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APPLICATI�.N FOR CONSTRUC'� .vN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />DEMOLITION i l COMBINATION I 1 BUILDING I� MECHANI.:AL I l PLUMBING fl SIGN <br />IOJECT ADDRESS <br />� %�d SC1 rnm � � <br />/7�ank Jo�jnso+- 3�1/0 �„k�A` ��t- ���� 96�4' o2��j-6o7y <br />TENANT MRIIAUpN[55 CIiV IIP PiIONF <br />RRf.HITECiORDE5IGNEB MPILAppqE55 CiIY ZIP PIIO4F. <br />MAIL A��RGSS <br />Qiv 71P P�ION[ STAtE LIC[NSE r <br />MECIIRNICpLCONTRACTOR MAIL�DORE55 CIN iIP PIIOYE SihTELICENSE� <br />PLUMBINGCONTR4CTOR MnILA0DRE5S Cltt ZIP P110Nf STAIELICENSE• <br />CONTRRCT PRICE OF WOPN <br />DESCPIBE WORK RNO SOUnPE FOOTnGE INVOLVEO <br />1��.+vv v �^em�« KeriJ�nc� -}�i�x' is <br />�.r �Q..,4�1 -�o�. r��� <br />PROPOSED USE OF 9UIL�ING <br />LEGRLDES IPTIONOFPROPEPtt(5 OWN9ELOWORAT'TJAC IWOCOPIES/� <br />lOT � �'a BLOCK � � OF �/���'Q��' ` � �� <br />� �n� �D / � �, <br />P�HCELTA%IO.NUM <br />�/m (/��ia 00/ DOOS <br />CONSTRUCTION LOAN LEND[R, AODRE55. TELEPMONE NUMB@R <br />PLUMBINO <br />NO. TYPE OF flXTURE OR ITEM FEE <br />IAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CIOTHES WASHER <br />URINAL <br />DRINK�NG FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />FINK (RFRVICF — RAR F7 <br />FOR OFFICE USE ONLY: <br />FRONTSf-TAACK RE�R SETOACK <br />USEZONG <br />HEIGNT LIMITATION <br />OCCUPANCY Hpl <br />GRDUP <br />FlRE ALARM IlEO'0 <br />LOTAREA <br />NO OF I]W[LLING <br />urnrs <br />PIANS FPPROVE� OY <br />SIDE SETOACK <br />HEATING SYSTEM: I l GAS Cl ELECTRIC fl <br />LOMACT Pf.R50N AND 1'110NF. NO <br />I HEREBY CERTIFV THAT I HAVE READ AN� EXAMIWED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COFiiiECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPEC�FIED HERE�N OR <br />NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CON�TRUCTION. THAT I AM AUTHOR12ED BY THE <br />OWNER OF THIS PROPERTY TO PcFFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOfiS LAW 1827 RCW AND 296200 WAC. <br />X/��in�u9 �A�.._. e7 - 2 3- 9� <br />$IGNAiIIRE � ' DRTE <br />QiV BUSMGSS IICENS[ N9. <br />MECHANICAL <br />N0. TYPE OF FI%TURE OR ITEM FEE <br />A/C —NHNDLG UNITS — H.P. � <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br />HEAT PUMP i <br />UNIT HEATERS — B.T.U. M ! <br />I�1�/s1AyI:7��AStl3 <br />RANGE <br />PIPING <br />IUST FAN <br />SUBTOTAL 5 <br />PEiiMIT 5 <br />TOTALFEE $ <br />PtANCH[CNNIIMpfP �fEE ��ECF.IPTND. <br />vnCnNr S�rG reta <br />f1�E5 (1 NO OUILOING <br />sizE or oiocn.i <br />rwn+oir+c <br />045EMENi MECMANICFL <br />f7YE5 fl NO <br />ADDIPONAI PI AN CNECK <br />Oill[R <br />STATE BWLDRJG SURQIARGE <br />CITY OF EVERETT rueucwonKs <br />LOCALSALES — <br />TAX CODE IS 3105 TO7AL <br />