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APPLICATI,�N FOR CONSTRUC �ON PERMIT <br /> CITY OF EVEREI"f• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION �UILDING ❑ MECHANICAL ❑ PLUMBING fl SIGN <br /> PROJECT ADDRESS H ��� 5� �� � � ) I , <br /> ��,r �.. <br /> O Efl MAILA FESS � �� �� I� � Z�� �HONE [p�'�( Zj2.3 <br /> �o�� � �,�►� � .� � ��� �a� ����-� <br /> TENANT ��pILA0DRE55 CITY ZIP PHONE <br /> �RCHITECi OR�ESIGNER MAII.AOORE55 �iTY Z�P � �, PH�NE'i'j `y 21 '^ � "[' <br /> U.N .L -�� � � <br /> GENERAL C �AC70R MAILP URE55 CIN 21P PHONE SiATE LICENSE M <br /> MECHRNICALCONTRACTOR MAILADDRESS CITV ZIP PHONE STATELICENSE� <br /> PLUMBING CONTRACTOR �AILADDRESS CITY ZIP PHONE STATE UCENSE I1 <br /> CONTRACTPRICEOF WORK /, HEATING SYSTEM: ❑ GAS ❑ ELEC'iHIC ❑ <br /> J <br /> DESCRIBEM/ORKANDSOUAFEFOOTAGEINVOWEO NACTPERSONAN�P NENOQ� ��� �I �� <br /> ��. u 1Z� 4'�-s � <br /> I HEREBY CERTIFY THAT I HAVE READ AND E7� `�ED THIS <br /> APPLICATION AND KNOW THE SAML TO BE TRUE AND G 1ECT.ALL <br /> PROPOSEC USE OF BUIL�ING PROVISIONS OF LAWS AND ORDINANCES GOVERNING Th, fYPE OF <br /> � WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HtHEIN OR <br /> LE6AlD I IONOFPRO ERTVISHOWNbELOW AT7ACHTNOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THF. PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION Ofl THE <br /> PERFORMANCE OF CONSTRUCTION.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 /> ' - CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> . PMCELT/�LI�D�NJjMQ� ' �� <br /> O J�J Iz9 <br /> CONSTRUCTION LORN LENDER,AODRE55,TE�EPHONE NUMBER X DATE <br /> � $16NATU E � 1 1� <br /> �� <br /> CITV BUSINESS LICENSE N0. <br /> PLUMBINO MECHANICAL <br /> TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF FI%TURE OR ITEM FEE <br /> NO. � <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> � <br /> �AVATORY(WASH BASIN) i HEAT PUMP ' <br /> � UNIT HEATERS—B.T.U. M ' <br /> SHOWER � <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS ' <br /> � VENTILATION FAN ' � <br /> DISHWASHER � . <br /> LAUNDRY TRAY ; RANGE HOOD � <br /> , WATEf.HEATER ' <br /> CLOTHES WASHER � <br /> URINAL ' WOOD STOVE ' <br /> � <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � �. <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> ' GAS FIREPLACE � <br /> BACKFLOW PREVENTERS � � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE ' <br /> � GAS PIPING � <br /> ; EXHAUSTFAN ' <br /> � <br /> � <br /> � <br /> i � <br /> � <br /> � <br /> SUB TOTAL $ ; SUB TOTAL $ � <br /> PERMIT 5 PERMIT a !_ <br /> � <br /> TOTALFEE $ ' TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> RERR SET9AGK SIDE Sf,;BACN PLAN CH=CK NUMBER FEE REGEIPT NO. <br /> FRONTSETB K _ /a �� s ��,372 � ` � <br /> S FEE VAL'JATION FEE <br /> USE ZON LOT PREA VACANT 9TE <br /> �� f1VE5 � BIIILUiNC � <br /> (� <br /> NO.OF�WELLING SIZE OF BLDGRI. � <br /> HEIGHT LIMITATION � <br /> UNITS /jr �( /'�/iy PWMBIN6 <br /> TJ � Nc�} i <br /> OCCUPANCV NOAFSTORIES OCCUPANTLOAD BASEMENT MECHANICAL � <br /> C�ROUP � � <br /> U_ ❑VES � qpDIT10NAL PLAN GMECN i <br /> FIRE ALARM REO'D REASON i <br /> OTHER � <br /> FIRE SPRINKLER REO'D REASON � � <br /> STATE OUIIDING SURCNARGE j <br /> TVPEOFCONST PLINSAPPROVE�BY CITYOFEVERE7T PUBLICWORNS � <br /> LOCAL SALES �1 ' <br /> �/�/ DATE 9G TAX CODE IS 3105 70TAL ' <br />