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r � . <br /> � � APPLICATII..�I FmR CONSTRUCI .ON PERMtT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 a <br /> f� DEMOLITION f 1 COMBINATION i�E'UILDING I 1 MECHANICAL fy PLUMBING i 1 SIGN <br /> PROJECT AODRESS c,�� � r <br /> --"-t��� ��qu��P��T a�r� — GVE2�11 <br /> OWNER M�ILApDPf:S$ �f.ltt IIP PIIONE <br /> r �u ��MAa�J�� (,auc u,��,No;,1,.1,g.�g�z� 77s- n69� <br /> �-�a k:. .� <br /> IEtJANT MAILAOD E55 i.i1V i1P P�IONE <br /> ArlC11RECTORDE5IGNER MAILADpR[SS CIiV 21P �.q�p j_..,/��� <br /> �(�1eL�lE�.,Anl� "�i�l LaD- Sa��� A�DQ�` RS dE�UE � � vb Nct�IENIJL077UC <br /> GENEP�LCONiR�Ct R . �LPODRE55 CItV ZIP PIIO4[ STATELICENSE� <br /> MECHANICALCONiH�CIDR M1IAI�pDDRF.55 CITY .P PNOIJF $TATELICENSE• <br /> � 1-zcc-g?�,-v�31 <br /> �A�s �'tur,v� 'Po.P�x le7 ���r.� l.✓�. ��3,�_ �r4Nu-�LS�� wL <br /> PIUMBINGCONTR0.CiIXi M>ILADDRE55 C17V ZITi 1'HONE STAIELIGENSE� <br /> CONiR�Ci PPICE OF WORK <br /> ��cJ. �c�,� �'7�1, 1 5(� HEATING SYSTEM: f 1 GAS rl ELECTRIC <br /> DESC IBE WU K ANO SOUAR[FOOTAGE INVOLVEO CD'1TACT PERSON ANP PHO�E NO. <br /> Iq49 r-G 4� (�nvqiG !' - - - � <br /> I HEREBV CERTIFV THAT I kiAVE READ AND ExAMINED THIS <br /> PPOPOSEDU�E OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> S�Q—. WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGFLOESCRIPTIONOFPFOPE�tt�SMOWN9ELOWORATfPC11TWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior�__BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHErI STATE OR LOCA�LAW REGULATING CONSTRUCTION OR THE <br /> � ?(�J-�i PERFJRMANCE OF CONSTRUC?ION.TH T I AM AUTHORIZED BY THE <br /> 5� OWNER OF THIS PROPERTY TO RM THE WORK FOR WHICH <br /> �l. S � e APPLICATION IS MADE AN I OMPLV WITH THE STATE <br /> PARCEITn�t10. UMBER CONTRACTOR L N 1�27 A 96200 WAC. <br /> "�� Prs.r,.tt4�.0�0'OL -'� <br /> CONSTRUGTION LORN IwEN_D�ER,RODRE55.TELEP/IIONE Nl1MBER7 �f� 1 x " `,�'Q( � <br /> �Yn! �41vtin i i(YI�h� 'F�jL� C����•)(�J�� Ai RE D�TE <br /> �_ '-��� �� qQyrs ai ssucEr+ser+o. <br /> E��yL.. <br /> PL MBING MECHANICAL <br /> NO. TYPE OF FI)CTURE OR ITEM FEE N0. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � AIC—A/HNDLG UNITS—H.P. � <br /> � BATHTUB ; FORCED AIR SYSTEMS—O.T.U. M E.A. ; <br /> LAVATORV(WASH BASIN) / i HEAT PUMP � <br /> SHOWER ' UNITHEhTERS—B.T.U. M Z�jp � <br /> KITCHEN SINK 8 DISP i CLOlHES DRYEIIS � i <br /> DISHWASHER � � VENTILAT�ON FAN � <br /> LAUNDRVTRAY � RANGEHOOC — ; _ <br /> � CLOTHES WASHER � � WATER HEATER _ � <br /> URINA� WOOD STOVE ' <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERV'CE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING <br /> I EXHAUSiFAN � <br /> —•— <br /> � <br /> i � <br /> ' —�— <br /> � <br /> SUB TOTAI. 5 � SUB TOTAL S � <br /> PERMIT . 5 i PERMIT $ � <br /> TOTALFEE $ � TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONT SETA4CR REM SETOACK SIOE SETOACK PIAN�y Ey N�NUMflf.R �F:f: F[CEIPT N0. <br /> 20 ' zo' S' 'I?5 ��� 351.3z I 9�� <br /> usezor+e �oinaea V�CANTSIIE FEES VALUATION FEE <br /> �_� �3pQ �s n Hn ou..oiHc '78 pZ `��j+ . <br /> REIGHTLIMITATION NO.OF�W[WNG 512EOF�lDGT � <br /> q [{,� ' UNIiS I 'Lt(�9 SE LIVING f' PLUMOiNG _ f�i <br /> ���1 S Sf G.JUc:` <br /> OCQIPRtlCY NO OF Si0RiE5 OCCOPAM LORD BASEA�[NT M[CIIANICAI ��� � <br /> cnou3 Z �,I <br /> nres o � <br /> FIRE PLARM REO'U REASON AOOITION�L PIAN CNECK i <br /> � / , <br /> OTM[R � <br /> FIRE SPRINKIER P[O'D RUSON <br /> STAIEOUIIDINGSURCNPRGE � i�� <br /> i <br /> TVPEOfCONST PLl�NSAPPROV � � <br /> CITY OF EVERETT runncwonKs <br /> �_� LOCAI SALES <br /> onTe S�L��5'S TAR CODE IS 3105 TO7AL � ��� <br />