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APPLICATIG.1 FOR CONSTRUCT .JN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> i 1 DEMOLITION f 1 COMBINATION ✓F3UILDING �I MECHANICAL I i PLUMBING i ' SIGN <br /> PROJECT ADDRESS ��yy/ �m/ -� /?. ,'� / / /./O� <br /> .��iv c�u��r� �v <br /> O ER MRILAD�RESS CILY ]ip PIIONE <br /> e�s s�rmE <br /> +n n+ �nnoa�ss arv zir vi�oNe <br /> ARGMIiECTOR�ESIGNER MAII AD�RE55 QtY IIP PHONE <br /> GEN�;�CONiRACTOR MAI;.RDD9ES5 ❑lv :ip PIIONG STRTELICENSFM <br /> U,��.rL� <br /> MECNANICALCONTqACTOR MAILAD�RE55 C17Y 21P PHONE $TATELICENSE� <br /> PLUMPINGCONTPRCTOR MAILADDFE55 CITV ZIP PNONE STATGUCENSE� <br /> CONTMCT PRILE OF WOPK A � <br /> � HEATING SYSTEM: C1 GAS f�l ELECTRIC f7 <br /> DESCRIBEY/ORK�NpSOUAREFOOTRGE NVOLVEO � LONTRCTPERSONFNOPHONENO. ` <br /> �• <br /> 13 � cE' C � `' <br /> � I HEFEBY CERTIFY THAT I HAVE AEAD AND EXAAIINED THIS <br /> APPLICATION AND KNOW THE S4ME TO BE TRUE AND CORRECT.ALL <br /> PROPOSEDUSE OF BU1L ING�J T1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> GF �S// G � C� WORK WILL BE COMPLIED WITH WHETHER SPECIFIEU HEREIN OR <br /> LEGR�DESCRIPTIDNOFPROPERtt�5H01VNBELOWOfiAifACNTWOGOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tot eiocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORRED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICAiION IS MADE AND I COMPLY WITH THE STATE <br /> ?ARCELTAXI NUMBER CONTRACT LA 1827RCW i 296200WAC. <br /> 3 o G-� �o oa/ �`'�L �— <br /> CONSTII TION LOAN IEN�ER�ODRE55.TEIEPMONE NUMBER x J J � <br /> SIGN E 0 T[ <br /> LITV pU5ME55lIGCNS[N0. <br /> PLUMB�NG MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> � WATERCLOSET(TOILET) � A/C—lJHNDLGUNITS—H.P. � <br /> BATHTUB ; FORC'�D AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) i HEAT PUMP i <br /> SHOWER � UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK 8 DISP i �'IOTHES DRYERS i <br /> DISHWASHER VENTILATION FAN <br /> LAUNDRYTRAY ; RANGEHOOD � <br /> CLOTHES WASHEfa WATER HEATER —�— <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE � <br /> ' GAS PIPING <br /> i EXHAUSTFAN i <br /> i <br /> i <br /> i <br /> SUBTOTAL S ; SUBTOTAL 5 ; <br /> PERMIT S i PERMIT S i <br /> TOTALFEE S � TOTALFEE F ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETORCN P[AqSETAAGK SIOESETOACK PLANCHFCK➢IUMOFR FEE RECEIPTNO. <br /> �'�� — <br /> uSezoNe �oTan[a vnenrvrsne FEES VALUATION FEE <br /> nvEs n No ; � <br /> _ omiow� ���� <br /> � <br /> MEIGMTLIMITATIDN NO.OFDW[LLING SIZEOfHLOGIfI. i - <br /> ❑NITS p�pN01NG � <br /> OCCUPRNCY NO OFS70AiE5 OCCUPANTLOAD 9ASENENT MECHRNICpL i <br /> • .� I t7YES (Yr0 - � <br /> FIRE LA M@W'0 REASUN ADDITIONALPIANCNECN � <br /> I OTIIER � <br /> I <br /> fIRESPRINKLFP(iL0'D PEASON y� i <br /> A��y� 7/�u �b lG BUItDING SUFlCMARGE L ��-) <br /> rrw�, �ti .e�,w, <br /> nvE vc r. v,qNsnr no oor CITYO EVERETT rueucwonres ' <br /> LOCALSALES <br /> `� �� oa.e '� �0 9a TAX CODE IS 3105 TOTAL I <br /> �1'�r� '����-z. �59-,�,��o <br />