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APPLICATII.N FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> (l DEMOLITION � 1 COMBINATION i-1 BUILDIkG I 1 MECHANICAL � 1 PLUMBING f� SIGN <br /> PROJECT ADDRESS <br /> (c232 7 � DL S� �VUC�T� i��' �d�2�3 <br /> o/w�r+��n,, � L-,�n�.n`n�'c_n��ss �� <br /> 1�1T�'� E �M.�"•7 7�S�F �IT.32 Zy9 r,nv nr r��o��� <br /> lENnf�T � SE �v�'T w4 4p3o3 3¢7-1�oS <br /> MAI.ADDfiF55 CIiY ZIP CHONE <br /> PqGNITT.CTORDE5IGN[R MAILApDRE55 CITY 21P PHONF <br /> GGNERALCONiPnCtOR MAtLADpR[55 (;IiV ZIP PHOYE SiATE�ICENS[� <br /> O�� <br /> MECH�NICALCONiRGCTOR MAI�A[1DRE55 CITV IIP PMONE STATELIGENSE� <br /> PLUMBINGCONIPACTOR NAIL��DRE55 CIiV ZIP PHONE STAi[LILENSEv <br /> CONiqACi P{+�E OF W K <br /> d!���' HEATING SYSTEM: �GAS fl ELECTRIC (� <br /> DESCRIBE WORK AND SOU4RE FOOtAGE INVOLVED CO T'A�'.i"P[R�SON I�. wPIIO �NO <br /> /�t00 12X)S BpD40 Q�*n 1 Su SQ F( }�R� F' � �?_��Q�- <br /> , I HEFEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � rnq¢oseouseo omiowc APPLICAiION AN�KNOW THE SAME'i0 BE TRUE AND CORRECT.ALL <br /> Y PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> M WORK WILL BE COAIPLIED WITH WHETHER SPECIFIED IIEREIN OR <br /> LEGALDES irrioNorraorenrvis��ovmieeiow nnnar.NTw e nieei r1- NOT. THE GRANTING OF A PERMIT DOES NOT PFiESUME TO GIVE <br /> ior�_ �4 o�ocK or� 1 • AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUf.TION.THAT I AM AUTHORIZED BV 7HE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATIO IS MADE AND I COMPLV WITH THE STATE <br /> vnnCELTA%19 NUMBEn CONT C �AW 10.27 RC ND 296.200 WAC. <br /> �d S�� �00 /'7�� ��J <br /> C2"z:_, <br /> COdSTRUCTION LOAN LENDER,AODRL55.TELEPMONE NUMBER X V r � 3� 9� <br /> 51 i RE �T� <br /> GTV BUSINESS IICFNSG NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF FI%TURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—lVHNDLG UNITS—H.P. � <br /> BATHTUB _ � FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) i HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M <br /> KITCHEN SINK 8 DiSP � CLO'i HES DRYERS � <br /> �ISHWASHER � VENTILATION FAN <br /> LAUNDRY TRAY � RANGE HOOD � <br /> CLOTHES WASHEH i WATER HEATER � <br /> URINAL WOOD STOVE � <br /> DRINKWG FOUNTAIN METAL FIP,SPLAGE(WOOD BURNING) <br /> FLOOR DRAIN � FIREPLACE INSER7(WOOD BURNING) i <br /> BACKFLOW PREVENTERS � GASFIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) GAS RAN6E <br /> ' GAS PIPING <br /> i EXHAUSTFAN <br /> i � <br /> � � <br /> SUBTOTAL S � SUBTOTAI S ' <br /> i <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> fRONi5F10ACK l R[MSf:TpACK SIO[SROACN PLRNQ�f.CK UMO[fi �' FEE fiFCE1PTN0 <br /> / � <br /> %�%^ ,�C S ! 7��.'� � ��C�,=)[� ���)�, )�j. <br /> usEzov� ` �� Lotnnen vnCnNrsn[ FEES VALUATION FEE <br /> '_!�� nves n rvo ouuowc 8(00 ^ I : � <br /> i+Eicirt uMirnTior+ No or owEuiNc siz�or oiucrt.i. <br /> uNirs � <br /> I SF pp P�UMpING � � <br /> OCCUPANCV NO 0(S70Pi[5 OCCUPAtJi LOAD OASEMENt � <br /> GROUP 1 / MECIIANICAL � <br /> � I flVES I�/70 � <br /> FlRE ALARM RE00 RFASDN A�DITIONA�PLFN CHf.CK i <br /> N� otr�[n � <br /> rwesnniHKienneo�o r�ensoN <br /> �J� sTnir.nmioirvcsu�cHnnc� � � S� <br /> rvneoFcor�sr rinN�nnrnQvr{'ev CITYOFEVERETT ruaucwonKs -�--- <br /> V Ia IOCALSALES ' <br /> ��{ on�rE � 9S TAX CODE IS 3105 707AL � �� <br /> f- <br />