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APPLICATI�1 FOR CONSTRUC�i�iON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> f7 DEMOLITION fl COMBINATION f� BUILDING fl MECHANICAL f�LUMBING f I SIGN <br /> PROJECT ADDRESS <br /> Z 7_ G: .�ac <br /> �OWNER fiWILRDORESS 9`� CITV /� ��� 7,,1P�, 110NE � <br /> ��Cl/T�(./ ��r/Y7/'�� '�`��.�� 07/)1)�6` , i � 7 <br /> iENAHi // ��AI R Dfi[55 Cltt liP PI/ONE <br /> U %'7X-�'/�.-�" <br /> ARCHRlCTOBUESIGNER MRILADDRE55 LIiV 11P f910NE � <br /> G2NEFALCONTFlACTOR MARRODRE55 CI1V 21P P1109E STATEUC[NSE� <br /> jvA/t'UM c�ivr (l� z � Guii/A/o/�/�I� SiLoNo��iSb 98zYo 3dl�PG�' - YoA�y��.��s <br /> ECHANICALCONTRACTOR MPIL���RE55 Cltt ZIP PNO�E STATEUCENS • <br /> PWMBINGGONTRnCTOR MA1LAObRE55 CITV ZIP PHONE STAIEIIGENSE� <br /> 6 � � <br /> CONTRACT PRICE OF WOt1K <br /> HEATING SYSTEM: Cl GAS f- ELECTRIC Cl <br /> DESCRIBE WORN AND SOU�RE FOOTAGE INVOLVEO COVTACi PERSON�ND PNON[Np. <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINLD THIS <br /> APPLIC�1TION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSEOUSE OF 8 ILOIN� pROVI510N5 OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> ! WORK WILI BE COMf'LIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LDESCRIPT N PROPER 15110WNBELOWORATTACIITYOLOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ioT p�ocK or_ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PER�ORM THE WORK FOR WHIf,H <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> GONTRACTORS LAW 1827 RCW AN 96.200 WAC. <br /> PARC[LTA%ID.NIIMBER <br /> CONSIAUCTON LO�H LENOER,ADDRESE TELEPIIONE NU�AOER x <br /> SIG URE DAtE <br /> �ITV BUSMESS LICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF FI%TURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. ' <br /> BATHTUJ ' FORCEDAIRSYSTEMS—B.T.U. M E.A. i <br /> LAVATORV(WASH BASIN) HEAT PUMP ' <br /> SHOWER UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK R DISP i CLOTHES DRVERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNDRYTRAY RANGEHOOD � <br /> CLOTHESVJASHER i WATER HEATER ' <br /> URINAL WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) �_ <br /> FLOOR DRAIN FIREPLACE INSERT(WOOD DURNING) <br /> � <br /> BP.CKFLOW PREVE�JTERS ; GAS FIREPLACE <br /> SINK(SERVICE—DAR, ETC.) GAS RAN6E ' <br /> GAS PIPING � <br /> i <br /> EXHAUSTFAN ' <br /> i <br /> SUB TOTAL 5 � SUB TOTAL 5 __� <br /> PERMIi S � PERMIT 5 � <br /> TOTALFEE 5 � TOTAIFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SEI�RCN R[4R SF.TOACK BIOE SETOACK PIAN CNECN NU OER �[E RECEI�T N0. <br /> � ������ ; <br /> usezoN[ ioTaeen vncnNrsrte FEES VALUATION FEE �_ <br /> nrEs n r+o � <br /> p111LDIN a i <br /> HEIGHTLIMITrIT�ON Nn �FDWELLING SIZEOFOLOGRI. i <br /> UNITS pLI1N�ING <br /> i <br /> OGCUPANCY NOOiStORiES OCCUPANTWAD BASEMENL �AECI�NICAL � <br /> GROl1P f7YE5 fl NO ' i <br /> PCDITIONAI PLAN GNECK <br /> FIREALARMREO'D REA504 <br /> i <br /> OTHFR � <br /> FlRESPi11NKLERPEOD PEASON � <br /> ST�1E OL9L�t\C SURCNARGE � <br /> � <br /> � <br /> rvveoFcoNsr rinNsnrrnovcnav CITYOFEVERETT PII�LiCW01iK5 � <br /> LOCALSALES ' <br /> pAiL <br /> TAX CODE IS 3105 TOTAL ' <br />