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APPLICATIG.� FOR CONSTRUCI .JN PERMIT <br /> CITY OF EVERETI'• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION Cl COMBINATION fl BUILDING MECHAIVICAL �PLUMBING f-1 SIGN <br /> PROJECT ADDRESS <br /> ��OW4ER MAILRDDRE55 CITV 21P � PMONE <br /> ,� �'�-�,�.i � l ;J l��i_�� � iP l�u t-v� ` �nl .�5���c� � <br /> �TE AN r MAILAp�RE55 CIT ZiP PHONE <br /> PR"C�ITE'CiOR0�E51GNER MAILAODfiE55 �;� CITY/� / ]iP PHONE <br /> /1!�(!�! � A =�Y�i�Or) //ID��/' /� �if � � u 0 � �//�7 �2 <br /> Fi€NER�LCONF AGTOR MAILAODRESS CILY IIP ' PHONF 5TATEUCENSE• <br /> S� <br /> MECHANICALCONTF�CTOR AIAILADDRE55 CItt ZIP PIIONE STr1TELICENSE� <br /> 1 ���� <br /> \ PWMBIN(fi�CONTR�CTOR MAl1.ADDRE55 GIiY 21P PMONE STAiELILENSE� <br /> Y )/�i�� <br /> CONiRACi PRICE OF WORK g � � <br /> /( :7 � � HEATING SYSTEM: GAS f] ELECTRIC Cl <br /> DESC IBE PN AND SOUPRE FOOTAGE INVOLVED C TACT PERSONfND PMONE N <br /> / /�� ' r(l6/1/AGF '� U ' I !7 <br /> ' N/ � , � <br /> �� � /1 I HERE6Y CERTIFY THAT I HAVE READ AND EXAMMED THIS <br /> �1 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PR coSEo�isc F BIIILDI c PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGFLOESCRIPTIONOFPROPEHTYISMONMBELOWOqPTTACHTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOCK oF AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THI!: PROPERTY TO PERFORM THE WORK FOR WHiI:H <br /> APPLICATION 13 MA �AND I COMPLY WITH THE STATE <br /> PAACEL A%I D.NUMBER CONTRA V�.t� RCW AND Z962OO WAC. <br /> �S � bo o � Z <br /> CONSTRUCT70 LOAN LENDER,ADURESS.TELEPMONE NUMBER x <br /> SIGN Or1 <br /> CITY BUSINE55 UCENSE NO. <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF FIXTURE OR ITEM FEE <br /> WATERCLOSET(TOILET) � A/C—A/HN�LGUNITS—H.P. � <br /> BATHTUB � FORCEU AIR SYSTEM .T.U. M E.A. � <br /> LAVATORY(WASH BASIN) HEAT PUMP � <br /> SHOWER ' UNITHEATERS—O.T.U. M <br /> KITCHEN SINK&DISP i CLOTHES URYERS i <br /> DISHWASHER � VENTILATION FAN ; <br /> LAU�DRY TRAV RANGE HOOD � <br /> CLOTHES WASHER WATER HEATER � <br /> URINAL WOOO STOVE ' <br /> DRINKING FOUNTAIN METAL FIREPLACE(WJOD BURNING) i <br /> —,-- <br /> FLOOR DRAIN � FIFiEPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLRCE � <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> � GAS PIPING <br /> � EXHAUSTFAN � <br /> � � <br /> � � <br /> —�— �_ <br /> � <br /> SU8 TOTAL 5 � SUB TOTAL $ � <br /> PERMIT 5 � PERMIT S � <br /> T07ALFEE S TOTALFEE 5 ' <br /> F'OR OFFICE USE ONLY: <br /> FROUTSETBACN �EARSEID�CK SIOESETAACK PVNCNECK,yUlAOER FEE AECHPTNO. <br /> �r s�3 ,�., <br /> useioNt �oinnen vncnNrsite FEES VALUATION FEE <br /> i <br /> f1YES ❑ NO ppILDMC � <br /> IIEIGHT LIM1IITAiION NO OF UWELUNC S�ZE OP 9lDG/1'1. � <br /> UNI15 P�UMBING � � <br /> T <br /> OCCUPANGY NOOi5i0R1[5 OCLUPANTLOAD 8.45[MENI M[CIIANICAL j <br /> GROUP <br /> nves n rvo ; <br /> FIRE RLARM REO'D REASON PDDITIONnL PLnN CH[CN � <br /> i <br /> OTIIER i <br /> FIRE SPPINNLER REO'0 REASON � <br /> STFTE BUILDING SURCHAAGE � <br /> � <br /> TVPEOPCONST. PLANSAPPROVEDBY CITYOPEVERETT PUBLICWORNS i <br /> LOCALSALES ; <br /> oqTE TAX CODE IS 3105 To7Al � <br />