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r <br /> APPLICI!►TI�,N FOR CONST�tUG'. 10N PERMIT �I <br /> ' CITY OF EVEaETT• BUILDING DIVISION <br /> � 3200 CEDAR STREET• EVERET7, WA 98201 • 259-8810 I <br /> ❑ DEMOUTION ❑ COMBINATION BUILDING f7 MECHANICAL f7 PLUMBING Cl SIGN <br /> PROJECT ADDRESS ,� 1 � I � S�h�,�ut (�J � <br /> I l <br /> OWNER MAILAODRESS Cltt Zi,0 ' PIIONE c�y�4'z3z3 <br /> U I U Gl Y�-K- ,d,u t� Zu� ' c.tl cf�1�7 <br /> TENANT � MAILAU ESS CITV ilP PHONE —� <br /> l/ l•— <br /> PRCHITE TORDESIGNEA MAILADDf1ES5 GIN ZIP PMONE ' <br /> ,�_V_�(__ .�p1 Ul N ��i� L/ L/ <br /> GENERAL CONTPACTOR U MAIL ADDfiESS CITY ZIP PHONE STATE UCENSE Y <br /> NECHANICALCONTRACTOR MAILADURESS CIiY ZIP PHONE STATELICENSE� <br /> PIUMPiNG CONTRACTOR MAILADDRESS CITV 21P PHONE STATE LICENSE N <br /> CONTRACT PPICE OF WORK <br /> �po D� HEATING SYSTEM: ❑GAS ❑ ELECTRiC ❑ <br /> DESCRIBEWORKAN�SOUAREFOOTRGEINVOWED CONTA TPERSONANDPHO NO. ,„� �� <br /> O <br /> Z5U <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USEOF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS ANU ORDINANCES GOVERNING THIS TYPE OF <br /> �'IL WOPK WILL BE COMPLIED WITH WHETHE9 SP'cCIFIED HEREIN OR <br /> LEGALDESCRIPTIONOFPROPERTV(SHOWNBELOW ATfACNThNO,C�O�P�IES NOT. THE GRANTING OF A PERMIT L'OES NOT F'RESUME TO GIVE � <br /> �or�BLOCK__OF ��"""�- � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I/�M AUTHORIZED BY THE <br /> � OWNEF OF THIS PROPERTY TO PERFORM THE WORK FUR WHICH <br /> � ' APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � anac I NUMBER CONTRACTORS LAW 1827 RCW AND 29620G WAC. <br /> ' � ` � x � . .lO1Q['iYv.�e- ��/�c1�, _ <br /> CONSiRl1CTI0N LOAN LENDER.ADDRESS,TELEPHONE NUMBEfl <br /> � SIGNATURE �;_` ^� � �� DATE <br /> �d <br /> • ' CITY BUSINE55 LICENSE NO. <br /> PIUMBING MECHANICAL <br /> a � NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF FIXTURE OR ITEM FEE <br /> � WATER CLOSET(TOILET) � A/C—AMNDLG UNITS—H.P. � <br /> � BATHTUB � FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br /> —�— <br /> LAVATORV(WASH BASIN) i HEAT PUMP � <br /> SHOWER ' UNITHEATERS—B.T.U. M ' <br /> � KITCHEN SINK&D�SP i CLOTHES DRYERS i , <br /> DISHWASHER � VENTILATION FAN � <br /> '. LAUNDRY TRAV i RANGE HOOD i <br /> � CLOTHES WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WO00 BURNING) i <br /> FLOOR ORAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � � <br /> ' GAS PIPING ' <br /> � i EXHAUSTFAN i <br /> i � <br /> i i <br /> i ' <br /> ' i <br /> SUB TOTAL $ ' � <br /> SUB TOTAL $ ; � <br /> PERMIT $ � PERMIT 5 i <br /> TOTAL FEE S ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FPJNT SETBA� R�AR SETBACN SIDE SETBACK PIAN CHECR NUM�B%R FEE � RECEIPT NO. <br /> lo n<<.6.53, 7.5� S3/7 <br /> USE ZONE LOTAHEA VACRNT SITE J FE S VALUATION FEE <br /> � l (}3 ❑YES -M nV BIIILI'ING '�Bo5 j� <br /> HEIGHTLINITATIDN NO.OFDWELLING SIZEOFBLC3R.L � <br /> � UNITS �,h ,��p � �� PLOM9ING � <br /> v <br /> OCCUPANCY NO.OGSi0FIE5 OCCUPANTLOAD BASEMENT MECHAIJICAL j <br /> GROUP / ' <br /> �' fl YES IaRO <br /> ADDITIONAL PLAN CHECN i <br /> FIREALARMflEO'D REASON T <br /> OTHER ' <br /> i <br /> FIRE SPRINKLER REO'D REASON � <br /> STATE BUILDINu SURCHARGE �(�J <br /> i <br /> TYPEOFCONST. PLANSAPP�� CITYOFEVERETT P�BLICWORKS j <br /> �r� LOCAL SALES <br /> oaTe O 4 9(v TAX CODE IS 3105 70TAL I.SO <br />