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APPLICATII.nI FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT•BUILDING DI�ISION �C� <br /> 3200 CEDAR RTREET• EVERETT, WA 98201 • 259-8810 <br /> f� DEMOUTION f� COMBINATION I� BUILDI��G �l MECHANICAL I l PLUMBING f i SIGN <br /> PROJECT ADDRESS <br /> c J "- — P�T� W►h <br /> °�NIY iF f{i�l.. C.t��°DRESS cin zm rr�a+E <br /> ,�.,r r,-�o,�,.� r? o, �ax S� s No Nar�lsH I.�r� �i 8�'ia ��N-al ff'-r <br /> TEN�NT MFII ADDRE55 CILY li PHONE <br /> D�5 iGti! CorrSu�T�FNTS <br /> ARCHItCCTOR0E5�3NEP MRiLAD�RE55 �itY ZIP PIIOtiF <br /> GENERPLCONTPICTOR MAILADDPE55 CI1V ]IP PIION[ SiATEUCENSF• <br /> MECHRNICRL CONTRACTOR MAII ADDRF.55 CIN ZIP PMON[ $TRTE LICENSE� <br /> PIUMBINGCONTRACiOR MAiLRDDRESE CiiY ZIP PHO��E STATEIIGENSE� <br /> CONTR�CTPNICEDf WC%�N HEATING SYSTEM: 1-1 GAS Cl ELECTRIC rl <br /> � .�� OD <br /> f1ESCRIBE WORK AND SOUARE FOOT�GE INVOLVE7 CONtOCT PERSON ANO PNONE NO. <br /> ZG?L�6 A-N 6ui�lt� � i� 33 -a16S <br /> .,l ! �I,q-T IS S NdwlNC, S <br /> I HEREBY CERT�FV TH4T I HAVE REAU AND EXAMINEU THIS <br /> APPLICATION AiJD KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> FROPOSEDUSEOFBUILOING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> _� W09K WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �ece�oescairna+oFvrroaenn'�sHormeeiowonnrrncHrwocovies� NOT. 7HE GHANTING OP A PERMIT DOES NOT PRESUME TO GIVE <br /> tor �O eiocK�J�) oF_� AUTHORITY TO VIOLATE OR CANCEI. THE PROVIS�ON OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PE9FORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AN I COMPLY WITH THE STATE <br /> CONTRACTO S LAW B27 RC AND 296200 WAC. <br /> PARCELTIJ(I.D.NUMBER <br /> CONSTRUCTON LO�H LENDER.ADIMiESS TELEPNONE NUMBER x �Z�S <br /> SIGNAiUPE DRT[ <br /> - Cltt BUSMESS LICENSF.N0. <br /> PLUMBINO MECHRNICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF FlXTURE OR ITEM FEE <br /> WATER CLOSET(TOILEI) � A/C—NHNULG UNITS—H.P. : <br /> � FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> BATHTUB � <br /> LAVATORV(YVASH BASIN) �T-- HEAT PUMP ' <br /> SHOWER ' UNITtiEATERS—L.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER VENTILATION FAN ' <br /> • LAUNDRYTHAY � RANuEHOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> UR�NAL ' WOOD STOVE � <br /> DPINKING FOUNTAIN � METAL FIREPLACE(WODD BUflNING) � <br /> FLOOR ORAIN � '�IREPLACE INSERT(WOOD BUFNING) � <br /> BACKFLOW PREVENTERS ; 3ASFIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) �iAS RANGE <br /> � GAS PIPING <br /> — � EXHAUST FAN ' <br /> i <br /> SUB TOTAL S ; SUB TOTAI S ; <br /> PERMIT 5 � PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> fqONT SETBRCK �EAR SEiBACN S�DE SETBRCN PIAN CHECN N Of�� <br /> FEE RECEIPTNO. <br /> �' <br /> FEES VALUATION FEE <br /> USE ZONE LOT ARf� VACANi SITE �� <br /> IlYES n NO pWLDING S 000 i =1� <br /> (J <br /> I i <br /> HEIGMTLIMITAiIDN NOC'.7WF.LIJNG SIZEOfBLPGrt1. � <br /> UNITS �f Q PLUMOING <br /> / ' I <br /> I <br /> I <br /> OCCUPANC� NO OLSTOFIES OCCUPANTLOAO BASEMENT IAELMANILAI � <br /> i PROUP � <br /> �q �� N A ❑YES fl NO � <br /> ADDIPONPL PUN CHECN � <br /> !�IRE�LFRM REO'D REASON � <br /> �✓/� onicn � <br /> FIPE SORIVKLER RCC'L REASO4 � <br /> STRTE OUILDING SU�GMPRGE � <br /> i <br /> N � <br /> TYPEOFCONST. PIANSA� ROVEDBY CITVOFEVERETT �'UPLICIVORKS � <br /> ,��T. wr1�-� � L9CALSALES � .�L ;� <br /> onTE � - a -9 5 TAX CODE IS 3105 707AL <br />