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�_,• � <br />� �. <br /> APPLICAT14r�1 FOR CONSTRUCTrON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> CI DEMOLITION rl COMt�INATION fl BUILDING fl NIECHANICAL r� pLUMBING fl SIGN <br /> PROJECT ADD SS <br /> OS-2S�� S <br /> � ER MFILADD E55 <br /> ✓ 'M fQ � ��N Z�� f NONE <br /> (.w � / .-JJ.6 B' �' <br /> T N< MAILAODR 5 CITV O <br /> 21P PHONE <br /> ARCHRECTOROESIGNER MAILADDRF.55 ��ry <br /> r��' PHONE <br /> ENERALCONiRAC O � MAILqDDRE55 ��J� <br /> 1 <br /> Z��' P110NE $TATE LICENSE� <br /> MECHANICALCONTRACTOR MAILADDRE55 ��Ty � <br /> Z�P PMONF STdTE LICENSE� I <br /> PWM6ING WNTRAC70R MAILADDPESS CIN <br /> Z�P PHONE STAiE UCENSE x '�. <br /> CONTPACT PRICE OF WORN li <br />, HEATING SYSTEM: fl GAS I-1 ELECTRIC I l <br /> DESCRIBE WORN AN�SOUARE FOpTAGE INVOLVE� CONTACT PERSON AND PHONE NO. � <br /> A � I <br /> � �}" J I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />� . Rovo eo use BUILDING � APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> , PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL�ESCRIPTIONOFPROPERTV(SHOWN6ELOWORATTACHTWOCOPIES� W�RK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> I - NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ��T BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> I �, OTHER STATE OR LOCAL LAW qEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> I , OWNER OF THIS PROPERTY TO PERFOHM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />� r� rac i.o.Nu ER CONT CTORS LAW 18.27 RCW AND 296.200 WPC. <br />� CONSTRUCTION L r1N LENDER.AUDPESS,TELEPNONE NUMBER O ,_,� � <br /> � <br /> I NATl1RE DATE <br /> CITY BUSINE UCENSE NO. <br /> �, PLUMBIN6 MECHANICAL <br /> ;� NO. TVPE OF FlXTURE OR I7EM FEE NO. TYPE OF ECUIPMENT FEE <br /> � WATERCLOSET(TOILET) � q/C—MHNDLGUNRS—H.P. —�— <br />( � BATHTUB ; FORCEDAIASYSTEMS—B.T.U. M E.A � <br /> I � LAVATORY(WASH BASIN) HEAT PUMP � <br /> SHOWER � ' <br /> ' UNIT HEATERS—B.T.U. M � <br /> , KITCHEN SINK&DISP ; CLOTHES DRYERS � � <br /> DISHWASHER ' <br /> ' VENTILATION FAN , <br /> . LAUNDRY TRAY ; RANGE HOOD i <br /> CLOTHES WASHER ' <br /> � WATER HEATER , <br /> URINAL � WOOD STOVE � <br />` DRINKING FOUNTAIN I METAL FtRFPLACE(WOOD BURNING) � <br />� FLOOR DRAIN � FIREPLACE INStn^T IWOOD BURNING) i <br />� BACKFLOW PREVENTERS � GAS FIREPLACE � <br />�' SINK(SERVICE—BAR.ETC.) ' <br /> i GAS fiANGE , <br /> GAS PIPING � <br /> � <br /> i EXHAUSTFAN � <br />� � <br /> I I <br /> SUB TOTAL $ � SUB TOTAL $ ! <br /> PERM17 $ , ' � <br /> PERMIT $ <br /> � TOTALFEE $ � TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> , FRONT SETPACK REAR SFTBACN SIDE SETBPCK PLAN CHECK NUMBF.fI FEE RECEIPT N0. <br /> usezoNe ioraaen VACANi51�E FEES VALU TION FEE <br /> fIVES fl NO <br /> UUILOMG ` � <br /> HEIGIIT LIMITATION N0.OF DWELLING SIZE OF BLOGT ' <br /> UN175 <br /> PLUMpING � <br /> OCCUPANCV Np0�S10RIE5 OCCUPANTLpq� Br15EMENT -�-- <br /> GROUP MECHANIC4l � <br /> lIVES fl NO <br /> FIRE ALAPM FEO'D RF.450N ADDIIIONAI.PI�N CNf.CK i <br /> i <br /> OTIIER � <br /> i <br /> FIPESPRINKIERREOD RF4cON � <br /> ST�IE BUIL�MC SURCIIMGE / �i!/� <br /> T L <br /> TYPEOFCON51 PL:.NSAPI'ROVED9V CITYOFEVERETT �UF1LIf,WOnNS <br /> LOCAL SALES _ <br /> oniE TAX CODE IS 3105 TOTAL '\ss- <br /> :. <br />