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.�. ,.. <br /> APPLICATII..�1 FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOUTION fl COMBINATION K BUILDING I�1 MECHANICAL f� PLUMBING fl SIGN <br /> PROJECTADDRESS 2821 Rucker Ave. Evere[t <br /> OWNER MAiL�DDRF55 CITV ZIP PHONE <br /> H . S . BarGreen Trus� same 98201 206 252 3161 <br /> TENANT MAII.ApORE55 qry ZIP PIIONE <br /> RRCNITECT OR OESIGNER MFILADORE55 CI'V LP PHONE <br /> ,ierry Hoco How Engineering 2535 152nd . Ave N. E. Redmond , lda. 98052 <br /> GENE CONTIiACTOR MAILADDPE55 �ITV ]IP PMON@ SiATELICENSE� <br /> _ i�w� <br /> MECHANICRLCONiRACTOR MAILA��RE55 CITV ZIP PIIONE STATEULENSE� <br /> PLUMBING CONTRACTOR MnILA��RE55 CPY ZIP pHONE STATE UCENSE� <br /> CONTP�Ci PPICE OF WORK � <br /> pnnOX $ 50 ,000 . 00 HEATING SYSTEM: ❑GAS ❑ELECTRIC C7 <br /> pE$CRIBE WORK AN SOURRE FOOTAGE INV LVBD CON Ci PE ,.ON D PHONE NO <br /> fietal �frame insi�e building for �oca�'e �'argreen 206 252 3161 <br /> earthqua$e nroofing <br /> Co£fEe nlant I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE OFBUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALOESCRIPTIOkOFPRCPERTY� HOWNBELOW RTTACNTWOCO IE5) <br /> 8A 66� D-0� �verett glatt NO7. TFIE GRANTIN6 OF A PERMIT DOES NOT PRESUME TO 61VE <br /> �or BLOCK oF -� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL lAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEITA%I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> 4391-669-903-�003 <br /> CONSTRUCTION LO�N LENDER,p�DRE55.TELEPHONE NUMBER x C� � �.�' <br /> ' SIGN ❑ OO DATE <br /> CITY BUSME55 LICEI E N0. <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TVPE JF F' 'TEM FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLF i <br /> BATHTUB ; FORCED AIP E.A. ; <br /> LAVATORV(WASH BASIN) � HEATPU� � <br /> SHOWER � UNITN� � <br /> KITCHEN SINK 8 DISP i CLl' ! ; <br /> DISHWASHER ' �� �O PLry� C� IC �EC �— <br /> IAUNDRYTRAY � • � <br /> CLOTHES WASHER � T— <br /> URINA� O N Y�'1�� ��� �— <br /> DRINKING FOUNTAIN � <br /> FLOOR DRAIN � / n` <br /> BACKFLOWPREVENTERS � I C��SMIIi �� ��Q'l` <br /> SINK(SERVICE—BAR, ETCJ � � � � <br /> �— <br /> � i <br /> �_ <br /> � i <br /> � <br /> � � <br /> SUB TOTAL $ � $ � <br /> PERMIT S i $ i <br /> TOTAL FEE S � .�FEE $ � <br /> FOR OFFICE U9E ONLY: <br /> FRJNT SETBRCN RERR$ETOACK SIDE SET�FCK PLAN CII NUMHER FEE RECEIPT NO. <br /> �/�:� �(��: /��S <br /> usezor+e �oTnn�n vncaNisire FEES VALU TION FEE <br /> G �/ flYES (l NO OWLDING SF�S�7�C UP�OF SO 04P � �O <br /> NEIGNT LIMITATION NO OF DWEILING SIZE OP BlD(iRl. � <br /> UNITS �^ PLUMI3ING �/ � r,'� i <br /> "1 <br /> OCGUPANCY NO OFSi0R�E5 OCCUPANTLOAD BASEMENi <br /> GROUP MEOIANICAL I <br /> / �2 � N� f7YE5 fl NO � <br /> i <br /> FlRE�LARMqEO'C REASON AD�ITIONRLPLFNGHECI' � <br /> N/� ' <br /> OtH[R i <br /> FIRE SPRINKLER REO'D REACON — � <br /> N STATE BUILOING SURCM4qGE 1 <br /> i <br /> i�,� <br /> TYPE OF CONST. PIANS AP OVE�BV i <br /> CITY OF EVERETT rueucwonKs � <br /> V � �. / � LOCAL SALES , <br /> V onre �S` TAX CODE IS 3105 TO7AL � � ; <br />