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, ;,._. <br />'� p�ap�,�GpT1�,.,� FOR CONSTRIlC'1 ■ON RERIE'.�fi <br />� CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STF;EET • EVERETT, WA 98201 •259-8810 <br />� i ' pLUMBING I 1 SIGN <br /> I 1 DEMOLITION ( 1 COMBINATION f � BUILDING <br /> �aNECHHNICAL <br /> PROJECT ADDRESS � �jC� //� S� S(� <br /> i r��o�+c <br /> cm Zir <br /> OWNER MAllAODRF.55 V�� 20�� �(�'1g� _ <br /> i��GG'rf I'D S�TaS yiy yS srsr,✓ EY r �� � <br /> J —�—P PIIONE <br />� IEN�NT IApI1.A[1DPF55 ._ <br /> � 71P PHpNE <br />/ MAII ADORES$ ��TY ___ <br /> I pRCHI1F.CT ON OESIGN[P <br /> cirv <br /> 21P PHONL StPT[L�CCNSE� <br /> cEr+Enn�cor+mncron ranu.nooness <br />� jl� PIIONF. SrA1E L1CF.N$E� <br /> `"" ✓1G�aS Z D� <br /> MFCNANICALCONTRACTOR MAILADORF55 �j �v� �(�j�� / q�^?3L/(� � __ <br /> �j� L��T,U� � rr � � -�- STAtE I.ICF.NSE� <br /> �l/IEb✓ � rr�o��' <br /> rnmi.nouness cin <br /> vwMei�+c c:or+inncroa ---� <br /> GONTRAGi PPIfE OF WOnK � _ NEATEMCs SY�TcM: �AS f�1 ELECTRIC f l _- <br /> �(�! U �_ II CONiAGTPFRSO��PN�'f�iJIFNO -- <br /> OESCRIBEY/ORKAND SOUA�`FOOTPGE INVOLVED <br /> �r?S CdNv�XS101� — — _ <br /> I HEREBY CERTIFY THA7 I HAVE READ AND EXAMINED TfiIS <br /> APPLICATION AND KNOW THE SAME TO �E TRUE AND CORRECT ALL <br /> PROPOSE�USEOFBl11LINNG �� ' PRC�VISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE OF <br /> WORK WILL BE COMPLIED WITH VJHETHER SPECIFlED HEREIN OR <br /> LEGAl�E9CPIPTIONOFPROPERTY�SHOWNBELOWORATTAGHTWOCOPIES) A�THORITY TOTVIOLATEAOR CANGEOLETHE PROVISION OF AINY <br /> �oT f7LOCN �� OTHER STATE OR LOCAI.LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TfiE <br /> OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18..^.7 RCW AND 296200 WAC. <br /> PARCELTA � ��� ���'/� <br /> X � p�tE <br /> CONSTRUCTION IOAN LEN�ER,PDDRESS, r.IEPNONE NUMAER 5�� qiUFiE <br /> ��' <br /> �— QiY�USINE55 LICE�bE NO ' <br /> � - tdECHANICAI FEE <br /> PLUMBING FEE NO. TYPE OF EOUIPM� ENT <br /> NO. TYPE OF FI%TURE OR ITEM yC-q/HN�LG UNITg-H.P. — <br /> WATER CLOSET(TOILET) , FORC�D AIR SYSTEMS-B.T.U. M E.A. � <br /> BATHTUB � HEAT PUMP � <br /> LAVATORY(WASH BASIN) , UNIT HEATERS-B.T.U. M , - <br /> � <br /> SHOWER � CLOTHES ORYERS <br /> KITCHEN SINK&DISP � VENTILATION FAN , <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY � WATER HEATER <br /> � <br /> CLOTHES WASHER yyppD STOVE � - <br /> URINAL � ��ETAL FIREPLACE (WOOD BURNING) ' - - <br /> DRINKING FOUNTAW � — p�qFpLACE INSERT(WOOD BURNING) � <br /> i <br /> FLOOR DRAIN � GAS FIREPLACE �� <br /> BACKFLOW PREVENTERS � GAS RANGE____ � <br /> _) SINK(SERVICE-DAR,ETC.) , GAS PIPING � <br /> � ' <br /> ' EXHAUSTFAN . <br /> _ � ' <br /> � ; <br /> � <br /> ' _ <br /> � SUB TOTAL S /� � <br /> SUBTO',AL S � pERMIT � ' I <br /> PERMIT � ' TOTAL FEE S -> � <br /> TOTALFEE S <br /> FOR OFFICE USE ONLY: �Fr �eceir�No <br /> SIOE SET9ACK PI AN C11ECN NU � � <br /> fRONTSET�ACN RF��SFTPACN �L <br /> VALUATION FEE _ <br /> FEES � <br /> �Ut�PE� V�CANI SIiE rt— <br /> pSG20NF i IVES I1 NO �pILOWG � <br /> i <br /> I�GWIITLIMITATION NOOfUWF.LUNG SIIFOFE3LUC,RI p���MfiING —��T <br /> UNIiS i <br /> i <br /> B�SFMENT tdECHANIGA� - i <br /> OCCUt'PNCY NO 0�S��A��S OCCIIPANT LG4U � <br /> GROUF IlYES fINO AOOIRONM.PI�NCHLGK _.� <br /> T <br /> i <br /> fiFA504 � <br /> FIRE pLA�M REO D `-- <br /> piNER <br /> i <br /> Rf nFON � <br /> fAF$PRINNIFR RFO�D titAlE I1lIIlOMG SUOG14fiGE �� <br /> rinr�snvraovennr CITYOFEVERETT �'�������wo"�s — <br /> irre oF r.ansr -.— <br /> LOCAL SALES TO7AL <br /> TAX CODE IS 3105 _ __ ______-- <br /> UA7E — <br /> __— _� . — -�727fI 'h�':_:.�i1������SCI�I��':�- �PYr�}Y'�4 �� <br />