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APPLICATII.�I FOR CONS7 RUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> ❑ DEMOLITION I 1 COMBINATION I 1 BUILDING yf MECHANICAL f l PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> �� . 1 '— � � � \ � <br /> OYMER —,` ' �MAILAOOPES:' CI Y IIP PIION[ , c.� �/ <br /> ,l-'f ^ly��� � � Il;ri.1�o,C���� ����/')�-�/ <br /> TEN�NT� MAII.RDDRE55 (,'ITV Zio PNONE <br /> �ll�l�L���1�L? � '��iimu.�= s/J c�'cCc�7 9k'ao/ <br /> RCHITECTOqDESIGNER MMLA�DPE55 CItY Zln �'HO E <br /> GENE LCONTM Tqi MAIL�DDAE55 CIIY ]iP PHONE STAIELICE E� <br /> �"� h�,-��/�;�;r� � �oo ia�,����,�.-- � �/� 5��� 2�� -- `%��'�'�l��,�'- <br /> MECHANIL�L CONTRRCTOR MAIL AD�RE55 CITY 21P PNM�E STRTE J ENS • <br /> fiUMBINGCONTRACTOR MAIL�DDRE55 Cltt ZIP PIIONE STRTELIGENSE� <br /> CONiR�Ci PqICE OF WORK <br /> •— HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br /> DESCPIBE WORI 0 SOU�RE FOOTAGE INVOWEO�. COYTAC PERSON ANO PIIpNE <br /> /' C" � — ,� <br /> '7 � <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �ROPOSED USE OF BUILDING APPLICATION ANU KNOW TkiE 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 /> LEG�LDESCRIPTIONOFPROPEHTV(SHOWNBELOWOi1A1?ACNTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior e�ocK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW RE INQ CO STRUCTION OR THE <br /> PERFORMANCE O NSTRU ON.T AT AUTHORIZED BY THE <br /> OWNER O O TO PE E WORK FOR WHICH <br /> APPLI 10 AD AND Y WITH THE STATE <br /> PMCELTA%I.D.NVMBER CONT W 18 RC WAC. <br /> CONSTHULTIONLOANLENDER.ADOR S.TEL HONE NUMPEP ' / / r_� <br /> SIGN�TU � DRTE <br /> CITY BUSME55 LICENSE NO. <br /> PLUMNNO MECHANICAL <br /> NO. TYPE OF FlXTURE OR I7EM FEE NO. TYPE OF FlXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—NFiNDLG UNITS—H.P. � <br /> BATHTUB � FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> UVATORY(WASH BASIN) HEAT PUMP � <br /> _ SHOWEF � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS i <br /> _ DISHWASHER � VENTILATION FAN i <br /> _ _ LAUNDHYTRAY � RANGEHOOD � <br /> � <br /> _ CLOTHES WASHER � WATER HEATER , <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ' GAS FIREPLACE ' <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE � <br /> GAS PIPING i � <br /> i EXHAUSTFAN � <br /> i � <br /> � � <br /> � � <br /> � � <br /> SUB TOTAL $ � SUB TOTAL S ' <br /> PERMIT $ � PERMIT $ / � <br /> TOTALFEE S � TOTALFEE S � <br /> FOR OFFICE USE ONLY: <br /> FAONT SET9RCK R@Aq SETBRCN SIDE SETBPCK PLAN CHE NUIM�F./ PEE NECEIPT N0. <br /> d- <br /> usezor+e iornaen vacaNtsrte FEES VALUATION FEE <br /> mEs n no BNLOING ; <br /> � <br /> MEIGHT LIMIT�TION NO.OF Dw[LLING SIZE OF BLDGrti. <br /> UNITS � <br /> PLUM9ING � <br /> OCGIIP�NCY NO 0!StORiES OGCUPqNi LORO BASEMENT MECHRNICRL i <br /> GROUP <br /> ❑YES Cl NO � <br /> � <br /> FIRE�URMREOD REr150N ADDITIONRLPLANCMECK � <br /> OTMER i <br /> FIRE$PPINKLER REO'D REASON <br /> i <br /> i <br /> STA1E AUILDING SURCHARGE i <br /> iVPE OF CONST. PlANS PPPR0YE0�Y CITY OF EVERETT PUBLIC WORHS � <br /> LOCALSALES <br /> DATE TAX CODE IS 3105 TOTAL ; <br />