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APPLICATlOrI FOR CONSTRUCT�JN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> f1 DEMOLITION �l COMBINATION Il BUILDING �] MECHANICAL ' PLUMBING fl SlCyil <br /> PROJECT ADDRFSS <br /> ���; D '1LU rl�.�' - � :�i �J <br /> o n+mi onese✓ ❑n rir rHorie <br /> Gt� � , � � �.h-z��> <br /> IEN�Ni 61nILpOpR[55 CI1V ]ip �`HONE <br /> ARCHITECTOROESIGNER MAILRODRE55 CITY pIP PMOkF. <br /> GENERRiCONTRaf.TOR AIqILA�Of1E55 CITY 71P f110N[ SiATELICENSEr <br /> MECH�NICALCONTRACTOR MAIIADORE55 CITY Z�G PIIONE STq1ELICENSEr <br /> PWMPINGCON1PnC70R NNLAD�RE55 CIiY zIP PMONE STI.TELILENSE� <br /> c��'i�'�//� , � �� �/_�c� C.�>,h s P ?1��T)�;"4�z1��%� �c.� <br /> CONTRRCT PRICE OF WOIIN I <br /> � � HEATING SYSTEM: ❑GAS Cl ELECTRIC ❑ <br /> DESCRIBE WIXiK AND SOUARE FOOT�GE INVOLVEO �pNTACT PERSON nND PHDNE N0. <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE OF BUILDING APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LUESCRIPTIONOFPROPERTY�SHOWNBELOWO�iRTTaCMiWOGOPIES) NOT. THE GRANTING OF P. PEFMIT DOES NOT PRESUME TO GIVE <br /> ioT eiocK__or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER gTATE OR LOCAL LAW REGULATING CONSTRUCT�ON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL T �o.rvurnee�aJ� " CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONS���JO�LENDER.ADORESS.7E�EPHONENUMBER x ��/��_���, �/S�S <br /> SIGNATURE �� D�iE <br /> CITY flU51NE55 LICENSE NO. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS-9.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) HEAT PUMP , <br /> SHOWER � UNITHEATERS—B.T.U. M <br /> KITCHEN SINK h DISP i CLOTHES DFYERS � <br /> DISHWASHER � VENTILATION FPN T <br /> LAUNDRY TRAV � RANGE HOOD ' <br /> CLOTHES WASHER � WATER HEATER T <br /> URINAL � WOOD STOVE <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE�NSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ' <br /> SWK(SERVICE—BAR, ETC.) GAS RANGF T— <br /> __ _. <br /> GAS PIPING ' <br /> EXHAUST FAN i <br /> i � <br /> �— <br /> i i <br /> — ' <br /> SUBTOTAL 3 SUBTOTAL $ � <br /> PERMIT S i PERMIT $ i <br /> - — --�— <br /> TOTAL FEE 5 ' TOTAL FEE $ � <br /> FOR OFFICE USE ONIY• <br /> FRONT SET[i�CK RE0.P SF.THACK SIDE SETBRCK PLAN CHECK NU110E(i FEE RECEIPT N0. <br /> usezoNe �.otnnen vacnNrsite FEES VAWATION FEE <br /> nvEs n r+o ' <br /> eunoir+c � <br /> HEIGH7LIMIT�TION NJ.VFOWELUNG SIZEOPBLOGRI. <br /> UNIiS PLUM�INO � <br /> OCCVPANCY NO OFS�CMIES OCCUPPNTLOAO BRSEMEN7 � <br /> GROUP MECMANICAL i <br /> IlVES �l NO � <br /> FlREAIAPMRE00 PEASON AUDIPONPIPLANCHECN � <br /> OiMER � <br /> FIRE SPRINNLER PEO'0 RE�SON <br /> � <br /> STRi[BUILDINGSORCIIRRG[ � ' <br /> � <br /> T'PE OF WNST 71ANS nPPROVED BY CITY OF EVERETT ruouc woaKs <br /> LOCAL SALES � , <br /> oATE TAX CODE IS 3105 TOTAL ; <br />