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,(jAs.e /D � rY7ayo/e P/ai� . <br /> APPL.ICA710N FOR CONSTRUCTION PERMIIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVEREI�, WA 98201 •259-8810 <br /> ❑ DEMOLITION fl COMBINATION ��t BUILDING k7 MECHANICAL k� PLUMBING fl SIGN <br /> PROJECT ADDRESS S��ICo <br /> -5�-� io '� �� . liJ Eder�, GlJa 5��o� <br /> OWNER M�ILADDf1E55 CIIY 21P 1'110NE <br /> calr�rr w,,,�c T.,�, 12811 Elth Ave. W #A-201 LUerett. 41A 98204�p_�/513-9006 <br /> IENAN� ~ MNLAWRESS CIIY 21P PIIONE <br /> ARCHITECTOROESIGNER MMlA00RE55 GIN ZIP PIIONE <br /> GENER�LCON7FlACTUR MNLAUUnE55 CItY l.lP PIIONE SIATELICENSE� <br /> , Sa7 H G, Tn 1 811 8 '� Av W #A-201 F.vPrPfit. 4�. 9R7na �p(,/51'2-9006 SFtFfTT110KN <br /> MECHANICAICONTRACTOR MAILnODf1E5S CITY Zm PII@�E St�IEUCEN5E1 <br /> PLUMBI��GCONIRRCTOR MMLADUPESS Cltt 7.IP PHONE STATEUCENSEN <br /> CONTRACT PRICE OF WORK <br /> �p�� ��� �d HEATING SYSTEM: f,�(GAS f�ELFL'iRiC ❑ <br /> D SCRE IBE WOFlK AN�SOUARE FOOiAGE INVOLVED CONiACi PEfi50N ANI)PIIONE N0. <br /> Construction o` -�ne in le amil esic.'. nce d lark 206/513-9006 <br /> Beverly King 206/513-9006 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PFlOPOSEDl15E OF BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> Slri le famil dW2111ri WORK WILL BE COMPLIED WITH Wl1ETHER SPECIFIED HEREIN OR <br /> LEGALDESCflIPTIONOFPpOPEflN�SHOWNOEIOWORATfACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 70 GIVE <br /> ior 8a BLOCK or AUTHORITY TO VIOLATE OR CANCEL TIiE PROVISION OF ANV <br /> OTHER STAT[OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> Merrill Creek Gardens D1V. I. PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI7.ED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAi10ElTA%I.U.NUMBER CONTRACTORS LAW 1027 RCW AND 296.200 WAC. <br /> 52�.eCt IIQIII2S� Ii1C. <br /> CONSTRUCiIONIOANLENCER,�DDRE55,�ELEPHONENUMBER xB •�('�`L�. /'-(-CC.(�/;) �/��/I� <br /> SIGN�LUPE U U ��7E <br /> CITY BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE i <br /> � 3 WATER CLOSET(TOILET) � NC—A�HNDLG UNITS—H.P. � �, <br /> 1 BATHTUB ; 1 FORCED AIR SYSTEMS—B.T.U. M E.A. � ! <br /> 3 LAVATORY(WASH BASIN) i HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> 1 K!TCHEN SINK 8 DISP i �. CLOTHE^DRYERS i <br /> —--•-- <br /> 1 DISHWASHER � $'� VENTILAflO�FAN � _ <br /> LAUNDRY TRAY ; 1 RANGE HOOD i <br /> 1 CLOTHf:S WASHER i WATER HEATER � <br /> � <br /> URINAL ' WOOD STOVE ,i_ <br /> DRINKING FOUNTAIN i METAL FIFiEPIACE(WOOD BURNING) i <br /> FLOOR CRAIN � fIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLCW PREVENTERS � GAS FIREPLACE i <br /> SINK(SENVICE—BAR,ETC.) � GA�f1ANGE �_ <br /> ' - � GAS PIPING ' <br /> i EXHAUSTFAN � <br /> i ' <br /> — / � <br /> � _— —__--r— <br /> , — � <br /> SUD TOTAL $ ' SUO 701AL $ � <br /> i <br /> PERMIT $ i PERMIT $ —r— <br /> --�— <br /> T07ALFEE $ � TOTALFEE $ ' <br /> FOR OFFICE USE OMLY: <br /> fRONT,5E7�A� / /�.�6P� S�/T��� PLf�N CIIECN�NIl�MO�` FEE �� RECEI/ ���v /� <br /> � �_� , � <br /> USE20NE �.OTAqEA � VA NTSITE FEES VALUATION FEE <br /> �J -�� `f" '�p nvFs n No evaoiNa �%y Z78 � IC� <br /> HEIGHTLIMI7Al10N J NO.OFDWELLIN6 SI2EOFOLDO/fl. ` � <br /> �J Q / UNI75 j�57 sf �14i/�C,�+ p�UMpING � <br /> U�� SZ SF CA�,s E, ' <br /> OCCUPANCY HOAf S70f11E5 OCCUPANT LOAO BASEMENT MECIIr11lICAL � <br /> G�3 2 � � <br /> nves o � <br /> noonior+n�r�nr+cnecK 1 <br /> FIREAVFMREO'D nEnSON � <br /> OTNER ��. I / /n :_ <br /> FIRE SP �NN ER PEO'0 REASON <br /> n� S1A1E0111LDINC�511f1GH�RGE � � � <br /> TVPEOFCOST PlANSAPPROVED9Y CITYOFEVERETT �UALICWORKS 2 �i <br /> �J}� LOCAL SALES <br /> —�� onTe S�Z6 5 TAX CODE IS 3105 TOTAL � �'J �`J 1 <br /> � <br />