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APPLICATIO� FOR CONSTRUCTION PERMIT <br /> CITY OF F.VERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET� EVER�TT, WA 98201 •259-8610 <br /> i i� DEMOUTION fl CJMBINATION fl BUILDING I-1 MECHANICAL f� pLUMBING fl SIGN <br /> PROJECT ADDRESS �+ /� <br /> ��J� �-1 � I�A SV <br /> OWNEF /� y MAILAO�FE�55 CITY ZIP <br /> � .DKO I�I �/IU �-OI� / !+� �L Z nPHONE -. <br /> iENANT MRILA�DRESS c�Ty. ��*-�-- L��'Y35� <br /> ZIP PNONE <br /> ARCHITFCTORDESIGNER MAl1.p00RE55 CiTV ZIP PHONE <br /> GENEBALCONTBALTO1R MAILAODRESS CIP/ IIP P110NE SGTELICENSE• I <br /> �o�p l9/S /� l� Slc �v{7 1�208 j39 ZII�/ <br /> MECHANICA CONTRACTOR M I�ADDRE55 Clry $I�, <br /> PMONE STA7E LICENSE� <br /> PLUMBINGCONTRRf,TOR MAILAOOPESS CIN Zip PHONE <br /> STAiE LICENSE� <br /> �W�rysu��(o P)un�w;�T„c l'3l8 512 53J �tA=. Hi o1�r S?-z� �6� y3sSs�- I'�fl�QYS{�l 17� <br /> CONTR�Ci PRICL OF WORK V <br /> HEATING SYSTEM: (� GAS f-I ELECTRIC �l <br /> DESCRIBE WORN AIJD SOUARE FOOTAGE INVOLVEO CONTACT PERSON AN�PHONE N0. <br /> I HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS � <br /> PHOPOSED US OF BUILL`�NG (� �! APPLICATION AND KNOW THE SAME TO BE TRUE AhD CORRECT.ALL <br /> ���° CedsC�s 1'iz'�- 9' ��W J��, r�G PROVISIONS OF LAWS ANC ORDINANCES GOVERNIiJG THIS TYPE OF <br /> LEGALOESCRIPTI7NOFPROPERTY(SNOINNBELOWORATTqCHTWOCOPIES) �'�'ORK WILL BE COMPLIED WI7H WHETHER SPECIFIED HEREIN qR <br /> NOT. THE GRANTINr OF A PERMIT DOES NOT PRESUME 70 GIVE <br /> �oT 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 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOqM THE WURK FOR WHICH <br /> APPLICATION IS MADE AND I CQMPLY WITH THE STATE <br /> PARCEL TAl!I.D.IJUM9ER CON7RAC RS LAW 1027 R W N',296200 WAC. <br /> CONSTPUCTION IOAN LENDER,AC�RE55.TEI.EPRONG NUMBEH �� / /� �//�f <br /> x_ �� �J .� f o � <br /> SIGNATURC OFTE <br /> qTV HUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FUITURE OR ITEM FEE NO. TYPE OF EpUIPMENT FEE <br /> / WATEHCLOSET(TOILET) � A/C—A/HNDLGUNfTS—H.P. � � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) ' � <br /> � HEAT PUMP <br /> SHOWER ' <br /> ' UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS � <br /> DISHWASH'eR � VENTILATION FAN , <br /> LAUNDRY TRAV ; RANGE HOOD � <br /> _ CLOTHF.S WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE � <br /> _ ORINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> ( FLOOR DRAIN � FIREPLACE INSER7(WOOD BURNING) � <br /> BO�CKFLOW PREVENTERS ' GAS FIREPLACE � <br /> , . <br /> SINf((SERVICE—BAq,ETC.) GAS RANGE <br /> �OUI /��CS � � <br /> . i GAS PIPING � <br /> � <br /> i FXHAUST FAN ' <br /> - � <br /> � <br /> � <br /> i - <br /> _ � � <br /> � �— <br /> � <br /> SUB TOTAL 3 SUB TOTAL 3 ' <br /> � PERMIT 5 PEFMIT $ , <br /> TOTAL FEE $ � TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> �RONTSETflACK RFAR5�7BACK SIDESETBnCK PL�NCIIECKNUMFIEA FE[ REf.EIPfNO. <br /> usezoNe LOTAREA V/CANTSRF. FEES VALUATION FEE <br /> IIYES fi NO T <br /> -- DUILDING � <br /> i <br /> HEIGHT�IMITATION NO OF UWELLING SIZE OF B.O(:/il � <br /> UNiiS — � <br /> �'1UM111NG i <br /> OCCUPRN,^,Y NO OiStOFicS CCGUPANi�ppO BRSEMENT — —�— <br /> fiROUP MECMANICAL � <br /> I f1YE5 t�INO - <br /> FIREALAfiMREOD qFN50Y -- AO�I110NOLPl�NC��GCK <br /> FlRF.SPRINKI.ERPEO'❑ RFncpN �iNE� <br /> $i�i[ppIL01NG SURCHnqGE <br /> rvveoFr,or+sr r;nNsarvnovFnov Ci7YOFEVERETT r`��eiir,wones � <br /> LOCAL SALES ——____�__ <br /> onre TAX CODE IS 3105 rora;. � <br />