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���1�� !', <br /> � <br /> APPLICATION FOR CONSYRUCTION PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION Cl COMBINA'iION BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SION <br /> PROJECT ADDRESS���_`�Z-=� <br /> �7=^ �cjc.h CV..��l�,� � �t.�C'�� �'t1 �1��D_j <br /> �OWNER MAILA�DflE55 CITV ZIP PHONE <br /> ,n�,f ��s r4uia l�r r�. (� G�.,:t�, l�i�.c . � �v5� �� s�i <br /> TENANT MAILADORESS CITV 21P PHONE <br /> ARCHITECTOR�ESIGNER MAIIADDRE55 CIN ZIP PMONE <br /> Jd1�'�� Csj j�a7y1lSi/ <br /> GENERALCOYTRACTOR MAILP��RE55 CITY ZIP PHONE STATEI.ICENSE� <br /> �--,nt �� �,��w� _ Co�.�.n,Tr� a ,o;u3 <br /> MECHANICALCONTRACTOR MAILADDFE55 CITV ZIP PHONE STATELICcN5E1 <br /> PLUMBING CONT�ACTOR MAILA�DRES CIN ZIP PHONE STATE LICENSE� <br /> CONTRRCT PRICE OF WORK c <br /> 2��,��'p HEATING SYSTEM: GAS ❑ ELECTRIC O <br /> DESCRIBEWORKANDSOUAREFOOTaGEINVOLVED C NTCTPERSONANDV ONENO. <br /> �'lcw r.,,2�.lyT,�,-, — ¢� ��t 8i � <br /> � 3u� � � - fi s 6Y9 S a3 <br /> � I HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS <br /> P OPOSED USE OF BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> S F PROVi310NS OF LAWS AND ORDINANCES 60VERNINa THIS TYPE Of <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIfIEO HEREIN OR <br /> LEO�IDE RIPilONO VROPERTY�SHOWNBELO �ATTACH 0.COPIES) NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> �or���K o � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> - OTHER STATE OR LOCAL LAW REOULATiWO CONSTRUCTION OR 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 /> PAPCELTAX 1. NU CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> _�i '��' . uuo5fl� 000v �2 '7l7'6 <br /> � ' CONSTqUC110N LOAN LENDER.ADDRE55,TELEPHONE NUMBER X Q <br /> : — SIONATURE ���� DATE <br /> � <br /> ' Cltt BUSINESS LICENSE NO. <br /> ' PLUMBINa MECHANICAL <br /> NO. TYPE OF fIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATERCLOSET(TOILEn � A/C-AMNDLGUNITS-H.P. � <br /> Z BATHTUB ; FORCEDAIRSYSTEMS-B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNITHEATERS-B.T.U. M � <br /> � KITCHEN SINK&CISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN —�— <br /> LAUNDRY TRAV ; � RANQE HOOD <br /> i <br /> CLOTHES WASHER � WATER HEATER , <br /> URINAL � WOOD STOVE � <br /> DRINKINO FOUNTAIN i METAL FIREPLACE(WOOD BURNINO) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNINO) � pv <br /> BACKFLOW PREVENTERS ; OAS FIREPLACE � <br /> i <br /> SINK(SEFVICE-BAR,ETC.) � 6AS RANOE , <br /> ' OAS PIPINO � <br /> � EXHAUST FAN � <br /> ' � <br /> i � <br /> i <br /> i � <br /> SUB TOTAL $ � SUB TOTAL S � ' <br /> PERMIT $ , PERMIT $ , <br /> TOTALFEE $ � TOTALFEE $ � <br /> FOR OFFICE USE ONLY: � 73 <br /> FRONT SETB � REAR SETBACN �) SIDE SETBACK PLAN CHECK NUMBER PEE � RECEIPT N0. <br /> � ��� Ff�d�l N[r� 7 � � _ _+ <br /> USEZOyF� —� LOTAREA VACANTSIiE FEES VALUATION FEE <br /> \• �ZS/ f�l'9E5 I"1 NO BUILDING �J`^J �.f� �� v <br /> HEIGHT UMITATION NO OF DWELLINO 512E QF BL I �•✓,J LV <br /> � UNITS 3Y`75 �F. L�w.v4 -/- p�UMBINO � <br /> 67� Sf. GnRAGE �� �-� <br /> OCCUPANCV NO.OFSTOFIES p�LUPANTLOAD BASEMENT O ^� <br /> GPOUP MECHANICAL 1/`J <br /> 3 v-/ Z- nves � <br /> FIREALARMPEO'D REASON ADDITIONALPLANCHECK ��� <br /> OTHER � <br /> FIRESPRINK�ERREO'D REASON <br /> STATE BUILDING SURCHARGE � <br /> i�117 <br /> TYPEOFCONST P�pNSAPPROVEDBY CITYOFEVEREIT PUBUCWORKS j <br /> I� LOCAL SALES c�D OD <br /> DATE TAX CODE IS 3105 rorAL �ri- � � <br />