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APPL.ICAT�O.., �'OR �OH�TRUCT�..dN P���1� <br /> CITY OF EVERETT• BUILDING DIVISION <br /> , 3200 CcDAR STREET• EVERETT, WA 98201 • 259•8810 <br /> ❑ DEMO!_ITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL [`�_PLU�981NG ❑ ,,IGN <br /> PROJECTADDRESS: S3� y/ 'r p� c,i=_��_�______�ct': � r <br /> OWNER MnILA0IN1E55 Gin. <br /> nr ri�a�� <br /> �R��y yor�lE 5 r,JC . <br /> TEN�NT AIALAD�RE55 3�Yi' 3�:C'� <br /> CITY I�P PhONE <br /> ARCHITECiORDE5IGNER MAl1ADORESS ��n. --- <br /> IiP n110NE <br /> GENER�IGONi1.A�ipq MAII�DDRE55 ��j� --'—I��--- <br /> ���ONE $f4TELICENSE� <br /> MECHANICALCONTR�CTOR M�ILAUDFE55 GITY IIP I <br /> PIIONE SiATE LiLERSE� <br /> PLUMb:NGCONTRACTOR MA��pDRE55 ��;y 71r-- <br /> PuONE STATE LICENSE� <br /> �nerF�� r-�o2rHJEs?- r��u,�..Q„�G, i.JC. 1U. c3cx 82a-3y /�,c.=��.:e �J.t � , <br /> C'1NiMCTPRICEOFWORR . 7GG,2j p7�'G)'�7�'�B�G fia@rF.IP!/.�Ulf � <br /> NEATING SYSTE7�A: ❑ GAS ❑ ELECTRiC ❑ I <br /> DESCRIBE WORN�NO SOUARE FOpTAfiE INVOLVED CpN7ACi{`O1SON AND=MJNE ND li <br /> _Y�c J(� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> VROPOSED USE Of BUILOING APPLICATION AND KNOW THE SAME TO BE TqUE AND CORREC7 A:L <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAlDESGPIPTIONOFPROPERTY(SHOWNBELOWO{iARACNTWOCOPIES� WOFK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A pERMiT DOES MOT PFESUME 70 GIVE <br /> toT_ _eia•� oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTFiER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNUFIZED BV THE <br /> OWNER OF THIS PROrERTY TO PEHFORM THE WORK FUR WHICH <br /> APPLICAI�ION IS MA!�� AND I COMPLY WITH THE STATE <br /> PMCEL TA%I.O.YUMBER CONTRACTORS LAW ;R 27 NCW AND?96.200 WAC. <br /> CONSTqUC7�OK'AM!LENOER.AODRESS.LELEPHONE NUM�Eq �/ ,� r� / <br /> x�` _.�_�Q r S�/T� Ca <br /> � . � SIGnw 1)f7E � DATE <br /> � CIIY OUSWC:SS LICENSE NO <br /> . PLUMBING MECHANICAL <br /> ' NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EpUIPMENT FEE <br /> � 3 WATER CLOSET(TOILET) � A/C—NFINDLG UNRS —T— <br /> ,2 BATHTUB ' FORCEDAIqSYSTEMS � <br /> � <br /> � LAVATORY(VIASH BASIN) � HEAT Pt�MP <br /> SHOWER ' UNIT HEpTERS , <br /> KlTCHEN SINK 8 DISP ; CLOTNES DRYER� <br /> / OISHWASHER � <br /> ' RANGEHOOU �— <br /> / LAUNDRY TRAY ; WATER!i[A7ER � <br /> CLGTHES WASHER i WOOOSTOVE � <br /> i <br /> � A� ' METAL FIREPLACE(WOOD BURNIfJG) <br /> G�INfSING FOIiNTAIN i FIREPLACE INSEflT(WOOD BURNING) ' <br /> FLOOR DRAIN G�S FlR[PLACE � <br /> BACKFIOW PREVENTERS ' GAS RANGE � <br /> SINK(SERVICE—BAR, ETC.) � GAS PIPING �— <br /> ' EXHAUSTFAN � <br /> � � <br /> � <br /> � <br /> i <br /> � ---�— <br /> SUB TOTAL S � SUB TOTAL b ' <br /> PERMIT E � PER6qIT S , <br /> TO7ALFEE E � TOTALFEE 5 � <br /> FOR OFFICE USE ONLY: <br /> FqONTSETB�CN REARSETP�CN SIDESfTBALN PUN[II[CRNIIAIpffl PEE RECFIPTNO <br /> usEzoHe iorenen v�e�Hrsire � FE VAIUATION FEE <br /> ❑YES ❑ NO <br /> OUII�ING <br /> HEIGHT LIMITAiION NO O��WELLING SIZE O!BIOGRI -- � <br /> UNIfS <br /> riuuoinu <br /> OCCUPANCY Np Oi 90wE5 OCCUPANilOAO BASEIAENI I <br /> GROUP MEC�I�NICN � <br /> ❑vE5 ❑NO -- -- � <br /> FIRE SPRINKLEq flE0'D I1F�SON pU�l IIpIMI.PI r1N Cllf f.N i <br /> �_�__ <br /> O111E11 � <br /> FIPEALAIiMREO'0 qEASON <br /> SIAIE BI11l01NG 511nC11npOE <br /> TVPEOFf,ONST PLANS�PCROVtOBY CITYOFEVERETT rueiicwnra�ti '� <br /> LOCRL SALES ---- ___�_ <br /> o�rE TAX CODE IS 3i05 TOTAL <br />��� <br /> �--.�.;.u"^�.i.'.°W',,.,,r,. , r.. .� I . . - - - -- - .___. — --_ . . �� - : <br /> ... .�*',.� � ,� -. ._.._...._ _ . - - �� <br />..r.,� �„ I �;` � - �'�' , <br /> , � " - . ' <br /> , , � y� , .._ . ;r �y . <br />..,�, � �- "" i _ , � ' „�� <br /> .. ,.. _�,._ _ <br />