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� � `` ��1�PP .� A4'IG.� F0�3 CONSTRUC? .J1�1 ��R�IAIT <br /> I �, 11 A <br /> �l L ��H �0 1995 CITY OF EVER�TT• BUILDING DIVIS�ON <br /> ___....`... <br /> ..... 3200 CEDAR STREFT• EVERETT, Wa 98701 • 259-8810 <br /> i ! DHa1�YIl�N�vC��tl, COMBINATION f l BUiLDING I ; iVIECHAMCAI i%✓pI.UMBING f l SIGN <br /> PROJ DDRESS � i <br /> 70 0�' Pt,►c� e�erie�r >� <br /> OWNEfI MAILAppRE55 CITV ZiP PHONE <br /> Onu-� h6Mes, _GK. 33�� FuHanw-� AJE g. �'ia� Se9rn& 9g�oa- 3,zs- sJx� <br /> TENnNT ,.INI A�DBE55 GIiV .'IP PHONE <br /> ARCf11TECTOR�E5IGNER MF!LADCIin55 GIiV ZIP PMONE <br /> GENEPFLCONT9ACTOR MAiLADDRE�o CITV ZIP PHONE STATELICF.NSEM � <br /> MECHANICALCONTRACTOi7 MFILAO�RESS CIiV TIP PHONE STATELICENSEv <br /> PWMBINGCONiPACTOR MAILAODRE55 CIiY ZIP PHOYE STAiEI.I�ENSEn <br /> PAuA� rka.r«,.�sr P�u,�a�aS, saG. Po 8ox Ba}39 ✓�a,�,oaE 9soss Ysl.�,r..o n.oC=FaPi4YeM <br /> WNiHACT PRIGF.OF WORK <br /> HEATING SYSTEM: I-1 GAS fl ELECTRIC CI <br /> �ESCFIBE WORK AND SOU�RE FOOT�GE INVOLVEO COYIACT PEFSOY ANO PHONE N0. I <br /> I HEREbY CERTIFY THAT I HAVE READ AND E;;AMINED THIS <br /> — APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSED IISE OF BIIILDING PRO'JISIONS OF LAWS AND ORDINANCES GOVERNING TfiIS TYPE OF , <br /> VJORK WILL BE COMPLIED WITH WHETi1ER SPECIFIED HEREIN OR <br /> LEGALOESGRIPTIONOFPl10PERTY�SHOWNBELOWORATfACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NO7 PRESUME TO GIVE <br /> �or BLOCK oF AUTH�RITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEAFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICFI <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> aance�Tnx i.o.NUMeea - CON7RACTURS LAW 1827 RCW AND 296.200 WAC. <br /> CONSit1UCTI0NLOANLENOEfi,A�ORE55,TELEPHONENUMBER X��Li�1 �^_�I ��•q�r <br /> C •L [J <br /> S^IG��'TCUfl'E� ' DATE <br /> �Jl�+ <br /> CITV BU9NES5 LICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TUR[OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> 3 WATER CLOSET(TOILET) �/ � AIC—A/HNDLG UNITS—H.P. � <br /> e7, BATHTUB �y ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH 6ASIN) �g � HEAT PUMP T— <br /> SHOWER 7 � UNITHEATERS—E.T.U. M � <br /> � KITCHEN SINK&DISP i CLOTNES DRYERS i <br /> � DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HOOD ; <br /> / CLOTHES WASHER � WATER HEATER —r— <br /> U(iINAL � WOOD STOVE ' <br /> DRINKING FOUNTAIN i P/,ETAL FIREPLACE(WOOD BURNING) i <br /> FL�OR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTGRS ; GASFIREPLACE ; <br /> SINK(£EqVICE—BAR, ETC.) GAS RANGE —T <br /> GAS PIPING ' <br /> � <br /> i EXHAUST FAN i <br /> i i <br /> i i <br /> i <br /> i <br /> SUB TOTA�_ 5 � SUB TOTAL S' � <br /> PERMIT S g,p i PERMIT S <br /> TOTAL FEE 5 � TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSET�A:K RE�RSETBACK SIDESETOACK PLANCH[CKNUM�FJ���� FEE FFCEIFTNO. <br /> r� Q <br /> u,ezorte LOTAREA VAC�NTSITE FEES VALUATION FEE <br /> __ flYES fl NO pUILDING i <br /> HEIGHT LIMITATION N0.Of DWELLING S12E OF 9LDG/TI. <br /> UNITS P�UMOING <br /> OCCUPANCV IlOOFSi0NIE5 OCCUPANTLOAD BASEMENi ldECHaNICAI � <br /> GROUP � <br /> ❑YES fl NO '~ <br /> FIREALARMREO'0 RFASON AD�ITIJ�IALPLANCHECN <br /> T <br /> OTHER � <br /> i <br /> FIRE SFNINKLEP FEO'D REASON ' <br /> i <br /> STATE BUILDING SURCHAfiGE i <br /> 11'NEOFCONST PLANSAPPROVE�BY CITYOFEVERETT POBUCWORKS ' <br /> LOCAL SALES , <br /> ontE TAX CODF. IS 3105 TOTAL I <br /> ..,__—'___—_'_ ,— ,—. ^-- � • <br /> ..t <br /> e <br /> ` ,v...a_.�`.:.:r �n. ;@. <br /> . ' �� <br />