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i <br />� APPLICATIL�1 FOR �ONSTRUC� .ON PEF3IUIIT <br />� CITY OF EVERETT • BUILDING DIVISION <br /> 3200 CEDAR STREEI • EVERETT, WA 98201 • 259-8810 <br />( <br /> ❑ DEMOLITION f 1 COMBINATION f� BUILDING f� MECHANICAL �7 PLUMBING �I SIGN <br /> I — <br /> PROJECT ADDRESS ��/o /O fi n, `� / � / / <br /> �.� /..7-L �'� <br />� owNEa rani�noDn[55 Cin zir r��o.ve <br /> I Select Nomes 12811 8th Ave Id IIA-201 Everett WA 98204 513-900G <br /> i TENANT MAILADORF.SS CIIY ZIP PfOCF <br /> IqfiCHRFCTONO[SIGNER MN�pD[1RE55 CIiY ZIP PF^."F <br /> GENEP�ICONifinClOfi MAILnDOR@55 CIIY ]IP PIIO»G STATEUCENSE� <br /> ldECHANICALCONTRACTOR MNLAO�RE55 CITY 21P PIIONG STATELICENSEu <br /> Anchor FlumbinQ PO Box 1478 Marysville 98270 286-7889 ANCHORPH141LN <br /> PLUMBINGCONTRACTOR MN��DDRE55 CITY ZIP PIIONF STATEIICENSEx <br /> CONIRACT PHICE OF WORN <br /> HEATING SYSTEM: ❑ GAS Cl ELECTRIC ❑ <br /> �ESCRIOE WOBN�ND SOWPE FOOTAGE INVOLVEO C0�lTACi PERSON�N�PIIONE N0. <br /> Sprinkler 1p�,_�(� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAIJ�INED THIS <br /> APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSED USE OF BUILUING pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> SFR _ WORK 'NILL BE COM'LIED WITH WHETHER SPECIFIED HEREIN CR <br /> IEGAlOESCRIPTIONOFPROPERtt(SMOWNOELOWOFATfACNTWOGOPIES) rvvi. fHE GAANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or o�ocK or_ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br /> PERFORMANCE OF CONSTRUCTIOh.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THiS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATIOtJ IS MADE AND I COMPLY WITH THE STATE <br /> PAPCELTAX I.D.NUMBER CONTRACTOAS LAW 18.27 RCW AND 296.200 WAC. � <br /> /�� <br /> CONSiRUCTION LO�N LENOER,AD�f1E55,TF.LEPHONE NIIM�FA X ,��S—Y S <br /> SIGNATURE DATE <br /> GTY OUSIN[SS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE�F FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> T <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS � <br /> DISHWASHER VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HOOD i <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS i GAS FIREPLACE � <br /> SINK(SERVICE—BAR, ETCJ GAS RANGE <br /> � GAS PIPING � <br /> � EXHAUST FAN � <br /> i ' <br /> i � <br /> SUB TOTAL S ! SUB TOTAL S ; <br /> PERMIT S � PERMIT 5 � <br /> TOTAL FEE $ ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> FfiONTSETOAGK RGMSFTOACH SI�ESEIDACK PL�INCHECKN WDER �) FGE RECEIPTNO. <br /> /;.���l'l <br /> :; � <br /> useZOr+e �ornnen vncnursrte FEES VALUATION FEE <br /> IlYES fl NO pWLDING � <br /> i <br /> i <br /> HEIGHT LIMITFTION NO.OF 01YELLING 512E OF BLDGICI. � <br /> UNITS PLUNf1ING � <br /> OCCUPANCY NOAG510PIE5 OCGUPANTLO/D B�SENENT �/,[���nNICAL � <br /> GROUP <br /> fIYES Cl NO i <br /> FIREP.IARMPEO'D PEASON �DDITIONALPLANCH[CN . � <br /> OTHEii ��� /,�.� � v ��CI <br /> �i��ui i <br /> FIRE SPRINNLER REO'0 �EASON � <br /> STATL BI11L�I G SUFlLIIAfiGE � <br /> � <br /> TYPEOFWN57 PLANSAP RpVEOUY CITYOFEVERETT �UOLIClYORKS — � <br /> �� � LOCAL SALES � <br /> o�T� � ; _ w�� TAX CODE IS 3105 TOTAL _ �_ <br /> -'�--_"-��� <br />