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.�. <br /> APPLICATION FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILOING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> I-I DEMOUTION fl COMBINATION fl BUILDING I-1 MECHANICAL r1 PLUMBING IGN <br /> PROJECT ADDRESS � �J� S� <br /> owrv 1 � MAILA�OPESS cm zm rNove <br /> �� S�/�tc-� _-.._._ <br /> TENANT MAILADURES$ Cltt ZIP FHONE <br /> �,•�M-l- C�.�s.� (r� ji�i5� i9�/���: sf" Fv 5�r-� <br /> ARCHITFGTORDESIGNER MAILA�ORESS pltt )IP PNONF. <br /> _�<fi fJ�� �r.�v����/ta �.L,., /��k.•<rc<� ���7s 3ss=v�x/ �i'�Pr4�cAo�)�1 <br /> GENEfi L CONif1AGTOq MAll^A0�'RE5^$ CIIY 71P P�ION[ 5 ATE IIC[NSE• <br /> /�-/// ' <br /> MELHANICAICONTRACTOR MAILADDRE55 f.IN 71P pNONE Si4TE�ICENSE� <br /> �j� <br /> PLUMBINGCONTRAf,TOR MAIL URE55 CILY ZiP pNONE STA7ELIGENSE� <br /> CONTRACT PRICE OF WORK ' <br /> -K / �o p� HEATING SYSTEM: f 1 GAS fl ELECTRIC fl <br /> DESCRIBE WORN AND SOUARE FOOTRGE INVOLVED CONTFCT PERSON r1ND f'NpNE NO <br /> ti 3SS-o3'�y <br /> 1� il e t( �o���� .�� <br /> p� R � �� �� /,� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �`'�''S �y �'•3�` �� ''^ � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROPOSED USE OF BUILOING PROVISIONS OF LAWS AND ORDINANCES GCVERNING THIS TYPE OF � <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESGRIPTIONOFPROPEPTV(SHOWNBELUWLWpTTAGMTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or etocK 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 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOfi WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELiAI(I.D.NUMBER CONTP.ACTORS LAW 18.27 RCW 8.200 WAC. <br /> CONSTRUCTIONLOANLENOEH.AD�PESS.TELEVHONE NUMBER x /�Q� /��I� /S <br /> SIGNATURE ������ DAiE <br /> CITV BUSINESS UCENSC N0. <br /> PLUMBING M[CHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> , WATERCLOSET(TOILET) � A/C—A/HNDLGUNRS—H.P. � <br /> BATHTUB ; FORCEDAIFSYSTEMS—B.T.U. M E.A. ' � <br /> � <br /> LAVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK&DISP ; CLOTHES DRYERS ; <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRYTRAY ; RANGEHOOD ' <br /> CLOTHES WASHER � WATER HEATER —T <br /> URINAL � WOOD STOVE <br /> DRINKING FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) � GAS RANGE . <br /> ; GAS PIPING <br /> � E%HAUSTFAN ; <br /> � i <br /> SUB TOTAL 3 ; SUB TOTAL S ; <br /> PERMIT $ � PEAMIT 5 <br /> TOTALFEE $ � ?OTALFEE $ � <br /> FOR OFFICE USE ONLY: , �� <br /> �RONTSETflACN RfAqSEiDALH SIOESETpACH rinr�cnr NNUMOGR �Ef RCf.FIPiNO. <br /> O�� <br /> usezo .,,,� i.orpqea vncnHtsire FEES VALUATION FEE <br /> ,�^� nves r No Q�,,� ' � <br /> ounniNr, C � <br /> � <br /> HEIGNT LIMITATION NO OF ONfELUNG $12E OF BIOGRI <br /> ❑NIIS PIUMflMG � I <br /> OCCUPANCY NO Ot SiORiEe OCCUPANT 104D BASEMEN� —}— <br /> GROUP MECIIANiC4l <br /> i <br /> (IYE$ 11 NO ' '-- � — <br /> FIREALARI.IREOD iiFA50Y FDD�11pNN.PI.NlCN[GK ' , <br /> � �_ <br /> OiHER <br /> FIRF.SPPiNKI.ER FEO'p BEnSpN � <br /> Sinl[OIIIIDI`!6 SUi1GrIMiG[ r <br /> iJ� <br /> rvveoFr.oNsr cinusarm eqov CITYOFEVERETT ru5iir,wonKs <br /> �� LOCAL SALES �� � <br /> uA,E � � � 'j 'g� TAX CODE IS 3105 7o7n1 ;� I �� <br />