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APPLICATI6A FOR CONSTRUCT�ONi PERMIT <br /> CITY OF EVERETT • BUILDI(JG DIVISION <br /> 3200 CEDAR STREET• EVERETT, JJA 98201 • 259•8810 <br /> I-1 DEMOLITION �l COMBINATION I-1 BUILDING J� MECHANICAL �l PLUMBING f l SIGR' <br /> PROJECT ADDRESS <br /> 8��8 ���'�U� S� <br /> IOWNER MAILA��fiESS CITV 21P PNO. E <br /> 2�,v �/.q-�.� S�v�� <br /> NANT MAILAOORE55 (:ITY ZIP PIIONE <br /> ARCHITFCT OR OESIGNER MAII.AOORESS CITY ]IP PNONF <br /> GENER4LGONIR�GTOi1 MAILAODRE55 CIIY ZIP PIIUN[ S�ATGLIC[NSEM <br /> � MECHANICALCONTIIA'C/TOR MAILA�DRE55 CI7Y ZIP PIIONF $TATELICEHSE+ <br /> QUi6�/TY/Y�'"�1T/�✓� / lr" �T G/��G'y .�/� L�/� l82�y 7��«8 Q�/4Li:�J��8/�� <br /> PLUMBINGCaNTRAf.TOR MAILAO�RESS Cln' ZIP PHONE SiATLLICENSE� <br /> CONTRACT PPICE OF WOR <br /> `,�� ll� HEATING SYSTEM: �AS �1 ELECTRIC f l _ <br /> DESCRIBE WORK qN0 SOOARE FOOTAGE INVOlVEO CONT�CT PERSON�%�`E�i ��� ���� <br /> //Y <br /> �� �C U �� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORfiECT ALL <br /> PROPOSED USE OF BUILOING pROVISI0IIS OF LAWS AND ORDINANCES GOVEfiNING THIS TYPE OF � <br /> �c /� �c WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIPTIONOFPROPEPTYISHOWNBELOVlORATfAGHTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � ipr eiocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FUR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> PARCEITF%I.D.NUMBER /' <br /> CONS�RUCiIONLO�NLENDER.ADORE55.TElEPHONE NUMBEP �����/j� /// �/�� <br /> IGNATU�-=//�`y!'%;—`- 04 <br /> CITY BUSINF55 LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNIT HEATEPS—B.T.U. M ' <br /> KITCHEN SINK 8 PISP � CLOTHES DRYERS _j_ <br /> DISHWASHER VENTILATION FAN ' <br /> LAUNDRY TRAY ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER _ ' _ <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS � <br /> GAS FIREPLACE � <br /> SINK(SERVICE—BHR, ETCJ GAS RANGE <br /> � GAS PIPING � <br /> ; EXHAUSTFAN ' <br /> i � <br /> SUDTOTAL S ; SUBTOTAL 3 ?; <br /> ��� <br /> PERMIT S � PERMIT 5 I <br /> TOTAL FEE 5 ' TOTAL FEE S ' l- ��. <br /> FOR OFFICE USE ONLY: <br /> iRONT SET[1ACK PEnR Sf.TBACK SI�E SETB�CK �IAN CIIECK NUMAFR F[F FFCFIPT H0. <br /> USEZ9NE �.ornHen vnca�+rsrte FEES VALUATION FEE <br /> IIYES !1 NO 9111L0INf, <br /> ❑EIGHTLIMIiAtION NO.OFDWELLING SIZEOFBLDGRI <br /> UNRS PLUlA�ING �__ <br /> t <br /> OCGUPANCV NO Of S�OniES OCCIIPANT LOAD BASEMENT MECINNICAL <br /> GOOUP <br /> IlYES 11 NO <br /> FIREALARMREO'D �FASON ADDi110N4LPLANCHECK � _ <br /> OT��EP <br /> i <br /> FIRF.SPRINKIER REO'0 RFA90N <br /> STATE OUIIDIYG SUfiCH4RGE <br /> IVPEOFf,ONST PI�NSlPPROVE.DOY CITYOFEVERETT ru�i�cwonKs I <br /> i— <br /> LOCALSALES -- -- ; <br /> oatE TAX CODE IS 3105 TOTAL ' <br />