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APPLICATI�.N FOR CONSTRUCI rON PERMIT��y� <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 �� <br /> �l DEMOUTION f 1 COMBINATION fl✓�UILDING ;1 MECHANICAL I� PLUMBRJG I i SIGN <br /> PROJECT ADDRESS �,ti <br /> /D 5�/3 3 �rp S� <br /> ovrt+en n�m�aonn�ss cnr zm ri�ovr <br /> l.�tilccvtst ��.rf �1�J/�1iC�'r}�jqrue�p,�� �/���Z'_�1�� <br /> TE AN�T-- NNL��Oq[55 ❑LY 71� � PIIONE <br /> ARGIIRCGTOROESIGNER MRILADURE55 C11Y TIP PN04F <br /> S"A' ��P/-G'.�!-�-�' I 7/`�� "7 <br /> GENERRLCO'�A�O� MARADDfI[55 CILV 7iP PI�OV[ SiRtEL�C�M1�C• <br /> MECN�NICALCONIRACTGfi M1IAII�D�RES$ Cltt ZIP PIIO�f SiATELICEAeVr <br /> FI.UMBINGCONiRnCTOR MAILAU�RE55 CIIY ZIP PHONE STAiELICENSE• <br /> � CONTRACT PRICE OF WOItK <br /> HEATING SYSTEM: GAS I-1 FLECTRIC f_l <br /> . DESCRIBEWOPNPNDSOUAREFOOTAGEINVONED LO4iACiPE OI:Af�DPNON <br /> I H[REBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AN6 KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PR01'OSEO USE OF Bl11LUING ��� PROVISIONS OF LFWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAlDFSCRIPTIONOPPROPERP;�SHO�YNOELOWORATf�CMTWOrp��'I � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE <br /> ior �_etxK or �/ ��� � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> / OTHER STATE OR LO(:AL LAW REGULATING CONSTRUCTION OR THE <br /> Hi����� C � �� / OWNER OFNTHI3 PfiOPERTY TO PERFORM THE WORKIFOR WHICH <br /> � �� 2_q� �� APPLICATION IS MADE AND I COMPLY WITH THE STATE � <br /> ��ce�rnx i.o.Nurreea CONTRACTOFS LAW 1827 RCW AND 29s200 WAC. <br /> CON[TRUCTION LORN lENOER,AO�RE55.TEIEPMONE NUMBEfi X��//72_t��/.�'�^ /�/ ///�� <br /> SIGNAtURE �AT <br /> CIiV OU9NE55 LICEN$[N0. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEEr_ <br /> WATER CLOSET(TOILET) � NC—AMNDLG UNITS—H.P. � <br /> 'j BATHTUB ; / FORCEC 41R SV-�STEMS B T.U. E.A. � <br /> LAVATORY(WASH BASIN) i HEAT PL'MF � ' �- � _ <br /> SHO\VER UNIT HEA'f�RS—B.T.U. M '�_ <br /> KIiCHEN SINK 8 DISP i CLOTHES DRYERS �_ <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRY TRAY ' RANGE HOOD _T_ <br /> CLOTHES WASHER WATER HEATER �_, <br /> URINAL WOOD STOVE `_ <br /> DRINKING FOUNTAIN METAL FIREPLAGE(WGOU 9URNING) _ <br /> FLOOR DRAI4 � FIREPL�CE INSERT(WOOD f3URNING) ' <br /> BACKFLOW PREVENTERS � � GASFIREPLACE � <br /> SINK(SERVICE--BAR,ETC.) _ � GAS RAN.iE <br /> — ��3 6AS PIPING _ <br /> i EXHAUST FAN ' <br /> i <br /> _ � i <br /> SUB TOTAI_ S � SUB TOTAL S <br /> PERMIT S PERMIT S � <br /> TOTALFEE 5 ' TOTALFEE S <br /> FOR OFFICE l' ' 4NLY: -1 2 <br /> FRCNT SETPRCK / PEAR SET'ACK SIDG SETBA�J PI�N CHECN NUMO[R ��E �E�//���L — <br /> n <br /> use zoN[ �ornnEn v,+cnNr srtE EES VALUATION __ FE[ T_ <br /> � � nres n r+o emioiNc 57.rj 6Z3 r � �,' ' � t� <br /> H[iG11TUMITATION / NOOFDWELLING 9�_OFOIOC+RI. �., i <br /> uvits 1543 Sf L�v�uy �' rwMnwc /�1 <br /> S -/�R-oCaG <br /> OCGUP�NCV NOOFSi.�IES OCCUPANTlOPO BAS[M[Nt � � MEC:idNICAL ('/� ���� <br /> C' r � •� �,1 /� IlYES IW/JO — � <br /> i <br /> —�� ADDIiIONAI PL/N CM[CN � <br /> FIRE ALARM Rf.OD P'c4SON —�-- <br /> � OTNER �� i�����. i� i _ <br /> p�q[5�' INNLER Rf O[J REASON /�� <br /> � STNE OUILOMP SUfiCH�RGE �\ !J �.. � <br /> ivrr� vinNsnrrno:Eoov CITYOFEVERETT �unucwo�Ks ,7iJT'��' <br /> `J ��- LOCAL SALES I <br /> S�fJ onTe Z/ (O �J`� TAX CODE IS 3105 TOTAL _ <br />