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LSPPLICATIOrd �OR CONSTRdICTra�N PERIIAIT <br /> CITY OF EVERETT• BU!LDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br /> I-1 DEh90LITION �l COMBINATION f 1 BUILDING MECHANICAL i l PLUMBING f l SIGN <br /> PROJECT ADDRESS _' _ <br /> �i t'!� � � I - � � <br /> � � _�� = i i � ; �� <br /> OWNEP MRILAD�RE55 Cltt ZiP P110NE <br /> � RvC ��l1 I�N ����� L��4;,D �v �v�� 1=�`P?1 jT �'l�al�,� ��� �-,`-�-�-1 I Z;��+ <br /> 7rNANT MAILAOORESS f.ITY 21P PHONE <br /> _��A1�_ <br /> ARCHRF.CTORDESIGNER MNIAD�RE55 Clrv ZIP PMONF <br /> GENERALCONiR�CTOR MaIlA00f1E55 CIIV IIP PHONE SiATELICGNSE• <br /> MECHANICALCONTR�CTOR MPILA�ORE55 CITY ZIP PIICVE STATEIICENSE� <br /> �G 1� <br /> PWMdRJGCONTPAf.TOR MAILAODRE55 GIiV ZIP ANONE SiFiEULENSE� <br /> CONTRACT PRICF.OF W ✓ <br /> � `7,�� ��� ; 7 _ HEATING SYSTEM: I � GAS i I ELECTRIC I I � <br /> OESCRIBE WORK ANO SOUARE FOOTAGE INVOLVED CONTACi PERSON AND PHONF NOi � <br /> G = i�r c,c�= ��.�� ��J <br /> � :�>�1��4--', ��`, -- <br /> I HEREBY CERTIFY THAT I HAVE READ AND C�AMINtC THIS <br /> APPLICATION ANU KNOW THE SAME TO BE TRUE AND CORRECT ,1LL <br /> PROPOSED USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVENNING THIS TVPE G.` , <br /> WORK WILL BE COMPI.IED WITH WHcTHER SuECIFIED HEREIN OR <br /> LEGALDESGRIPTIONOFPqOP[Rtt�SHOYMBELOWORATfACHTWOCOPIES) NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior etocK oF AUTHORITY TO VIOLATE OR CANCEL THE ?ROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCT;ON.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAX ID.NUMBER CONTRA//C//jj//JJ RS LAW 1827 RCW AND 296200 WAC. <br /> CONSiPUCT10N l OAN LENDER.A0DRE5S.TELEPHONE NUMBER __ �r�%t/--` �D��' / � <br /> SIGNA URE ��TF <br /> QTY 9USINESS LICENSE NO. <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. ! <br /> PATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. _� <br /> LHVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS—B.T.U. M ; <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION FAN <br /> LAUNDRY TRAY ; RANGE HOOD _�_ <br /> CLOTHES WASHER � WATER HEATER _ � <br /> � URINAL ' WOOD STOVE ; _ <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) � <br /> -r- <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD�URNING) ' <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) GAS RANGE <br /> � GAS PIPING � <br /> ; EXHAUST FAN � <br /> � <br /> � � <br /> � <br /> / - ' <br /> SUB TOTAL $ � SUB TOTAL 5 ) -'� � <br /> PERMIT 9 � PERMIT $ '-j� <br /> TOTAL FEE S ' TOTAL FEE $ _ ' <br /> FOR OFFICE USE ONLY: <br /> fRONTSFTPACK REAqSF.TB/CK $I�ESETBACN f'IANCII[L�NUMPFR �[F R[f.FIPiNO <br /> � [// � •�� <br /> usEloNe i.ornnen vncnNrsirF FEES VALUATION FEE <br /> �i ves i�� No owiniNc � <br /> I <br /> HEIC.IITUMITATION NOOFpWELLING SITEOFBIOGRI i <br /> lINRS PLUM�ING <br /> T <br /> OGGl1PPNCY HO Of S�Of1�iE5 OCCIIPANT LOAD ��SEMENT � <br /> Ct10UP �AECN�NIC�L i <br /> IIVES il NO <br /> FIREALARMREO-0 �FASON ADUi110NA�PI.ANCN[CK i <br /> -�-- <br /> on�en <br /> FIRF.SPaINNLERPFO'� RFRSON <br /> STNE Al1R�ING$IIRCHMGE � <br /> i <br /> TYPE OF f,ONST PIANS APPROVF[t AY CITY OF EVERETT runnr,wonKs <br /> LOCAL SALES � <br /> ���E TAX CODE IS 3t05 TO7AL <br /> I <br /> i�=. . . , _ .. z �C ,�,�,` . �.— r, <br /> � , ,� ^ o'�y . <br /> � �<• .+�. :_.. c- .z- .. .. . .Wl p ��.,Js'!:^. ,Vi71y„ _.trtY+a�leA'�t. <br /> s� . � � . _ }•',i` . , ::. <br /> ++. <br /> 4 <br /> . . ...... ._ <br /> <!. N' , i'.�Y .r. . . .C. G r' ' �. . . .. ..._ <br /> o. <br /> � ': .. . .-�..w - .� . J..!.._... — :e . . .-. - . ♦"w.� <br /> . .. - .. . „ �.- �Y+� <br /> ... . �..-.. ....�. .��-�. ' �w�. <br /> �. ... ._ .. .�. .... .���.— .�.�. . i � - .-r... . . . <br /> �,_ � . .�.... <br /> - .. .. . �a. �.��. ..... .".r`y.. '.Y.. <br />