FOOT4GE INVOLVED <br />rnoroseo use oF euaoiNc <br />LEGAI �ESGRIPTION OF PROPERTY (SNOI4N OGLOW <br />�or etocrc or_ <br />PA(iCE1.TA%ID.NUMBEN 1 /�" <br />L/ <br />CC STAUCTIONLOANL[NDER,A�ORESS.TELEPMONE NUM�EB <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />2 WATEN CLOSET (TOILET) <br />BATHTUB <br />SHOWER <br />KITCHEN SINK & DISP <br />LAUN�RYTRAV <br />CLOTHES WASh <br />DR;NKING FOUNTAIN <br />FLOOR DRAIN <br />BAGKFIOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL S <br />PEFMIT S <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />FRONTSET��CN pE�R SETBACK SI�E SETAACK <br />USE 20NG <br />IIEIGIIT LIlAIT�TION <br />OCCUPANGY NO Of SiORiK <br />r,noun <br />I iR[ ALAHM PE00 <br />�IHf SPRINNtER REO'D <br />FEE <br />arv <br />0 <br />0 <br />ZIP PIIONE STATEUCENSE� <br />23`i'�/��C <br />HEATING SYSTEM: Cl GAS C] ELECTRIC I-1 <br />CONT4CTPERSONANDPHONENO. <br />�i'I�iilNl'l /Inn/��/ � �C'� _1/A . <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 1'HIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THF ?ROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE Of CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER nF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 2962L0 WAC. <br />/1 /1� <br />x ���_! `�. �` `./� 1 �, j . )�S <br />SIGNATURE J 04TE <br />CITY 9VSMESS UCENSE NO. <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />A/C —A/HNDLG UNITS — H.P. � <br />FORCEDAIRSYSTEM&-6.T.U. M E.A. � <br />HEAT PUMP , <br />UNIT HEATERS — B.T.U. M � <br />CIOTHES DRYERS � <br />VENTILATION FAN � <br />RANGEHOOD � <br />� <br />WATER HEATER , <br />WOOD .�'iTOVE � <br />METAL FIREPLACE (WOOD BURNING) ; <br />FIREPLACE INSERT (WOOD BUHNING) � <br />GAS FIREFLACE ' <br />GASRANGE � <br />GAS PIPING � <br />_�� EXHAUSTFAN ; <br />SUB TOTAL 5 <br />PERMIT S <br />TOTALFEE 5 <br />PLANp1ECKNUM�FP I PGE I �ECEIPTNO. <br />LOiAPEA VACAN�gTE FEES <br />flYES I7 NO ppILpMG <br />NOOFOWELIING 512GOfOlUG21 <br />IINIiS <br />PLU1.I�ING <br />OCCUPqNTLO/D pASEMENT M@CH4NICAL <br />f]VES fl NO <br />REASON A�OITION4l PLAN CHECK <br />OiHER <br />PEASON <br />SiAIE OUIIDING SURLIIMGE <br />a�nnsnrrnoveoev CITYOFEY;'ft�?TT ruoucwonKs <br />LOCAL S!'.!.[S <br />onre TAX CODe l.�� ;! OS TOTAL <br />