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,�..�......_. ,� � <br /> .�w ��.. <br /> APPLICATIt�N FOR CONSTRUCti ION PERMIT <br /> CITY OF E4ERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98207 •259-8810 <br />, fl D@MOLITION fl COMBINATION fl BUILDING I-1 MECHANICAL fl PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> �'/c�y /�'�`` �J� SE <br /> ON��� MMIADDRE55 CITY 21P PIIONE ' . <br /> TENANT / MAIL�DDRE55 CITV ZIP PNONE <br /> �rrJlu�v,�M� �W�u� �t+� <br /> RRCHITECTORDETf.NER MAILpODRE55 �ITY ZIP PHONE � — �— <br /> 4 GENERALCONTRACTOR MAILADDRE55 LITV pin PNONE SiATEUCENSE� <br /> �.-CHANIC�LCONTRACTOR MAILADDRE55 CITV LP PNONE STATEULENSE� <br /> I�' � PLUMBINGCONTRpCTOR MRILAO�Rf55 CIiV ZIP PHONE STAT@�ICENSE• <br /> CONTMCT PRICE OF WORK <br /> HEATIWG SYSTEM: C:l GAS C-1 ELECTRIC !-1 <br /> DESCRIBE WORN�ND SOUARE FOOTA�.E INVOLVED CONTACT PERSON RNO PHONE NO. <br /> un..6� � � T !5 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ?ROPOSED USEOF BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> PROVISIONS OF LAWS AND ORDINANCES GOVFRNING THIS TYPE OF <br /> LEGALOESCRIPTIONOFPROPERTY�SHOWNBE�OWOfiATfACMTWOCOPIES) �'ORK WILL BE COMPLIED WITH WHETHER S?EC!FIEC HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NO'i PRESUME TC GIVE <br />. LOT e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />, PERFORMANCE OF CONSTfiUCTION.TH.4T I AM AUTHORRED BY THE <br />�� OWNER OF THIS PROPERTY TO PERFORM THE WOflK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />� FMCELTA%I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 29fi200 WqC. <br /> fANSTRUCTION LOuI LENDEfl,ADDRE55.TEIEPHONE NUMBER x /�J_/_�/'�/ � <br /> G V � <br /> . SIGNATURE DRTE <br /> CIiV BUSINE55 LICENSE NO. <br /> � PLUMBIN6 MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OP E�UIPMENT FEE <br /> WATERCLOSET(TOILE'n � A/C—AMNDLGUNRS—H.P. � � <br /> BATHTUB � <br /> , FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY ' <br /> (WASH BASIN) � HEAT PUMP , <br />� � SHOWER � NIT <br /> U HEATERS—B.T.U. M � <br /> KRCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br />� DISHWASHER � VENTILAT�ON FAN � <br />� LAUNDRY�RAY � <br /> i RANGEHOOD � <br /> � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL � WOOD STOVE � <br /> DFINKING FOUNTAIN � METAL FIfiEPLACE(WOOD 9URNING) ; <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE <br /> SINK(SERVICE—BAR, ETC.) � GAS AANGE �— <br /> ' � GAS PIPING � <br />'I � _ EXHAUSTFAN , <br /> ' � <br /> i , <br /> � � <br /> i ' � T <br /> II SUB TOTAL $ ; SUB TOTAL S ' <br />� PERMIT $ , � PERMIT $ � . <br /> TOTFL FEE S � 70TAL FEE $ � <br /> i <br /> FOR OFFICE USE ONLY: <br /> FRON:SETBACN REAR SETBACK SIDE SET6Rf,l: P�AN CIIECN NUM9ER FEE RECEIPT N0. <br /> 50Z�� <br /> usezoNe IOTAPEA VpCANT5IIE FEES VALUATION FEE <br /> i � <br /> _ nvEs n No BIIILDINfi � <br /> � <br /> HEIGHT�IMITATION NOOFOWELLING SIZEOFBLDGRJ � <br /> VNI75 <br /> PLUMBING <br /> OCCUPANCY NO Oi5i0RIE5 OCCUPANTLOAD BASEMENT MECM4NICAl i <br />, GROUP <br /> � <br /> flYES fl NO <br /> � <br /> FIPE PURM HEO'D qEA50N ADD1110NnL PLAN CHf.CK � <br /> —T— <br /> i <br /> OTIIER ' <br /> FIRE SPRINNIER REO'D pEA50N <br /> STF1E BWIDINC$UqCMAfiGE <br /> TYPEOFf,ONST PLANSFPPf10VEDBY CITYOFEVERETT �UBLICWORNS r <br /> LOCAL SALF:i — <br /> __ onTe TAX CODE IS 3'205 TOTAL ; <br />